Kiwiology

I used to work in upstate NY, frequent NYC and LI/Jones Beach yo I can tawk funny just like yooze guys And yooz New Yorkers dont BBQ anyway you eat bagels and cawfee ... get it right man jeez

I've seen people inject anything they can get their hands on so not a lot surprises me any more honestly Our heroin problem dried up in the mid 1980s and just never came back

Nubain and fortral were in mainstream use until 1990 when we got morphine; I suspect some of the now defunct hospital based services carried it for a little while afterwards. I know the London Ambulance Service used it in the early-mid 1990s as well.

If its still in him leave it there, if its bleeding try to pack some bulky combine dressings around it Gain IV access but no IV fluid for now; pain relief is going to be quite important I would imagine Put him on the scoop and transport, I wouldn't worry about spinal precautions. There is only a role for a helicopter if the patient is more than 60 minutes by road to an appropriate hospital

For a trauma patient there is most likely little benefit in calling for ALS outside of pain relief and chest decompression

Wow last I heard of fortral was when we stopped carrying it here in 1990

Now that I scrutinise this event more closely you can come and stay in the yard, but you have to still keep an eye out for the Emergentologist bloke Your services will also be required after I've eaten so much I'm not able to stand up under my own power and need assistance Hmm, it might also be required that you keep Dwayne in line, prick is liable to get rotten fucking drunk and start trying to be inappropriate or something, you can restrain him while I talk the cops out of taking him to jail and showing up with that van full of cops who show up to shut down parties, which means they basically club everybody over the head with a nightstick, if you put up a fight you get a dog set on you and your beer and food gets confiscated and goes toward the next Police Association fundraiser

Did we say you were invited? Fine, you are invited but you have to bring a dish, and potato salad isn't a real dish, nor is anything pre-made from the deli section Oh, and don't be bringing any of your damn New Yorker mates, especially not the snobbish kind nor those who tawk funny that you can't understand and none of those damn upstate volunteers who dont even carry a blood pressure cuff yo? Actually, on second thought you can bring a dish and leave it on the picnic table and sit down the end of the street and watch out for that Emergentologist bloke, he's bound to try and crash our BBQ, if you see him text me and you might get a hot dog or something at the end of it Also, bring beer

Nah bro I was taking the piss, now get your white ass into that water and start swimming down from Kiribati or wherever the fuck you are, we can have a BBQ and get rotten drunk I am going to start the EMT City treehouse club or something and have a big sign that says "NO EMERGENTOLOGISTS ALLOWED / COMPREHENSIVE DRINKING / KIWI ON DUTY 24 HOURS UNLESS UNCONSCIOUS" That's a piss take on those signs you see in California which say "Emergency Department / Comprehensive Medical Care / Physician on Duty 24 hours" just in case you were wondering

Nah boss stunning you would be if I whipped out my taser

I'd have to strongly disagree with this. A competent patient always has the right to refuse treatment and/or transport until they are proven not to be competent; somebody who consistently says "I don't want to go the hospital" is competent. I've seen it might be common for blokes over your way to call the cops and have them put the patient on a psych hold, we do not have such a legal provision here. A patient can only be taken to hospital against their will if they are subject to a compulsory treatment order under the mental health act. There was considerable debate here about a case in 2005(ish) about a young bloke who'd been belted over the noggin with a 4x2 after consuming a box of cheap beer with the bro's, he walked out of ED after telling them he did not want to be there and ended up dropping dead not long after from some sort of buggery neurogenico. At the end of the day he was found to be in the right because he had consistently told the hospital "I do not want to be here" and that he knew he was at risk of going kaput and dropping dead. I know we all want to act in the best interest of the patient but there becomes a time when we simply cannot because the patient is free to choose what they do. DIE WORDS DIE! You know I'm thinking the Consultant Emergency Physicians over your way are really, secretly emotionally dead inside and need to have somebody to talk to so they make you blokes ring them up, coz you know the nurses don't like them and the patients cop them a gob full of abuse or complain about not having insurance and such .... Hang on, Bravo 711 calls Radio, need to talk to the doc .... got us a super mega snafu here, we're not sure if this bloke has been shot or stabbed by gangbangers, there's lots of blood everywhere, um, it's all over my protocol book, help, what doez I do? Oh and good to hear you volleys are now carrying blood pressure cuffs .... bloody hell And yes, I'm taking the piss, hmm looks like another case of Piss Takeoccus which is unfortunately resistant to all penicillins, cephalosporins, macrolides and tetracycline antibiotics ... even sulphonylureas but I forget if you give those to people with bacterial infections or diabetes, oh well people with diabetes are more prone to getting bacterial infections anyway so that probably works out right? Oh and if you call the medical control must you talk with a Consultant Physician or can you talk to the Registrar or House Surgeon? Here if you find yourself in the exceedingly rare situation where you need to seek advice from a Doctor, you must speak with the Consultant, you're not permitted to take advice from the Registrar or House Surgeon. Probably something to do with the fact the Registrar died last week from fatigue and we've yet to find a locum to replace him, and the House Surgeon is dangerously overworked and underfed over in minors putting in sutures or doing rectal exams.

you might not be ghetto if the 5 cars in your driveway work and you called the ambulance rather than drive one of them to the hospital for your minor complaint at 3am on a winters morning .... you might just be redneck if you call the ambulance to your trailer because you got it stuck in your sex box named Sony

I have searched several of my pharmacology textbooks and they do not say, however all warn that it may "wear off quickly" or words to that effect The data sheet from Medsafe (NZ equiv of the FDA) says that the effects of some opioid may be > naloxone Wikipedia, MD says naloxone half life is 1.5 hours but has a high (90%) first pass metabolism

I can't help but wonder if giving birth to Julie contributed to that big fat ass?

Great Nation of Indiana > New York Damn New Yorkers, can't understand a bloody thing they say, and their volunteer EMTs in the upstate don't even come with a blood pressure cuff!

Love you too bro Unlike Dwayne or that Emergentologist bloke, they just say they love me, pricks! Damn Emergentologists posting before me, I know naloxone only has a short duration so I am going to go look up this relapse thingamajingle, interestingly nobody here has mentioned it when we talked about leaving patients at home who have recieved it and refuse transport In Australia the Metropolitan Ambulance Service (Melbourne) has been waking people up and leaving them at home for twenty years or more as they (at one point) had a huge heroin problem, anecdotally they say its quite safe

Your instructor is an idiot and should have it written across his forehead in big red letters A patient has the right to refuse treatment and transport including that which may be lifesaving until proven incompetent Because you overdosed and got woken up does not mean you are not competent Bottom line if they can consistently tell me they do not want to go, why they do not want to go, that they understand the risk and they can call back to go or go themselves if they change their mind, then I have no problem leaving them at home. I've seen it happen before with my own two eyes in fact!

There is no easy answer to this question really as it depends on a multiplicity of factors e.g. what the patient actually needs, what you can do, the patient status, distance from an appropriate hospital (not necessarily the nearest hospital) and distance from back up. An extremely over simplified answer would be "when you cannot provide immediately necessary time-critical intervention that ALS can provide significantly faster than the patient is able to be delivered to an appropriate hospital"

This is sort of what happened here. Back in the day the minimum standard for volunteers was a one week Elementary Ambulance Aid course whilst for paid staff it was a six week (full time) Proficiency Ambulance Aid course. The difference being theory and four additional authorised competencies: salbutamol, BGL measurement, aspirin and cardiac monitoring. A volunteer could hope to eventually get onto a block Proficiency course i.e. taught in blocks not six weeks full time and this often took a year or more or simply they chose not to. Come 1995 the Proficiency Ambulance Aid Certificate was replaced by the Certificate in Ambulance Patient Care and Transport which no longer took six weeks but closer to six months to complete. Again the volunteers had to do a number of block weekends and class days (a total of 29) which made it really difficult for them to get enough time to go to the classes and for the Ambulance Service to find a group of students who were all free at one time to do the class! The very low completion rate of the National Certificate became something of a problem between the Ambulance Service and the Ministry of Health a couple years ago and it had been touted for several years before then that the Certificate was quickly becoming inadequate educationally for the modern demands placed upon the Officer i.e. much greater scope of practice, leaving people at home, evidence based medicine etc. We've now introduced the Diploma in Ambulance Practice which is a one year course completed via the internet (distance learning) plus a number of classroom blocks and an ongoing practical component. Sure, some people moan its too hard but most people don't know any different so they are keen and enthusiastic about it.

yeah well, you're pretty old you old bugger but you sometimes have good information too now, here is your grocery sack full of meds and walking frame, get back to your room for the night!

Hey, hey, hey I resent that remark, I have a stethoscope too!

Glad I could help you feel better Best nick off, bloke stuck under a tractor .... again, sigh! Ambulance, Lifeline airborne ...

Ahem, somebody should re-read the Hoosier Constitution, specifically the part that clearly states that the world begins at Gary and ends at Evansville? Bloody hell mate seriously trust it to take a once-was-has-been-Kiwi-import to remind you of such critically important matters? Thy shall not speak of Chicago nor ill of the Great Nation of Indiana Red base, November 100, transport not required, have turfed this one to NHS Redirect, be clearing twenty six omega, whats that, a suspended for us to go to now you say, hmm, I knew we should have transported ....

Probably fell in the chowder pot Hope he gets found safe and sound

Get your butt down to Indianapolis, but watch out, if you find your partner is a funny looking Kiwi bloke with a shaved head and lazy eye who likes to blast the air horn a shit ton, run like hell! Control, Medic 102 on location. Yeah, I'm just taking the piss mate, sorry I shouldn't make fun of your troubles but hopefully you feel a better now?