Kiwiology

Page E-5 of the 1994 NHTSA EMT-Basic National Standard Curriculum (minimum of 110 hours + 10 hours of practical) Now before we get all "but but but the NSC has been replaced by the National EMS Education Standards!" that may be true in like 2017 or something, but they're only slightly better. Sorry bro

Then I'll include it, but next time GSA-HEMS turns up you can be my bitch and hold the goes-in-the-patient's-proximal-endo-tracheal tube or if you're really lucky you can draw me up a flush Did you still want to include the Doctor bit? lol

Good to see somebody exceeding the minimum 120 hours

All of the above, especially #4

I find this unusual; many times we've taken the family member with us to hospital; it's just something normal here; in fact it's a breach of the patients legal rights not to allow this (unless they endanger the crew) and I think its unethical even if wasn't part of the law. The same as elsewhere in the US; a 120 hour course

I'm not a doctor, wait yes I am, either way, that's probably not a good idea

Both good points Now, who has seen my mommy? It's late and the mall closes soon, I don't want to end up with the creepy security guard in his office overnight or nothing ....

Bitch please if you Aussieologists actually did some work and not lounged around all day at the beach or watching the cricket you might be as awesome as us Within the realm of medicine we only know so much; the principle (especially in emergency medicine) is to exclude serious pathology through selected imaging, biochemistry and other studies (for example ECG) as well as physical examination/observation and if we can't tick enough boxes to say that what the investigations show meets the criteria for something then we revert to managing symptoms and out the door with you because we need to meet that six hour target set by the Ministry of Health oh by the way see your GP if you don't improve, hey can somebody get me a trolley over here the House Surgeon just collapsed from being malnourished; now did we ever get a locum to cover for the Registrar who died three weeks ago from fatigue? And oh man don't look now but it's one of those educated nurses to hassle me about something, they've probably interpreted the biochemistry and imaging studies I ordered themselves .... I think this bloke's desire to want more for his patient is admirable but if the hospital has performed sufficiently sufficient examination and investigations and found nothing major wrong then at that point there's not a whole lot more the emergency department can do. Where's the Emergentology bloke when you need him? I think I see him over there on the phone trying to organise a locum Registrar to cover the other Registrar who died three weeks ago from fatigue ....

Now that I think a bit more it interests me greatly that mannitol has been used for years in head trauma (since at least the early 1970s that I personally know of) but hypertonic saline has been shown to have no effect ... aren't they basically the same thing i.e. an osmotic diuretic? And aren't drugs ending in "ol" a beta blocker? Shouldn't it be manapril? No wait that'd make it an ACE inhibitor, hmm manamide? And are you my mommy?

I'm not sure a CT and review by a Consultant Physician can get more detailed; except if she was seen by me, a Consultant Kiwiologist, why? because Kiwiology makes all branches of medicine look like crap, except Chuck Norrisology, I can't compete with that beard and cowboy hat. Unfortunately medicine is an inexact science, people with no risk factors for cardiac disease drop dead from cardiac arrest, people with no abnormal immune biochemistries and normal physical exams drop dead from viral meningitis which the underfed, dangerously overworked and extremely fatigued House Surgeon forgot about because most people forget there is viral and bacterial meningitis and so on ...

Gad zukes man this is the internetz why would you take anything on the internetz seriously? It's ok mate nobody takes me seriously anyway, its because I have a funny accent

*Grabs his shotgun and starts lobbing solids around Get the feck out of my yard you physiologic need satisfying person ... wait, are you here because you heard that sticking a hot poker up your dick is the cure all ... you sick freak what sort of person would do that? *Grabs shotgun and resumes lobbing solids around Get off my lawn!

Don't lie Dwayne we know you're a facetious bastard .... man, what are we going to do with you? Light and sirens are used here but not very often. We can use the red lights alone and not have the siren going, which is most often what we do and a quick blast of the siren approaching intersections or when driving through red lights. There is little (read: any) value in lights and sirens transport and it's way more dangerous than it is good.

This. We have 10% glucose as well and also use D5 for mixing ketamine This as last I heard of any study about hypertonic saline was a trial in San Diego County in 2009.

If you get them to drink what is in the cup before they use it they can also get the diabeetus and be just like everybody else with their Western lifestyle induced co-morbidities so there's plenty of patients for me when I come and work in UK; nee naw nee naw red base november 100 on location, hi there mate better make it two scoops of chips please we're feeding the whole complex tonight sort of thing .... For mild to moderate asthma in children I'll use their own spacer if they have one; I think it's more settling and familiar to them then shoving a nebuliser mask and cramming nebulised salbutamol down their gob. You must be referring to those new whiz-bang high tech nine week trained Emergency Care Assistants ... transforming NHS Ambulance Services my ass, for the worse maybe. Anyway must digress, my chips are ready, time to go feed the complex

It is hell on earth, I can't hear the physiologic split in S2, damn it to the bowels of bloody hell, it's nunngered, totally nunngered bro, I'm never going to make a good stethoscope wearing person when I grow up! Ima cry in the corner and try to suppress Dwayne laughing at me, bastard ... That Emergentology Consultant bloke probably laughing at me too, as he floats in Jones Beach with his MAST pants sipping a cool margarita; prick Hang on I think I hear gangbangers coming, no wait it's not gangbangers, it's a variable S1 .... oh look it's VT, hmm lets shock it, oi bro, this might hurt a bit, don't reach out or nothing ....

I agree with Wendy; it's not appropriate for a healthcare professional to impart their own beliefs onto their patients; these super religious types are great for doing this and shoving God so far down your throat he comes out your arse; my uncle used to do this until he flipped out saying God was somehow hooked up in his plan to waste his dentist ... next minute, nut house. Now, lets say for example I think sticking a hot poker up my dick is the cure all - it's not appropriate for me to go spouting it left right and centre to patients. It doesn't matter what it is, there is a clear professional/ personal boundary that one must understand and clearly this person does not; not surprising it's coming from a super religious home-school (read: somewhat socially isolated) person. Oh, and I don't think sticking a hot poker up my dick is a very good idea .... ouch man, sounds like something Dwayne might do (taking the piss)

Me: Hey baby so how about this cherry point huh? Female Long Islander: Yo can somebody call the ambulance up in here for this guy with the funny tawkin, I'm gonna twist him up like a bagel or or former asexual mayor Ed Kotch Damn New Yorkers ... oh and oxygen is bad

I knew you emergentologyists liked pain ... sick freaks ... and I took your MAST pants because they're great for pool parties at Jones Beach

I agree with your points

That's rather profound Mr DFIB

You bring up a dilemma indeed. This person is perfectly entitled to their religious beliefs, in fact true to form I am reasonably religious but I don't go spouting it left right and centre or shoving it down everybodies gob. I have seen first hand the problems of hyper religion from somebody who was a mental health inpatient none the less so I agree with you there. You should say something; not because religion is the issue but because it shows a greater sort of lack of understanding of professional vs personal boundaries; t's not really appropriate to share personal beliefs with a patient whatever they may be; now thats not saying you can't share an opinion on the football or something you know if you're talking with them about say, football, but there is a line that should be drawn.

Didn't your mother ever tell you to "get out of the fridge!" ... mine did, usually around dinner time! Oh, and I wonder if Wanda would have died anyway because she might have eaten some of those black eyes peas she fixed for Earl on the advice of Natalie Maines?

I've been on about this for years and have stated several times in this post the empirical basis for a conclusion that hyperoxia is bad; however that said we cannot base our treatment on the empirical or we'd still still be putting two big bore drips in every trauma patient, infusing litres of crystalliod and blowing up those MAST pants. You good sir are correct in saying that the evidence base is limited but what evidence exists seems to be pointing away from routine use of supplemental oxygen in the normooxaemic patient. Do we give the normovolaemic patient IV fluid? http://heart.bmj.com/content/95/3/198.full http://archinte.ama-assn.org/cgi/content/extract/archinternmed.2011.624v1 http://www.jephc.com/full_article.cfm?content_id=576 http://www.medscape.com/viewarticle/752314 http://content.onlinejacc.org/cgi/reprint/56/13/1013.pdf I'm going to disagree and say that the acutely hypoxaemic patient is not hard to spot and will routinely get a high volume of oxygen shoved down their gob by nonrebreather mask. We should not only consider the patient with stroke or myocardial infarction but patients who are at risk for re perfusion injury i.e. post-ROSC and those patients who receive manual ventilation; there is much confusion that ventilation equals oxygenation (another pet hate of mine that fucks me off no end and makes me want to smash people in the head with the oxygen tank) and universally I think it's been common place to ventilate the snot out of people where flooding their cells with oxygen might not be a good idea; e.g. a narcotic overdose with a hypoxic noggin Glad we could be of help

It depends. The job requires a good amount of fitness and endurance for things like CPR, extricating patients down stairs, out from behind the loo when they've arrested, small hallways, carrying 30kg of equipment etc ... It also requires excellent mental fitness; you can't be the sort of person who goes to pieces over a cut finger or gets upset when somebody calls you foul names or yells at you; you can't sit there with the crowd and cry, somebody has to take charge and get stuck in and do what is required. You need like no really must have some way to balance the job and life otherwise you'll just go fucking mental and end up in the corner on psych meds or totally burn out and end up ... well, in the corner.