Kiwiology

This is an issue I am quite interested in however is large and complex and gets people very flustered (preaching to the converted much? lol ) We classify shock as being from "uncontrolled bleeding" meaning if "profoundly shocked" you get just enough fluid to perfuse the brain and generate a radial pulse or shock as being from "other sources" which means you get fluid until you are no longer "poorly perfused". I'm talking about hypovolaemic shock here not distributive (e.g. anaphylaxis or neurogenic) or cardiogenic. People who are Super CrookTM from anaphylaxis (as an example) are going to recieve lots of fluid and adrenaline until they are not Super CrookTM whereas some old bloke with cardiogenic shock is going to get very small (250ml) boluses of fluid provided there are no significant crackles in his chest and he doesn't develop any. As for fluid in hypovolaemia - Fiona Moore from the LAS said it best - cold salty water neither clots nor carries oxygen. The days of shoving two massive drainpipe drips into people and infusing litre after litre of crystalliod until they bleed clear are long dead; anybody who still practices like that should be banned or castrated or some shit

That's all I can say .... srsly

DISTRICT 1 9.53PM SUSPICIOUS / SICK PERSON *Kiwi rolls up in a two tone 1988 Dodge Diplomat equipped with massive red-blue rotator light bar sporting hip pouch full of suxamethonium, .357 Magnum N frame and peers over his aviator sunglasses, removes big ass wooden nightstick from belt and throws patient up against car; what you doing up in here boy, you know you don't belong in these parts, you coming to buy drugs? Oh lookey here, where'd this cash come from, never mind that, I'll just keep this, now get out ass out of here, don't let me see you in these parts again boy, *taps nightstick on car, you hear me? Go on out of here. get off my street! ... Control one baker, patient refused transport, we clear twenty-six omega Corrupt? What you talkin' bout man I'll stop now before I loose any more points ....

My book collection is starting to look like I have been thieving from the medical school library or something Guyton's Textbook of Medical Physiology Raff and Levitsky's Medical Physiology Cecil's Textbook of Medicine Harrison's Internal Medicine Hamilton's Emergency Medicine: An Approach to Clinical Problem Solving Harwood-Nuss' The Clinical Practice of Emergency Medicine Roberts and Hedges' Clinical Procedures in Emergency Medicine Rosen's Emergency Medicine William's Obstetrics Clinically Orientated Anatomy Current Medical Diagnosis and Treatment Lippincott's Textbook of Cardiovascular Medicine Dubin's Rapid Interpretation of ECGs Lippincott's 12 lead ECG interpretation Lippincott's Illustrated Review - Biochemistry Bates' Guide to Physical Examination Green's 12 Lead ECG Confidence Porth's Pathophysiology - Concepts of Altered Health States McPhee's Pathophysiology of Disease Lippincott's Illustrated Pharmacology Goodman & Gilman's Pharmacological Basis Of Therapeutics I've also found Medical and Psychosocial Aspects of Chronic Illness and Disability quite interesting Now, does that mean you should buy all these books? Not unless you have lots of spare cash, but I have used and found them all overlappingly helpful in that they cover the subject matter presented from a slightly different angle than its sibbling book

Ron Paul is the only choice Damn New World Order probably won't allow it but it's worth trying for Now, me, medic_texas and Ugly_EMT are off to hide off the Grid

Life's a trip mate; but the most important thing is not the money money money or the rush rush rush it's the people you care about most - because one minute they're there, and the next second, they might not be.

You're really asking a loaded question that is like following Alice down the rabbit hole ... y'know I hear that Alice in Wonderland bloke was tripping on magic mushrooms when he wrote it; anyway Consider a simple question from one of the Paramedic (ICO) assignments I was reviewing: "Briefly describe the pathophysiology of DKA" To which the following answer was provided by the student: "IDKA a shortage of insulin resulting in less glucose entering cells. This results in hyperglycaemia and cells shifting to metabolising fatty acids (the. Fatty acids are metabolised to ketones and these are acidic. The signs and symptoms of DKA are predominantly related to the effects of the hyperglycaemia and the effects of acidosis" vs the answer I originally wrote in my submission back in 2007 "Diabetic ketoacidosis is an acute complication of hyperglycaemia and hypoinsulinaemia. Hypoinsulinaemia causes the fat storing properties of insulin to be reversed activating hormone-sensitive lipase and hydrolysis of triglycerides releasing large quantities of free fatty acids into the blood. This release of free fatty acid causes the liver to transport it to the mitochondria where it is beta oxidised and enters the Krebs cycle to produce ATP for energy. The beta oxidisation also produced large amounts of Acetyl CoA and aceatoacetic acid as byproducts. In addition to the aceatoacetic acid produced by anaerobic metabolism of the cells, B hydroxybutric acid is produced in the liver from fatty acid accumulation. The production of these acids causes blood acidity to rise above normal and results in metabolic acidosis. In addition to metabolic acidosis caused by anaerobic metabolism the other complication of DKA is osmotic diuresis. Because there is excess circulating glucose it creates hyperosmolar gradient towards the extracellular fluid and shifts water out of the vasculature along its gradient. The extremely high level of glucose exerts its osmotic effect on the renal tubules greatly reducing fluid reabsorption resulting in less sodium is reabsorbed, causing the macula densa to dilate glomerular arterioles and increase GFR. These two factors increase urine output and can lead to dehydration and hypotension" It's like asking how long is a bit of string ....a how deep in tho the biochemistry and pathophysiology you want to get; now some bloke who actually understand biochemistry is going to probably look at what I wrote and laugh because I have no bloody idea what the hell beta-hydroxybutric acid is or whether there is alpha-oxidation before beta or some shit

Thanks mate! I consulted the following - Rosen (Emergency Medicine 7e) - Tintinali (Emergency Medicine: A Comprehensive Study Guide, 7e) - Harwood-Nuss (Clinical Practice of Emergency Medicine, 4e) ... and I found some tidbits of useful information even tho it's a bit broken down and spread around Suprisingly Fleisher (Textbook of Paediatric Emergency Medicine, 5e) was less helpful My human development book is good for that psychological touchy-feely wishy-washy crap but doesn't help ... Y'know my friend the House Officer (PGY1) said everybody on her paediatrics run was shaking in their boots; I don't blame them, children are useful for collecting Government tax benefits, pre-boarding the airplane and fetching beer and snacks for you when old enough but bloody hell sick children are so complex! Oh my medical library (containing well over 100 textbooks) is open to all for free; if you don't bring the book back just ask Shattered Legs Charlie what happens (*.... goes to find orthopaedic textbook)

Hi all I have a side interest in tutoring at our Diploma (BLS) and Paramedic (ILS) levels. It should be well noted I do not under any circumstance utilise the standard "Paramedic" texts (Caroline/Bledsoe et al etc) and teach only from established medical texts, in fact my medical library probably rivals or exceeds most medical libraries! (probably means I have no life?) What I am looking for a bit of help on is something concise that lists the key anatomical and physiologic differences between adult and child ... it's doing my head in. I've looked through the following and haven't gotten very far except isolated snippets - Bates (physical exam 10e) - Guyton (medical physiology 12e) - Nelson (paediatrics 17e) - Roberts (clinical problems in paediatrics 5e) - Bunch of two semester A&P books (e.g. Marieb) Now I never did like kids, whining, crying snivelling little buggers who wriggle around and seem fine then up and die on you from missed meningococcal septicaemia after you left them at home and now I can see why Thanks

No, rural providers should be paid the same as urban counterparts. In some jurisdictions such as Victoria (AU) I believe they pay rural Officers more and/or have subsidies for rent and student loan repayments so they can get staff to work in shit hole rural towns.

What in the bloody hell are you talking about we don't talk funny; I tell you its you blokes who have the nunngered vocabulary Although this one time in rural New York .... Me: Yeah this is Tom, wicked allergic to bee stings, stung twice, reckons no SOB but his chest sounds a bit buggered, wheezy, doesn't seem crook like cardiovascular, bit perkier on some salbutamol, you blokes got adrenaline eh like if he goes to poo? Upstate rural New York volunteer EMT: <blank state like he's being beamed up by aliens> .... what? Dramitisation - may not have happened

Agreed; the local country cop who is on-call at nights will go out to jobs in his jammies and throw a Police jersey overtop and the local volunteer Fireys will pull their turnouts on over whatever they have on. Now, if only the Ambulance Service would stop being queer and let its Officers wear a jumpsuit like AU and UK we'd be getting somewhere. We have overalls for helicopter and SERT (Ambulance Rescue) but are not allowed to wear them operationally because black and white "is more professional". It's quite easy for Joe Vollie to throw on his onesie

Pros: I keep coming back Cons: I keep coming back This site is a good tool to kill a few minutes, learn something new, teach a little, shoot the bull and generally engage the neurons in something collectively constructive. And I've met a few interesting people here. But the best thing is you blokes over this side aren't as queer as those neo-Nazi bastards who run that other site

Six people eh? Sounds like that time I turned round and saw four firefighters standing there doing ... nothing "Where did these firefighters come from?" "Fire station" "But why?" "Medical run" "But ... how?" "See that guy there? He's the engineer, he drove the fire truck here" "But why?" "Medical run" "Um, but ...." "Medical run" And that's about the truth of it </slightly taking the piss>

Nah we put patients in the waiting room all the time; sometimes in chairs sometimes on a hospital gurney

What, these books are known to have been used on our BHSc (Paramedic) degree

And it gave her 2/3 of her daily fibre requirement too y'know

Basic Chemistry Lippincott's Illustrated Reviews Biochemistry Lippincott's Illustrated Reviews Microbiology Guyton's Textbook of Medical Physiology Cecil's Textbook of Medicine Harrison's Internal Medicine Rosen's Emergency Medicine William's Obstetrics Clinically Orientated Anatomy Current Medical Diagnosis and Treatment Lippincott's Textbook of Cardiovascular Medicine Dubin's Rapid Interpretation of ECGs Lippincott's 12 lead ECG interpretation Bate's Guide to Physical Examination Pharmacotherapy: A pathophysiological approach

Hey new peoples You're just in time to enjoy some fresh made burritos and a freshly bootlegged season of COPS ... old school! :

If you want to try ketamine, stop by the local rave or dance club and ask the glossy eyed teenagers

Don't write a novel, write something that is concise and clinically relevant yet of appropriate length It takes practice, I used to be absolute bloody rubbish at writing PRFs

Cheap shit food is cheap because its mostly made from things that the federal government gives farmers subsidies for - e.g. high fructose corn syrup and it's a lost less money consuming to make a box of synthetic crap than it is to grow, harvest and transport fresh fruit and vegetables to the supermarket It also doesn't help that the TV commercials are now telling parents that some sugar loaded, diabetes causing cereal is "healthy" because it contains wholegrain or that chocolate cookies are healthy because they contain X amount of fibre .... who believes that shit? Makes my noggin want to explode

3,000 ambos or there abouts; 2,000 volunteer and 1,000 paid; about 600 vehicles and 150 ambulance stations which in 2010-2011 did 357,000 jobs and transported 330,000 of them We have two prime levels (Paramedic and Intensive Care Paramedic) with the volunteers (and a few paid) being at the Emergency Medical Technician level

Look up osmolarity, tonicity, haemodilution and clotting The last two are quite important when it comes to IV fluids in trauma resuscitation