Vorenus

I work in Germany with the Red Cross (here, it is one of the main emergency care providing organisations). Yep, that`s all I meant.. The typical shock symptoms you stated above and the treatment for first responders, that`s all clear. My point was, that I couldn`t imagine being taught specific symptoms of internal bleeding in a first-aid-course, in the original post of the thread it sounded like that (maybe I misunderstood it). Anyway, it`s not that important, I was just wondering...

Most of it has been answered. Still, just my thoughts: With any level of trauma - no. As stated above, there are tons of possibilities of different traumas. With abdomnial trauma, or with accidents where the patient fell (out of lower or higher heights) and with car accidents I`d be more careful. Also, any pregnant woman with abdomnial pain after an incident that is not actually focused on the abdomen, I`d consider a possible candidate. Àlthough, with high risk pregnancies I`m more cautious. No. Who`s not in need of an IV, doesn`t get one from me. With minor traumas you often don`t need one.

You`re propably right with that. Personally, I`ve had no bad experience with dogs so far, but animals generally like me. Though there was one particular norvegian wildcat (those are the big kittys) in a patients flat that was kind of vicious (or only generally frustrated, this kind of animal is nothing for a 50 square-meter flat), not to forget one scary first moment with a rather unnerved looking buffallo (though he was rather friendly in the end).

Hm, you could propably use one of those nasal application devices to spray the dog in question with ketamine... Sorry, I just got carried away with my thoughts.

Thanks for your answer zippy! Yeah, I wanted to take the university route. As far as I understood it, the NHS-based courses train only their own workers, so you would have to take the traditional route starting with EMT-B and hope to get qualified in your line of work for one of the courses. So, it would be UCAS for me. I`ve already made some background search, but I would need to contact the NARIC to transfer the grades of my Abitur (A-Levels) into their system. But I`m not really worried about that part, since my A-Levels were very good. I understood that every degree must be HPC approved - but the diversity of the different degrees is still a puzzle for me. How can they be so different to end with various degrees - while they are still all HPC approved. They all result in the same profession with the same competences (at least this is my understanding), there`s gotta be a reason for that?! E.g. at Hertfordshire, you can either study Paramedic Science ending wih a Foundations Degree (3 years) - or, you can study it and end with a BS Hons (4 years, with one gap year in which you are working with the London NHS). They are both HPC approved, still they are ending with different degrees and you need different UCAS scoring points to start (being: Foundations Degree < Bs Hons). Just to understand my confusion and persistence towards that point: if I would really take the decision and go that route, I would naturally try to get the best degree, which would give me the most knowledge and possibilities, available.

No need to adress me using the 3rd person - believe me I`m not that important. And I`m not only old enough to drive a vehicle, I`m also old enough to work as a provider in the EMS.

As stated above, the advantage of raising legs in such a case is controversial. That being said, keeping the pat. warm with a blanket is basic first aid, whatever the diagnose may be. I don`t see any special therapy first-aiders could apply for internal bleedings, therefore, I can`t see the need to learn them this specific knowledge. See tniuqs link above and read the comments, there are some good reasons why tourniquets shouldn`t be in the hand of first responders.

Good advice, thanks! Now I just have to find an otter box that fits my Samsung.

Just out of curiosity - what kind of first-aid-manual is this? I`ve done a first aid course here primarily before getting my drivers license and I can`t remember being taught anything about internal bleeding, not about how to diagnose it, let alone how to treat. Seems a bit far fetched for first-responders. That being said, in the most cases there would be nothing more to do for a first responder than dial 911.

So, I never wanted to have a Smartphone at all. Now I have a Samsung Touch-Screen-thing (a rather cheap one though). Up until now I had a very solid normal oldschool mobile phone (the kind where you are amazed in the way like "wooooooah, look, it has even a colour display!!?!?!") which I could even throw down and use it again. I`m very fond of those solid phones, `cause you can carry them all the time with you. With the mobile phone before my last, I could even open beer bottles when nothing else appropriate was anywhere near, though after a half year having started that practice it deserted on me so that could have been possibly too much. Anyway, my father bought himself a new phone the other day and he is completely useless when it comes to technichal things. So, he bought himself this Touch-Screen-thing - only to realise after using it for about five minutes that he can`t deal with it. So since my old phone is somewhat broke too, he persuaded me to take the Touch-Screen-thing so he could buy himself something that is simpler when it comes to handling. So, my concern and question to you other carriers: Do you carry your phone at work at all? The thing seems so fragile and the touch-screen so sensible that I don`t think it would survive your average work day (like carrying someone down some stairs while scraping along at the wall with the half side of your body). Any experiences about how solid they are? Yeah, I know - stupid question...

"orientate yourself" - is what I wanted to right. Couldn`t edit it any more...

Yep, also you limit the the bodies own blood coagulation to work its way, or, by a raise of the BP you could destroy the clots that have already established themselves. The permissive hypotension replaced the aggressive fluid therapy of older times, meaning you tolerate a mild hypotension (low blood pressure) in order not to enhance the blood flow. A good tip is to tolerate on the peripheral pulses. You will want to give just enough fluid (or vasopressors) to have palpable peripheral pulses.

Hey friends, got some questions regarding this topic, especially (but not only) for the UK members of the beard. So, as a preamble. I`m kind of frustrated of working in the german EMS, even though I`m not that long into the profession, The shitty laws regarding EMS that give you nothing but holes to fall into, regardless of which way you turn, the lack of approved competences, the general concecpt of it being so foolishly thought through! All the while working at conditions and for money that are quite laughable. Let`s just say that much - when I`m on the rig with a partner, that is a Rettungssanitäter (=something like EMT- B and therefore my subordinate -> guess who`s getting more fricking money? Yep, my partner. Because here, it`s policy to hire you as a lesser rank, to save money, while all the while you are working in your actual position. Meaning - while I`m taking all the resposibility and doing ALS (up to the extent that we are allowed to) I`m getting lesser money then my colleague because we are in the same pay class, but since he`s longer at the firm we are working, he gets more money. Sorry for ranting, it`s just that... . Anyway, the more than bleak future prospects here, added with a long-term desire to live outside of Germany, let me think about doing something else. I`ve been looking into studying Paramedic Science in the UK, and though my researches are just at the first stage, I have still have some questions some of you could propably answer. I`ve been confused about some aspects. For one thing, there seem to be different finishing titles, but I can`t really see the relevant difference between the single study courses (that may also be due to my lack of knowledge regarding the UK university system in itself, it`s quite different from ours). Beneath others, I`ve been looking into the University of Hertfordshire. There programme seems really interesting, all with the gap year between the second and the forth being a year where you only work at the London NHS. You end with a Bachelor, which seems good to and you even have the possibiliy to get your Master in Paramedic Science, though I`m still unsure what good that`s gonna give you...?! Also, it`s near to London, a plus in itself. Is there someone that has experience with the concept in itself, or even with making the course at one specific uni (Hertfordshire even)? There seem to be a lot of positive remarks about the study route... As said before, I don`t have any real plans yet, I`m just thinking a little bit around the corner (maybe dreaming ). The most negative part would be the freaking outstandingly tution fees, which would propably kill me. Any answers would be greatly appreciated! Greetings Marius

Hmmmmmm, Wiener Schnitzel Funny thing, I wanted to right Wiener Schnitzel in the first place, `cause it`s like my favourite food - but I didn`t remember the english translation. So, due to laziness (didn`t want to look it up), I just wrote beefsteak. How could I have forgotten that WIENER SCHNITZEL means WIENER SCHNITZEL?!

Hm, as a shop owner, I would rather keep the money then feel safe the 10 min two EMS dudes throw down their beefsteaks - in the end, most shops open at 8am and close at 18pm. I guess it`s more divided between these two reasons: 1. giving credit to you for doing your job (that would be mainly smaller, privately-owned restaurants), but mostly: 2. as i`ve said before - the reason for any other discount is to make sure that people come to your shop and better-even, come again. (that would mostly apply to your big chains).

Yeah, I can understand that. It definetely has just something... Never wanted to judge you! Besides, I`d rather take a walk in your moccasins, than in my boots: http://www.grotec.bi...0-mid-large.jpg

Yep, Í`m with the others on that one. I wouldn`t have asked for a discount either. Generally, but that`s only my opinion, you can only ask for something that you have the right for. I mean, in a kind of demanding way - sure, you can ask for anything, wether that`s intelligent or tactfull is written on another paper. In that case...Nah! To Topic: In our hospitals cantine we get staffs discount (same as nurses, doctors,etc.). As well as in some other hospitals. There are two or three hospitals in our state that give you a meal for free if you brought a patient (nurses and staff can eat there for free too) - obviously, transports to these facilities are highly popular. The Subways in the near bigger town has a discount for EMTs as well as Joey`s (German pizza franchise) and some other food delivery services (but not only for EMS but also for hospitals, the police, some other municipal officials -> mainly groups of people who often purchase -> therefore, to make them happy is a good business strategy ).

@tniuqs: I get your point and I too believe that FireEMTs post was too harsh and overjudgemental. On another note: It`s kind of hard to read your posts when you hide your own sentences between those long quotes. Just my thought, without meaning any offence.

Reminds me of these... http://www.rippenspreizer.de/ EDIT: http://www.rippenspreizer.de/4images/details.php?image_id=64 ----> "Keep calm, I`m a dentist!"

Here, med students have to do a first-aid-course (16hrs) - which I consider as kind of a joke + a ridealong on the emergency vehicle responding to 911 calls. But as far as I know, they only need about 20 hrs - which is as much as two day shifts with us.

What were the results of the Nitro on the dog? Unconsciousness? Did the doggie survive?! EDIT: Not my own story, but saw the picture and read about it in a local EMS paper. I think it was in Bavaria, but not sure about it. They were called to a car accident with multiple patients. So there were quite enough crews, but it turned out to be not to bad and there were just few minor injuries. In one of the cars was a dog, which was hurt (don`t remember what he exactly got, I think fracture). Since there were enough teams there and this crew had nothing to do, they treated the dog - with the help of an veterinarian that was also there as a participant of the accident. The picture showed the crew kneeing on the street beside the hurt dog, while the vet doctor was starting a line on him. In the background you could see the crashed car.

In the most cases of industrialized countries life standard is now nearly the same, if you compare rural and urban areas - there are of course differences, but they are minor compared to regions of this world, where there still is a huge difference between those two settings. Even though that being so, I guess most living in a rural setting have saved that attitude, or got it tutored by the elder generation. I just changed position 2 months ago - from an urban post to a more rural one (though they are not that far away from each other), and that`s just my personal opinion, but there really are more bullshit-calls in an urban setting (which doesn`t mean they`re non-existent in rural areas ). So for me, that would be one explanation, but with such differences as you posted above, that can`t be the only `cause. I guess it`s a mixture between attitude, the idea Richard proposed and some other influences (a large crowd being settled in a small space is an adavantage for infectious diseases, some basic points like smog, stress, etc.)

Well, I get your point and I agree with you on most of the above. What I meant was: Even if tolerance could be achieved - it wouldn`t be by such provoking texts. And when it cannot be achieved in the overall way that would be quite welcomed (though unrealistic, I`m with you there, mankind just isn`t able to do that) even then, just because that`s not possible - you don`t need to make it worse. P.S.: I do believe that tolerance can be achieved/can be found, within single individuals, just not in a group, `cause there`s a certain dynamic to a group within itself that can bring out the worst in people.

Yeah, that`s a totally different situation. Don`t get me wrong, I don`t think the response of that provider was very collegially either, and would I have been asked, I would have done it. But I would as well have thought (and that`s the whole point of that argument) - couldn`t they have done it alone? From what engine told, I figure there were at least (!) six people in that room, all on duty. That`s totally different from being the only provider in a restaurant and acting as first responder to an arrest. Just wanted to point that out - again, I`m not saying the medics reaction was nice, but he wasn`t wrong.

Yep, I`m with Bernhard on that one. There obviously were enough folks there to work that code. Do you often continue to work your codes in the ER - they should be enough to deal with that on their own. I once reanimated at the ICU of a smaller rural hospital. We were approximately 2-3 nurses, one physician and my partner and I. They could have dealt with it on their own, but since we would have transported him anyway to the next stroke center if we would have acchieved ROSC and it would have been shown for him to have a neurological incident (which seemed likely), we stayed and helped them out a bit.