WelshMedic
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Everything posted by WelshMedic
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Yes, this time last year as a result of a lateral MI. Luckily on the cath lab table. Have no.lasting effects. When did you qualify and what are you doing now? Feel free to PM me.
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Hi all, I was attracted to this thread by a random mail. I am still around too. Has been an interesting couple of years after having a cardiac arrest over there in the States. Have now fully recovered and am back at work. Nice to see some old names, particularly good to see that Wendy is all grown up now and a proper nurse ;) .Carl
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Secouriste. I completely understand your situation. Considering your command of the english language, would it be an option to study medicine somewhere else in the world? Carl
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Hi Rich, No, I don't work in any of those jurisdictions, I am on the other side of the Atlantic in the Netherlands. I can contact specialist cab companies that deal in wheelchair transport so I guess it's sort of the same thing. Carl
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Well, it's far from perfect (for what it's worth I think the Australians have a pretty neat system) but we are regarded as an integral part of the healthcare team and not just 'ambulance drivers' which does make it satisfying.. Carl
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Well Mike, I think it's an interesting point you make there. The way that healthcare works here is that everyone is insured and so everyone has equal acces to primary, secondary and tertiary care. We have nurses in dispatch that triage calls and give appropriate advice. If an ambulance is deemed not necessary then the caller will be referrred to another pathway (usually the family practitioner but there are other channels, e.g. mental health services). If we do get called to someone that, retrospectively, doesn't need an ambulance I will refer them myself to one of the alternative pathways. Carl
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Hello both, I am indeed Welsh but I fell in love with a dutch girl and married her. That's how I ended up here. The road to ALS EMS here is indeed only accessible via the nursing route. It's basically nursing school to post graduate critical care qualification and then into EMS. The whole process takes about 6-7 years as we also like candidates to have experience in the critical care field. I am currently doing a teaching degree (BEd.) in order to teach nursing and EMS at college. I also run the placement program for nursing and medical students so if you are looking to hear more then I'm your man! I can also arrange ride-alongs but you'd have travel a bit far.... Carl
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Hi Secouriste and Fab, @SC: well , I think you'll find that a strong fire lobby is a common factor in a lot of countries, certainly in the US! Good to hear that although there are different services that you have training to the same standard. I wish you all the luck in getting into medical school this year! @fab: it's in Belgium where the nurse occasionally replaces the doctor. However they are bound by very strict protocols and need to call for advice for all but the most simple calls. Here in Holland EMS is nurse-led. It's been that way for the last 30 years and so we have developed far reaching protocols which include almost all ALS interactions (with the notable exception of RSI). We do have physicians available, there are 4 on duty that cover the entire country by helicopter. They are strategically placed in Amsterdam, Rotterdam, Groningen and Nijmegen. Both Groningen and Nijmegen regularly have calls over the border in Germany. So you see, it's a small world! Carl
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So, if you like, the calls come into the central 112 salle de regulation (I think that's what I heard on the video, right?) and then they send the nearest unit as it doesn't matter which organisation it is. Is that right? Carl
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See my PM.
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Secouriste, I watched the film and I noticed that the SAMU dealt with at least three different EMS organisations: you guys, the fire department and the Red Cross. Are all of these organisations involved in 112 calls in Paris and if so, who decides which organisation goes to which call? I love Paris, by the way, have been there a few times in the past few years (I'm only about 4 hours away in Holland). It must be pretty busy there for EMS, I would have thought. I know it's already been said, but I also think your english is absolutely amazing! My compliments! Carl
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Does being a member of the Rescue 911 fanclub count? I just luurve Mr. Shatner.... (Hi all, again! Good to be back here!)
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House Officer=Intern, Senior House Officer=Resident, Registrar=Chief Resident, Consultant=Attending Physician. Lovely place to visit but wouldn't want to live there myself. I mean, how many bungy jumps can you do before it gets boring?
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Oh man, that is just inspired!!! You have made my day.
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And here's me thinking this guy was your hero: Now he was seriously cool.........
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Krumel, Whilst it isn't seen as a standard cocktail, I have used esketamine and fentanyl together in the past. The fentanyl hits the nocireceptors and deepens the dissiassocative effect of the esketamine by virtue of being an absolute (as opposed to relative) anesthetic drug. I would personally only reserve it for polytrauma patients that have multi-system injuries and whereby I need to watch the haemodynamic status very closely. Having said that, for these patients, it is very effective indeed. My initial bolus dose would be: midazolam 0.05mg/kg, esketamine 0.5mg/kg and fentanyl 0.15 mg/kg. I would titrate from there. The pain score would lead me further. Carl.
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Right on! Let's get this debauched party started then!!!!!!!!
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Love it! Oh and your daughter wasn't bad either.......
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Inspired my man? Did you pose for this particular piece of art? And did she make you come? Is this actually allowed here???? :whistle: :whistle:
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Here's a personal (and entirely unrelated) Nightingale anecdote. I did my nursing course back in the 80's in the UK. On one of the internal medicine floors we had a fierce Sister (Charge Nurse/Head Nurse) that insisted that the open end of the pillowcase always faced away from the door. This was still in the time when RN's actually did mundane things like make beds and feed patients. WTF? I hear you say (nursing is great for rituals, I reply). I was a precocious student that was never content to just do as I was told so I decided to question the rationale. After a little research I found out that NIghtingale has advocated the same during the Crimean War as sand would blow into the hospital tents and get in between the sheets and pillowcases making them uncomfortable for the wounded soldiers. Yet more than a hundred years later there were still colleagues following her doctrine!! She must have made one heck of a mark on our profession. Oh and I suddenly feel old by telling this story... Carl.
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On the same website and a great fun: http://www.trauma.org/archive/resus/moulagetwo/moulagetwo.html See how you get on.. Carl.
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Good man! But well, what do you expect from a Kiwi? (note to Kiwi: it's the Dutch flag you dingbat! ) And Scott, thanks for the compliment! I'm very flattered, on behalf of all my colleagues, even if I'm not sure it's true. There are some pretty smart people around here too. WM
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Hi Toni, TNCC is the Trauma Nursing Core Course. This is the nursing equivalent of the PHTLS and ATLS. The question arose because a young colleague from the ER has just completed the course and there they were very anti permissive hypotension. Everybody got 2 large bore IV's and lots of fluid. Carl.
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Hi all, Not sure if I'm in the right place here, but here goes: Does anybody know if the current TNCC doctrine still includes 2 large bore needles and lots of IV fluids or are have they moved onto permissive hypotension? I ask it because it's a current discussion on a Dutch EMS forum, apparently they still advocate lots of fluids there. I said I would ask here, talk about international co-operation! Thanks in advance for the help! WM
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Oh, you are more than welcome! You wouldn't be the first, either..
