WelshMedic

I can remember one time when I picked up a young girl who'd been kicked in the stomach by a horse. She obviously had a splenic injury and so I decided to get her quickly in the back of the vehicle and transport. On the way I gave her two IV's. My colleague driving in the front kept giving me funny looks but said nothing. The next day I was summoned to the boss. How on earth could I be so stupid and dangerous as to cannulate a patient in a moving vehicle? No-one had ever attempted it before and I was, on no account, ever to try again. How things change... wm

Oh, and before I get kicked off this site for inciting violence, it was meant light-heartedly

Or we could kick somedic's head in for being such an arrogant tosser..... What's the difference between God and a paramedic?......Come on, you all know the answer..... WM

When Dr Death mentions ambulance control he means the dispatch center. The crew would request a medical team via dispatch who would then pass on the request to the hospital. It has nothing to do with on-line medical command, that is an uniquely american (?and canadian) phenomenon. WM

Ain't that the truth...... WM

No Zippy, it's about offering the patient the right kind of care.....If I wanted to be a van driver with a first-aid certificate then I'd have joined the RAC as a mechanic. WM

Don't get on the freeway and drive 15 miles and then suddenly realise that you shouldn't be on the freeway at all. Sad, but it actually happened. Sufficed to say that the person in question no longer works for us AND we have just installed SATNAV. WM.

This is not meant to be an inflammatory post, just a bona fide question. If Zippy hangs out here a lot and does all this event work in his spare time, why doesn't he go the whole hog and just join the Ambulance Service and do his ICHD exams? So Zippy, enlighten us, if you will..... Just to give my take on this clash of systems thing ( if anyone's interested, that is). For the past 30 years in the US, ALS has been provided by people who are trained to do just that, ALS. The training involved is very focused and, presumably, of a reasonably high standard wherever you go to school. BUT, it has it's limitations. A paramedic's idea of an holistic approach is to complete a primary and secondary survey in 5 minutes flat..... , just kidding!! Nurses are trained to look at the whole picture and have, whether you like it or not, a much broader knowledge base when it comes to pathophysiology. It's not meant as an insult, but we didn't go to school at degree level for 4 years without reason (even if I did spend the first three in the pub). (Just for the record, my experience is not just based on this forum, I organize a trip every two years for colleagues to the Eastern Seaboard to see how American EMS works) What does this mean in practice? With the majority of patients, not much. A cardiac arrest is a cardiac arrest, we all treat according to ERC guidelines, BLS, tube, needle, drugs. End of...However we all know that a growing number of patients are inappropriately referred or self-referred to EMS. A nurse is much more likely to look at alternative care pathways. Can I solve this problem together with the GP? I've been known to spend half an hour on the phone to social services to prevent a hospital admission. Is this my job? No, not strictly speaking, but it's about what's best for the patient. It's arrogant to suggest that a nurse can't do a medic's job. It's also patently untrue. I went from A+E (ER) nursing to pre-hospital. The best decision I ever made. I love the freedom it offers but also the challenges it presents. How do we get that 280 lb builder out from in between the scaffolding? Fantastic! It may not be everyone's cup of tea, granted; but it's got nothing to do with what background you have - nurse, medic or fishmonger. It's not my intention here to criticize my medic colleagues. On the contrary, most of the people I've met have been very skillful and, more importantly, very caring. It's just my vision on the benefits of a nursing background. WM

I'm welsh and working as a paramedic in the Netherlands. This is a good site on the whole but as always there are always one or two who think they know better....I'm sure you'll find out who they are.

Oh there's only about 700 miles between the two..........

Hi Terri, That's just the thing, there aren't any details. It was just me throwing an idea in the air and seeing where it lands. I would be more than happy to co-ordinate but I need local help on the ground. With me being in the Netherlands it would be slightly difficult to do on my own - there's the small matter of the Atlantic Ocean in between I'm a member of a similar forum here in the Netherlands: www.hulpverleningsforum.nl. We started arranging get-togethers a few years ago and it was such a success that it's now an annual event which has taken on huge proportions. We've even had our first forum marriage. I'm not suggesting that it would go the same way here, but surely a beer and a chat isn't that hard to arrange. So, what do you think? Carl.

Just think of the amount of stuff you could stash in one of those windmills......

Hello everybody, I've been around on this forum for a bit now and most of you seem like reasonable people. So, we're coming to the States in March of next year and visiting the New York/Philadelphia area. Anybody fancy a beer with me and a couple of other medics from Holland (no, not the tunnel; the country with clogs and tulips and illegal substances - you know the one I mean). So, how about it - an EMT City International get-together? (The first round is on me - so don't all turn up, i'll have to re-mortgage my house) Carl.

Has anyone stopped to think why the prevailing attitude here is the very reason why the prison system is filled to overflowing and why so many felons end up re-offending after coming out. I'm not suggesting that we make rapists or murderers EMT's but I do think that there are some gray areas here. If you have paid your debt to society and come out of prison with a serviceable qualification that you can use to find a paid job, then surely the chance that you're going to re-offend is much smaller?. Everyone deserves a chance to try again, surely? Carl. PS - to the person that said he'd rather die than be worked on by a felon - what planet are you on? If you're in that much trouble you really won't give a sh*t who does it, but you'll sure as hell be grateful!!!

Very slick, but I can't help wondering whether a film like that would attract the right sort of people to the job. It's very cliched, in the sense that it only focuses on the glory and guts. What about the nauseous oncological patient? That's also EMS isn't it? Carl.

Hi all, Click on the following link for a (very short) impression of EMS in the Netherlands. It's not my handywork, it's been made by the National EMS Association for high-school students to get them interested in the job. http://www.yourfuture.tv/site2.0/videoplay...tner=yourfuture Carl.

There are many of us in EMS that like to have a beer at the end of a shift to relax and reflect upon the day passed, as indeed we do tend to socialize in the same circles, and often alcohol is a factor here as well. This doesn't turn us into alcoholics automatically. I like a drink .....and yes, sometimes I drink too much. That's not because I need to forget, but because I like to try different beers and have a passion for good quality brews. Take next year for example, I'll be visiting the east coast ostensibly to provide my dutch colleagues with a ride-along with EMS in the US. A lot of the time I'll be spending in brewpubs trying their wares. Does this mean I have a problem? Carl

Oh, now I get it! Ordering water in a restaurant isn't particularly common here, if you ask for water you're likely to get tap water - which is obviously free. But there are lots of things about you lot that make us raise our eyebrows as well..... :wink: I mean, why is it that whenever I pay a bill in a restaurant I have to add the tax as extra? Why does the waiter/shopassistant always ask "How are you today?" when I really don't think he/she could really give a toss? An ex-movie star (may he RIP) as President? Barney / oh no, forget that one, my kids love him!!! Dan Quayle Need I go on..................... WM:

Yes, then you would want to get the pt as soon as possible to ALS. All of EMS here in Holland is ALS so it's not really an issue Carl.

You've lost me, mate! I think it's meant as a joke, so I'm probably just being a bit thick. Please explain (sorry for ruining the pun)

Hi everybody, I think that the race to meet set times is detrimental to patient care, especially in a medical call. I concur with my Canadian colleague. It takes as long as it takes. As far as an adult code is concerned, the idea of transporting whilst still doing BLS is completely alien to me. Why would you? What does the hospital have to offer in the short-term that you don't? Work the code, get ROSC or pronounce. Much simpler, much less dangerous and it doesn't offer false hope to the family either. We're a funny lot, us Europeans, aren't we? Carl.

Dust, Let me take that bit about the East Coast back, your actual words were: "the Northeast in general, sucks". Sorry! :occasion5: Carl.

Dust, I guess that when an outsider attacks any particular organization then they would tend to close ranks. If I were to say today that eg NYFD EMS are a bunch of cretins (which I'm not) then I would expect an avalanche of criticism, and rightly so. Attacking the employer is not that far removed from the above example. That's one thing that I've noticed in the US (it's a cultural thing, I think) - EMS is a way of life for a lot of people and they're very proud and patriotic to do what they do. I, however, (along with most people here in the Netherlands) enjoy my job but that's it. I leave at 6pm, shut the door and don't give the rest a second thought. I'm lucky to do what I do, I'd hate to work in a production plant, but at the end of the day it's just a way to pay my mortgage. Take for example your negative comments about most of the east coast early on in this topic. I never once noticed any form of unprofessionalism or lack of care with the services I rode along with (and plan to do so again at the beginning of next year) and, in fact, we were bowled over by the commitment shown by most people we met, and we collectively agreed the we could do with a leaf out of their book. You're forever telling us that there's a lot wrong with EMS in the States, some of which is true (Medical Control, whoever dreamt that one up? - "Sorry, mam, I can't give this life-saving drug to you because the doctor says no" I mean, come on here....) but let me say once and for all as an impartial outsider - There's a lot right with it as well! Have a pleasant day everybody (although mine is almost over), Carl.

Hello everybody, Just to update everyone on the result of this particular topic. I remember it caused quite a heated discussion at the time! We have decided to re-visit Crozer Health in Chester, Pa. and New Castle County in Wilmington, DE. I have connections with both services and so I made good use of them. Thanks to everyone for their input and it was nice to see how an simple question turned into a complex dialogue about the merits of different systems. Take Care all, Carl.

We didn't need to ride out in Philly as we already had something set up in Chester, PA (as you probably already know, a suburb of Philly). What I can tell you though, is that two of our FF's visited the Philly FD and were treated like kings for the day (own escort, lunch, the whole shooting match). I can't comment on the pt care, but they treated us like real guests and that we won't forget in a hurry. As far as the city itself is concerned, it is by far and away my favorite city in the US. Culture, history, friendly natives, great bars (including Monk's - the best belgian beer bar in the US - I mean, they can even get beers that they don't serve in most belgian pubs in BELGIUM!!).Try it someday, I've visited 5 times and I still can't get enough. Carl