Timmy

Fire and EMS should not have anything to do with one another.

BGL? BP - Sitting, Standing? Any SOB? Onset Time? What was he doing when it started? ECG?

Fluid intake and output? Temp? Skin Turgor?

Sounds great... Anyone wana pay for a return flight?

Happy Birthday

As long as it's only going to take a few seconds to grab the tin of ashes then I would... More info please tezza

You never know, he might make US EMS government funded! But, the UK is way to cold for me.

Gross

***Warning, Strong Language***

$100,000 for a broken wrist my arse! Get a life, how ridiculous. She should have been looking at were she was stepping. If for some strange reason she gets compensation it should only be enough to cover the medical bill. Good lord :roll: Chopper Reed says “Harden the F$#K up!”

I understand were your coming from. We to have quiet a few bad car accidents. Were lucky enough to have a big supermarket here but when you need to have a good shop you need to travel an hour away to the bigger town. I do all my clothes shopping because they don’t have many brand names here. I also do Christmas and Birthday shopping down there. There just about to open a McDonalds here which is quiet distressing because it will take the business away from the little local bakery’s and take away food shops that have been in the town for years. I’ve lived in rural towns all my life, in fact I’ve lived on a farm for most of it. I love the lifestyle and the people. Sure you may not get the frequency or clinical presentations that a bigger hospital or EMS service may see but I think it’s important to incorporate work with a good lifestyle you enjoy. I’ve lived in the city for a few months while I was going to medic school, I really despised it. Traffic, tiny little houses all packed close together, people everywhere, smog and the cost of living wasn’t my cup of tea at all. My town is about 8,000 people but right across the river is another little town with about 3,000 people. It’s mostly an orchard, vegetable and dairy growing area. The town is built along the river and in amongst bush land. The two towns are joined by a big bridge and it’s about a 3 min drive though bush land across a causeway. It’s pretty much a service centre for the surrounding littler towns, we have quiet a few little towns spread over quiet a distance. During the summer school holidays the towns population bumps by about 10,000 tourists who camp down the river. They normally bring speedboats, jet skis, dirtbikes and all those sort of toys. This can by quiet a busy time for EMS, fire, hospital and the town in general. We commonly see patient presentations from those toy accidents, burns from camp fires, gastro and food poisoning from camp food and generally people who just become unwell and present to A&E. We get quiet a few fire calls, normally 2 calls a day during December and January which is a lot to expect from a volunteer service. We have a lot of people who don’t know were they are, the river is full of little dirt tracks that wind around the bush for ages until you reach the river or the beach. A lot of tracks don’t have names just the beaches are named. Summer time also means an influx of thousands of overseas fruit and veggie pickers. With these people comes drugs and alcohol, they come here for work but they also don’t mind a good party or a good drink just to make the Australian experience that little more eventful. I do agree with everyone when they say rural is challenging! It is, very much. Long transport times, not having the appropriate facilities, specialized staff and equipment and even waiting for help can take some time and become very frustrating. About a year and a half ago my hospital had a young man present with heart failure and needed to be put on bypass to be stable enough to be flown to Melbourne, of course we don’t have those intensive care resources available so they flew up a team from Melbourne and did it in our little 3 bed emergency department. Nursing here can be quiet challenging, we only have on call doctors and there’s no guarantee that one will be rostered on. I don’t blame them, after working 12 hours in the medical clinic they don’t need to be called back after hours to look at someone, everyone needs a break. About an hours drive away is a town of about 40,000 people, they call it a rural city. It’s a nice town, big enough but still has a country feel about it. A lot of business people and tradesman travel to and back and some of the nurses that work at my hospital work part time here and part time over there to keep up with the different clinical presentations, you find the nurses who specialize in midwifery, ICU and emergency do this. This town has the major hospital for the area, the trauma centre and specialist services. We have about 5 ALS paramedics in my town, they normally run one ALS truck 24/7 but sometimes run two. It’s pretty easy going, they always have a steady flow of calls. The only bad thing I guess is they do a lot of driving to the trauma centre so it takes the truck out of service for about 4 hours. The drought has severely effected the town in many ways, a lot of people are having to sell there farms and animals and the lack of water it quiet concerning. But it amazes me how the people pull together and help each other out as much as they can. I know you may find it quiet difficult to become accustom to rural life but I’m sure you’ll find the locals very nice and welcoming, you’ll fit in just fine.

Just a question in regards to being competent after a fall. In Australia marking someone to be confident to make a medical based decision is a grey area, some services have mental status assessment, based upon this assessment and the paramedics ‘gut feelings’ they can force treatment on a patient with police intervention, this can include chemical or physical restraint if necessary. Let me give you a situation. You are the ALS provider at the rodeo, one of the boys comes down pretty hard. Upon arrival it is clear that the patient is not able to make a decision because they have concussion, don’t know were they are but he is adamant to get back on the bull, all the bystanders tell you he’ll be fine and not to worry. The rider gets back on the bull and subsequent dies or becomes severely disabled from the injuries his received on the previous ride. Are you as the ALS provider negligent? You had the legal right to restrain the rider based on him not being component to make an informed medical based decision due to not being aware of his surrounding environment but let the situation get the better of you. Does the rider/his family have the right to sue the pants off you? I know this situation seems a little extreme but it is a very real possibility. I find rodeo riders will come get treatment after their ride, when there out of the spotlight, some riders will get treatment based upon knowing you have pain meds ect. On a few occasions I have had riders tell me ‘please, just get me to hospital’ or anyone told me he didn’t feel right, and he was right, he had a spinal injury. He lying in the middle of the area on his back and told everyone not to touch him until we arrived. They know there own bodies, I trust that most will know when there seriously injured enough to ask for treatment. As a BLS provider at rodeo I have no responsibility to force treatment upon you but ALS on the other hand is another kettle of fish, this is why they get paid some much to sit at the rodeo lol

American 02 bottles must be weird! In Aussie our 02 regulators have a key thingo chained onto them, can’t really be removed unless you cut it off. I’ve need heard of carrying one on your belt lol…

lol! Oh well, it's there funeral

lol Dust, maybe he would have been better off? I do agree, rodeo, MX riders, speedway drivers ect let pride get in the way of common sense.

Last night I played witness to one of the most negligent, shocking, jaw dropping, words can’t describe display of first aid I’ve ever seen in my life. Let me set the scene. There was a rodeo about 2 mins walk from my house last night. I don’t normally go to these types of events in a non EMS capacity but seeing it was so close a group of friends and I decided to go as spectators. Out of curiosity I walked past the first aid tent to see who was covering the event. There were two old men sitting there with a massage table and a few bags, they were not in any sort of uniform and didn’t appear to be from any sort of company. I didn’t think anything of it and continued on with my friends. About an hour later a house kicked one of the clowns into the shoots quiet badly. He was kind of flipped over hitting his head on the fence part and landing quiet heavily on his right shoulder. He did appear to be unresponsive for a short amount of time. The commentator called for the first aid and these two old blokes hobble out, one with a cigarette in his mouth. They were on the ground with him for about 10mintues before they made him stand up and walked him back to the tent. He was quiet unsteady on his feet, his right shoulder was clearly fractured (drop of about 5cm) he was bleeding from the head and holding his shoulder, all crunched over, about 3 people were supporting him so he didn’t fall over. Again, out of curiosity from the poor management these guys had shown on the arena I walked down and sat near the tent with one of my friends who is a nurse. They sat him on the massage table, took his gear off and began massaging oil into his shoulder! It was clearly fractured, I could see from a distance the clavicle was deformed and angulated. The clown then told them he wanted to go back out there so the man gave him a cigarette, told him to have a few drags and calm down then suggested that he be taken to hospital! We then promptly power walked to the bar and had a drink to calm down. We also decided we’d seen enough, we didn’t want to provide a witness statement in the coroner’s inquest. I mean, I really couldn’t believe my eyes. I would have taken spinal precautions, controlled the bleeding, gave pain meds, maybe even fluids and defiantly called a road crew to transport.

When you've done plenty of Motocross and Rodeo standbys I guess you become immune to dumb people

Damn right! Gotta watch those roos as well. If it was like anything I saw last night, women can be quiet voilent too

I think Australians have a laid back attitude and generally most people appreciate help. Most of the paramedics I’ve meet are pretty easy going people who like to made a joke, there well educated and professional. The scope of practice is pretty good. You’ll find a lot of kids flicking though the university course book at the end of high school, seeing what the paramedic course entails, think it’d be a pretty cool job, apply and realize that the study is pretty full on and there a lot to know. The drop out rate for paramedics is pretty high. You’ll find a lot of jobs in Australia require a degree or higher level education. Don’t get me wrong, we have our floors. Sometimes the working conditions paramedics have are less than desirable, long hours, response times, understaffed ect. I really can’t explain why paramedics here a ‘respected’?

I have an issue that really gets me worked up since I've started nursing. This issue is namely people who migrate or seek residency in Australia who can't speak a word of English. While I respect there beliefs, religion and what not I find it quiet rude that they still can't speak English even though they've been living here for a number of years, in some cases 40 years. I understand some individuals have migrated to Australia under some trying circumstances but this is no excuse. We provide good quailty medical care to these people at a quiet substantially reduced cost due to there circumstances yet they still get frustrated, combative and complain that there not receiving appropriate medical care and make allegations that were racist because were not able to reach your family or get an interpreter in a timely manner, well I'm sorry, you chose to live in a rural are and these resources aren't always accessible at the drop of a hat. We do the best we can and I've got enough on my plate learning about nursing, I have no time to learn another language. When you ask about there personal life, jobs ect they normal say they stay at home, stay within there little groups of become house wives. What do they do with there day? Surely they can go down the street, pick up a cheap English conversion book and read it for an hour a day or even better, get English tutoring. But none of them seem interested in being pro active, taking part in the community or anything that will benefit there stay here. What does everyone else think? Do you have a similar situation? Is there a some sort of program that can be put in place?

Same old story. No money No staff No resources More patients It happens in hospitals around here, they advertise for medical/nursing staff, offer generous wages and benefits still no one applies. You take on more patients and try to deal with too many patients, people complain about waiting times or someone dying then you try fix the problem by closing beds and knocking back patients due to lack of staff and people still complain, its a lose, lose situation. Who wants to work in healthcare lol...

I couldn’t tell you what rhythm he was in, as soon as the medics rocked up I gave hand over and left. I passed them in the staff room at work a few days later, they did mention it but I had other things on my mind. I dare say it was a tachy rhythm and they probably gave amiodarone but I’ll confirm that when I see them next. Anyway, in hospital they found an electrolytes imbalance, I think he spent 12 hours in hospital with around 3 liters of fluid. Just goes to show how Red Bull can throw people out, we recently had a kid riding motocross arrest from to much Red Bull, he died trackside.

In Australia we like to stabilize on scene if we can, his improving with your treatment so there’s no hurry. We have no med control, just guidelines, so do what you like. After talking with him you find out his been at a party, has not had any sleep/eaten/had any fluids apart from alcohol in the last 48 hours. He states his had around 1250mls (around 5 cans) of Red Bull and a ‘no doze’ tablet this morning as a pick me up.

You give glucagon and push fluids. ECG shows a dysthrythmia (I cant remember what it was but one that will 'fix it self' once his been re hydrated) vitals are improving and BGL is coming up. The kid is now responding to your voice but is still quiet disorientated but able to answer some questions. He is Australian.

There's no history that I haven't mentioned already. Its a hot day, his been playing football, throwing up, been to a party, had no sleep and now his like this. OPA is down, continuing with glucose. The ALS ambulance is on scene, your the crew... Take it away.