Timmy

So, let me get this straight. The emergency ambulance didn’t have something as simple as a laryngoscope and magills? Why were they dispatched to a situation like this so ill equipped and under trained?

When ever I jump on the radio it sounds pretty dumb lol

Oh my lord! Now thats what I'm talking about lol!

Even though I’m only doing my diploma, I’ll put my 2 cents worth in if I may. I’m the first one to admit I’m no academic and find learning theoretically quiet difficult. I can read over a text a thousand times and still know none the better. Now, if it’s practical or visual I’m all guns. The course I’m doing mostly involves sitting in a lecture theater for 8 hours every Friday watching hundreds of PowerPoint slides and having the lecturer read them out, this type of learning for me is completely useless. Occasionally we have a full week of this. In this week we were taught the 11 body systems, we then have one week to study at home before our exam which I need to pass with 80%. The exam I think consist of 80 Multi choice questions, 40 short answer as well as diagrams. I’m not quiet sure how many times I’ve hear different lectures say ‘this is a nice to know, but you don’t need to know, just learn it for the exam’ I pose this question, why teach it? Having spoken with many paramedics, health professionals and even members of this site the general impression/feedback I receive is most only remember about 40% of what they learn in school. Why not teach this 40% well so everyone has a sound knowledge of the ‘need to knows’ instead of wasting our time on silly microbiological/microchemical and bioscience stuff we only need to know to pass the exam. I might add, after the exam it’s assumed you know it all, we move on, never to revisit most of it again. As for practical’s, yes we do a little, not much. Even then there are 35 people in the class and 1 teacher. We also have clinical placements which involve riding with both emergo paramedics and non emergo transport services, depending on what sort of crew you get you may not even get to touch a real patient. Just to save time they cancelled our aged placements and replaced it with an 800 word essay. If and when you graduate and your employed with a state service you get Clinical Instruction hours which involve working under a senior paramedic. What if the branch you’re working at has little work load? It’s just merely hours not experience. After these hours they stick you on a truck and off you go. Australia only recently moved from having a mix of on road and theoretical training to the 3 year degree. Having spoken with some high up people who have been in the job for years they say this move was merely just for money. The state services would rather recruit from a uni course (that the participant pays quiet a lot for) than pay for in service training program, some states still have this but it will eventually be phased out. In a heated discussion at one of our lectures we were pretty much told that not many paramedics or even some lectures supported the degree. There’s major debate at the moment about graduate nurses. Straight from uni and straight into the workforce, I’ve witnessed this first hand many times and can say I’ve never seen such clinical incompetence and cluelessness. Having a 3 year degree means Jack if you can’t put it into practice. You can’t blame them for being incompetent it’s just the way they’ve been taught. I fully support the suggestion to move back into hospital bases training. In conclusion, I’d much prefer to be doing an on road traineeship and I’d defiantly benefit from it but unfortunately my state doesn’t offer it. Anywho, enough of me carrying on. I need to study for this exam!

Our protocols are different here. Paramedics can’t sign a death certificate but can cease resuscitation. They can also render someone emotionally/mentally unable to make a decision. We don’t use medical control in Australia.

There's your answer, stop.

It really depends on what state you’re looking at going to. A lot of services require paramedics to have a degree. Some services still recruit off the street and train you to a diploma level but this is slowly being phased out. Get in touch with services like Queensland Ambulance, New South Wales Ambulance and maybe even St John in Western Australia and Northern Territory. As far as I’m aware you’d still come over as a student paramedic but you can apply for a lot of recognition of prior learning which may shorten the course quiet a bit. That’s of course if you wish to apply for emergency. A lot of mining companies and non emergency transport services hire overseas paramedics. Get in touch with the states recruiting officers via the ambulance services websites, those people will be able to provide deferent answers and will be a great help. Take Care

A resp rate of 36 is what you’d call inadequate breathing. While the patient is breathing, his breathing to fast for the oxygen to be any good. Using a BVM w/ 100% 02 or even IPPV for assisted ventilation is a good idea. What was his GSC and SP02? Do a test on your self, breath in and out really fast and see how long it takes to get lightheaded, there’s not enough oxygen getting to your brain.

I’d tend to agree but I like tick boxes lol. The ones we use at uni are the state service ones and it’s pretty much like writing an essay. In my ‘on arrival’ box I wrote a 600 word story and that’s before I did an ‘on examination’ all for a pedestrian hit by a car. Like my lecturer said ‘remember you must document everything little detail that happens, even if you made a clinical mistake’. I’d post a copy of the form but it’s a controlled document and probably to big to fit in the scanner lol!

I like your form! Lots of tick boxes and not much writing!

I’m guessing that NASCAR is similar to the V8 supercars in Australia. At our V8 events it’s not uncommon to have Intensive care paramedics, doctors, nurses and Physiotherapists in attendance. Last time I did the V8s they had a medical chase car which followed them on the first lap, this vehicle was staffed with a high performance driver, ALS paramedic and MICA paramedic. They have one First Intervention Vehicle which went to any crashes that happened during the race, staffed with an emergency nurse, ALS medic and MICA. In the medical centre they have a few doctors with varying specialties (anaesthetist, ER doc ect) and ER nurses and 2 state emergency ambulances staffed with ALS medics to transport to hospital if needed. I was one of the lowly First Responders in the crowd lol. They also have motorsport rescue/safety/fire teams. The F1 Grand Prix racing has many more Health Care Professionals, some world renowned. I’ve never had the pleasure of working trackside at a professional race but have done so many times at amateur racing. The ‘adrenaline attack’ as I call it is the most annoying thing in the world. I’ve never heard of the professional drivers refusing treatment but I mean they know that the people who come to help have done it a few times before and know exactly what’s going on. Many times I’ve had the guys who race just for fun refuse treatment, after I explain what could happen and they sign the release form it’s all good. If their out of the car before we arrive then meh, it happens. Most of the time their pretty corporative. The good thing about it though, if the EMS team say they can’t go back racing then the chief official normally complies.

I’m not from America but you still should be able to approach your ‘boss’ they should have a non bias approach to your problems. Failing this maybe a state officer or office? It really depends on what your problem is…

What do you mean by public safety? Like a danger or threat sort of thing?

In fire we can only go 10km over the posted speed limit. In built up areas sometimes we even go a tad under the speed limit because it takes a while to stop one of those trucks. Sometimes you get those whackers who go some stupid speed like my group officer :roll: As for EMS I have no idea, but I have seen them fly by my house but I live on a straight dead quiet highway so… Speed Kills, Slow Down :wink:

Stickers ay… I see no point… Even if I had an EMS or Fire sticker on my car the cops wouldn’t give a toss. That’s why we don’t speed or use my car to respond 8)

Here you Blood Alcohol Content must be .00 before you can drive the truck or be on duty. Ddon’t drink 24hours before you go on duty :wink:

Just a quick question. When a patient w/ a fracture states they felt/heard a cracking noise could you describe that as Crepitus? If not, what’s the term used to describe that ‘cracking’ noise?

Oh My Bad! Its been a long night

Has anyone mentioned event standby yet?

Maybe he can now afford to join weight watchers :shock: I didnt say that lol :wink:

lol!

Recently at a rave party we had security dump a drug OD on the floor of my first aid post. After establishing that he’d taken 12 “illicit tablets” and only slightly moving his foot when I did a sternum rub I gave him a GSC of 4. We put him on the ferno, dropped an OPA and did ventilations with the BVM. My convo sounded something like: Me: “Control from 530” Them: “530 send” Me: “530 transporting male patient unresponsive, breathing, no bleeding to ACMT (field hospital) – confirmed drug overdose - GCS of 4 – we’ve dropped an OPA – ETA 2 mins” Them: “Roger 530, is you patient bleeding, responsive or breathing?” Me: *rolls eyes* “Patient breathing, unresponsive and not bleeding” Them: “roger 530 good luck finding room, were a little tight for space here” Me: “WELL MAKE ROOM!”

Sheambo pretty much summed it up, not going to get much better than that! Just like to add a lot of communication is done by radio. I’ve studied Aboriginal and Torres Straight Islanders a tad. Not so much the EMS side more Health and Development. A lot of remote aboriginal communities live in dire poverty; mortality and morbidity from every day diseases/infections/sickness is quiet high even though something as simple as a basic immunization program or education in hygiene or access to clean drinking water could make a great difference. This is were RFDS is helping immensely with their mobile clinics. Some larger communities may have like a health clinic/mini hospital which is manned by nurse practitioners/health educators but most indigenous people have a fear or lack of understanding as to what the health care role plays. The government pumps quiet a lot of money into these communities but unfortunately it’s pretty much spent on alcohol. A lot of communities are quiet alcohol affected. A lot of residents may reside in a house which may only have a few old mattresses and the cooking facilities may consist of a frying pan and rice which will be eaten on the floor with your fingers. These houses may even house up to 7 children and 4 adults. Access to nutritious food is also quiet a concern as such morbidity from malnutrition is quiet common.

In my state for the most part Fire and Ambos work two 10 hour days shifts and two 14 hour night shifts followed by 4 days off one of those possibly on call.

After reading though all this I’m rather confused :? When you say BLS use a Glucometers are you implying that they stick the person, get the reading and that’s good enough? Or they stick the person, get a reading and have an understanding/education as to what the number means?