BushyFromOz

Mate you are completely missing my point A union is an Industrial body that exists for the sole purpose of respresenting the views of its members. Its members in this case are fiefighters Anything the UNION states is a representation of the will of its membership, therefore the statement of the union are the statements of its constituents, they are one and the same And for the life of me i cannot understand your issue with the "reduced services risking lives" argument. Just because no one has died as a result, does not mean the risk is not real. Organisations trot this line out all the time and we dont see you exploding in here about how low brow that tactic is. No, i have reasonable and educated opinion on the topic of unions and unionism, the only one whose opinion who is blinded is yours.

HI kids topic title is pretty much the question. up until recently, our IC's used verapamil for SVT within some pretty strict criteria, then adenosine was introduced (in a very poor fasion may i add) and the controls around managing SVT's relaxed. So basically these patient are being managed a heck of a lot more than we used to. Because of this historical context, the experience in managing AVNRT and AVRT's is at the moment quite poor, and creates some hesitation when you get to the connundrum of is this SVT or is this really regular Atrial fib. Reason i ask is i had a patient the other day with a HR of 202, no discernable P waves at all in Ld2, and when you mapped out the R-R intervals on a strip they were predominantly regular but occasionally had periods of slight irregularity. The monitored rate was also slightly variable at times in that it would run at 202 for 20 seconds, then 198 for half a minute in that sort of fashion. On moving this guy to the stretcher before chemical reversion his rate dropped to 150 where it fluctuated +/- 6 beats per minute, so the decision was made to not chemically revert. My question is, if you are unable to diferentiate between atrial fib and SVT, and you choose to give adenosine, is "paying off" as SVT, particulalry when symptomatic a sound clinical choice, or is erring on the side of it being Atrial Fib a better option? And if you give adenosine to atrial fib, are there increased risks involved. Posted from a mobile phone so i have no resources to look at this myself for a few more hours

The industrial body representing firefighter made those statements? The whole point of a unions is to represent and if need be publicly state the wishes of thir fee paying membership. Its entirely appropriate for them to make these statatements, provided it is on behalf of their membership.

And what city councils and state government do is dishonest too. No point bringing a cupcake to a gunfight. Are you sure this about unions, or is this about firefighters?

I have to take issue with this because by and large most Paramedics working in the public sector in australia are part of some form of union, and for this there are multiple reasons. At the very basic level one requires a representative for colledtive bargaining, and it might as well be my union rather than forking money over to a third party negotiating body. A collective agreement is the only way as it is simply not feasible to negotiate individual contracts for 2500 paramedics + conditions for the thousand or so paid first responders on our books.. We dont negotiate against a city or a county. We negotaite against the state government who is quite happy to spend literally millions on legal council to hold your wages back, hence, a union is the only way to negotiate in a reasonably fair manner, but their pockets are much deeper than ours so they will throws bucketfulls of money at the issue when we throw dollar coins Australian industrial law is complicated, we have what is termed legal or protected industrial action and then illegal or unprotected industrial action, Withdrawing some forms of labour may be protected, stiking is not. To strike is to take a significant risk in losing ones job, and in the case of failed collective bargaining, forcing the industrial court to write a collective agreement if we cannot agree on one with our employer. My emplyer is large, it is a state wide statutory service. If i am unhappy with my conditions i cannot go to the next city and work for one of their companies, departments or whatever you call them, there is no other employer in the emergency sector unless i change states, which if you have seen a map of Australia is not as easy as ducking to the next county. And if i do move to another state they only have one statutory ambulance service to work for, so i still have litlle choice. The state government and my employer occasionally like to make changes to rosters, services, operating procedure that are less than satisfactory to the publics interest. As i am a government employee i cannot speak publicly due to a code of conduct, but i can have the union do it for me. My union also provides representation for "disciplinary proceedings... some emplyers like writing procedures for grievances etc, but they dont like to follow them Our industrial climate at the moment is toxic. the government has a public sector wages policy of 2.5% with any other rises due to productivity offsets "actual bankable cash savings" as a result of a negotiated outcome", which i am no position to provide because i do not control the purse strings, so the only thing is to give up conditions. 2.5% is not even in line with CPI so you give up your conditions to meet inflation, or, you wage a nasty industrial campaign and take illegal industrial aciton, because the reality is, illegal action is the only leverage you have here. Ironically illegal industrial action is probably what the state government wants because it will force the industrial courts to force an agreement on us, so the service and the state government certainly wont get what they want, but neither will Paramedics, so its a win for them either way. Paramedics in my state have not had payrises that have meant inflation rates for nearly a decade, so the thought of making that 14 years is pretty much unpalitable. My union doesn't actually hold any cards, and is the only reason strike action is even mentioned.

Im already there... if i dont have a cup o char before 10am i get a violent headache, but i only need 2 cups a day to get by. Funily enough, we had a coffee percolator in our flat while i was at uni, thing was always brewing. I think thats where the problem started

Is there a common reason on the numbers of HEMS losses in the states? Is there a common reason on the numbers of HEMS losses in the states?

Yeah, theres a thank a Paramedic Day here, gives me the shits. The only people i want to thank me are the state government and its called a payrise above CPI Nothing useful to add except when I'm asked what's the worst thing Ive ever seen i use a modified line from "bringing out the dead" My reply is "baked beans on a pizza" The fact i dodged the question usually diverts them.

He he! I like it. Nice post mike.

Any chance i could get a copy of your 3P's craig?

you guys are thrombolysing CVA's in he field??

Oh my god.. when i logged in i saw you were the last person to comment on the thread and before i opened it i thought about ho much of asshole i am not to drop your name as well Sorry bro

As soon as the online guidelines are updated i will link it, but the draft is out and our ICP's (and me at some stage ) will be managing STEMI's wiht tenecteplase, heparin and clopidigrel without physician consultation Doc, whats the technique for measuring changes in the diameter of the optic nerve with ultrasound, and is it able to distinguish haemorrhagic from ischaemic CVA? Non physician ultrasound in EMS i think is limited to FAST exams and pneumothorax identification in Australia.

You mean your not a hangar queen anymore??

Bare foot and pregnant too... well not really, but the food baby is growing. In some ways this is going to be incredible., ive already decided that if im going to do this post grad diploma i might as well do the additional 8 points and get a masters afterwards. The time management is going to kill me though, 54 weeks back at university and then whatever hoops i have to jump through with my employer. Its going to get crazy

I think the point with therapeutic hypothermia in TBI is that it is isolated TBI without or controlled gross haemorrhage and the absence of volume loss into cavities or large tissue masses.

Hey Kat How do you guy go about preventing hypothermia in entrapped patients during the winter?

Greeing earthlings! I started posting 6 or 7 years ago when i was still at university getting my batchelors degree, you know, when you have free time and life was measured between drinking sessions rather than assessments - i would log in and get the musings of dustdevil, paramedicmike, dwayne, eydawn (sp?), kat, akflight, chbear, davis and all the other names i cant think of right now, and i would think to myself that i would like to be half as good as these people Then life (reality) got in the way Then i got a job Then i got a wife Then i got a mortgage And then i stopped posting, but it still drop in from time to time, but things have taken a turn the last few weeks, Becasue a fortnight ago on wednesday i was informed i had passed selection for MICA / ICP education which will bring with it a hole new world of hurt and adventure, so i will still lurk and not post. But the people here are still part of my inspiration Thanks guys

Shit? Really??? Ive wasted all these years.....

Maybe she saw what happened on the grassy knoll in Dallas?

Fair enough.... wouldn't want them as my family then, maybe there is a good inheritance involved Assisted living facility or not. I cant understand how a health facility of any type can have policy of not providing basic first aid to its residents and it be "legal"

What i cant understand is that the family had knowingly placed their relative in a facility of any type who is presumably reasonably fit and a reasonable quality of life but knew should their family member drop thei bundle they would recieve no help? Where is the famlies morals in this? The irony doesn;'t escape me that these people have paid money to an assisted living facility that provided no assistance for living... if she had have dropped dead i the street she would be better off. At least you can do that for free? I would have thought that any health are facility would have had a legal obligation to provide basic first aid and care for any of their residents, and basic first aid includes CPR.

Dont usually advocate litigation... but sue the ass off this crowd for sure!

All good points, but it will take some convincing for me to believe that EMS should be involved for the toothache at 2am with 2 cars in the driveway because " its not that bad, and i would take my wife to hospital, but i didn't want to wake the children up" there is a point where we should stop absolving adults of the responsibility of being adults

Yeah. Occasionally they would run something thats worth seeing, but by the time you factor in the 6 hour round trip, meals and accommodation somewhere near the venue, you dont get much change from 600 bucks