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Agreed ! Just me but I would be looking for Kernigs or Brudzinskis sign AND look at the Throat for a big beef Uvula with white pustules (as this is a bit of a free bee) Absolutely a good physical exam is mandatory, just becase a temp is up a tad is in no way can one put a finger on a Dx, and just how was the temp obtained tempanic, axilla or rectal ??? Neonatals respond to sepsis in other wierd ways like DIC and coagulopathys, color or mottling as croaker mentions in my estimation is by far a better indicator of how sick the child really is. No matter what the suspected DX transport for medic or emt level urban or rural, unless you are very remote clinic setting and can load with bug juice as then clinical bedside observation without labs becomes very, very important. (ps It sounds like this instructer has never been deployed in that situation, quite clearly) Arguing this senseless instructors 'senario's' is a waste of breath, just what was the point the instuctor was attempting to make ? superiour knowledge ? head butting ? or stimulate debate of the statistical occurance ? Strep vs Menigitis ? It sounds like a big fat fail for the instructor quite clearly demonstrates their depth of his or her knowledge and experiance in paediatrics This is not a horse or a zebra, my dx would be this is a jack ass te he. cheers

Try the GIBBS Headslap ... instant attention getter. It will only be a matter of time till he / she seriously injures or kills someone, no one is invincable. Many operations these days have GPS tracking recording speed and track this could also be another way to convince "buddy" to slow down after a download of info my the manager. cheers

Well silly me, I left my crystal ball somewhere so I will be listetening to WHO and infectious disease control experts, not conjecture nor opinion from the peanut gallery. WHY is because in 93 I developed a viral pnemonia and spent about 2 months recovering after 3 days on Bi Level support and very very close to kicking the bucket. SARS was 1 death in 100 (if I recall) and quite a few health care workers were complacent untill the full impact was clearly proven, too late for a few. For those that are interested a global tracking model has been developed .. here is the link. http://outbreaks.globalincidentmap.com/home.php As for exactly who is upset from the name, Swine Flu, meh ... The pork industry has pressured govenment to have name changed to H1N1 Human Swine Flu as consuming the other white meat does not lead to infection, the jump from species IS disconcertingand human to human airborne... damn that pig kissing kid anyway ! http://www.phac-aspc.gc.ca/alert-alerte/swine_200904-eng.php ah political correctness at its finest. cheers

Was that when the Groupies heard your nickname name was "12 inch" and they ALL started giggling and started spiking your drink ? Yea its all coming back now ;>)

I SO have to agree Richard .. the chicken little ran around in circles when SARs hit and like most major "wrecks" that I have had the pleasure of attending, natural or man made we are seldom prepared enough. Last reports are that in 2 months Swine flu has spread across ALL of Mexico dependant on the virulence of virus this could be just a wake up call that is needed.

JPINFV I guess thats my fault, sorry I sniped the footnotes and studies for brevity, the conclusions are extrapolated from Stats Canada, US Insurance Institute for Highway Safety and European Transport Safety Council and applied logic. spenac Agreed ... Safety is an Attitude.

In the research I have read from the Alberta Research Council for Trauma a Dr. Francescutti believes and he can prove that driving faster than 55 mph or 90 kms per hour at night, the vast majority of the poulation is out driving their headlights and reaction braking distances. Besides its Greener. Mobey you make a good point: I would hazard a guess that the "blue hair" behind the wheel is driving in those cases, but that is another topic in itself. cheers

No I think attitudes need adjusting, hence my application of the GIBBS HEADSLAP. <snip> Enforcement.

Funny but every study I have looked at states the same thing over and over, then my field experiance and listening to traffic investigators ... so please Define "inappropriate speed" ... svp. Now Factor in the "busy" times for ambulance operation and "E" responses then add the all important age factor and gender behind the wheel, throw in a bit of fatigue, I certianly hope ambulance operators are not drinking so eliminate that factor ... volia ... Speed Kills. cheers

AH an equal oportunity Grandmother ! I love it !

Well it was said in the 60s "Speed Kills" those that always just have to be ahead of the pack will eventually pay. I honestly have not had a moving violation or even been stopped in over 25 years this driving record goes a long way when looking for employment alone, drivers abstracts are required here in vast majority of cases upon hiring. Although I have the capability in my personal vehicle of travelling at > 105 mph ... do I NO ! I am very aware of gas consumption and do a lot of long distance driving consistant speed is the key to improving every response times. Personally I laugh at these clowns that speed all the time and then complain about gas prices. Still looking for a bumper sticker: PARAMEDIC ON BOARD ... GO AHEAD and PASS ME. I will introduce myself later. xxxooo Do I exceed when operation of Ambulance's but not excessively, 10 mph over is just fine but situation dependant, road condition much more imprtant, I limit risk as much as humanly possible, thing is usually I am stuck in the back. The patented "GIBBS Headslap" has been used more than once. cheers

Was just kidding about the swine flu FYI, heck our College in Alberta decided to "inform" we Paramedics just this am, pointless to post redundant info. What is truly terrifying is the availability of beds (well here any way) to realistically isolate potential patients until a negative or positive virology confirms, as an EMS provider it would be best IMHO to let the Hospital staff to obtain NP swabs ... unless ..... Now just an idea may be for a properly staffed and stocked Out-reach Mobile Response Team be implemented immediately to respond to the "concerned" public providing N 95 and more education and isolate potential, then do the proper diagnostic procedures and keep patients in their homes. Even if this does not amount to a hill of beans it would not be a bad idea to give this concept a trial i.e. (Out-reach Mobile Response Team) just thinking out loud is all. catch this: Alberta Health is suggesting sit at least 6 ft away from anyone in the waiting room, thing is I don't think they have actually looked recently just how already crowded it is or be moved to an examination room as if there is even close to enough bed's for present requirements alone, why am I laughing. Just my opinion again with W.H.O. now gently suggesting borders (levels 5 to 6) are closed and get your countries action plan together, kinda like closing the gate after the horse is gone after confirmed cases in 12 countries. Japan has reacted the best in my estimate so far (well thats just media info) with 1400 beds in isolation and a huge stockpile of Tamiflu, AND the wearing of masks is routine in Japan when someone is ill (its a cultural thing) very polite. cheers

docharris: Ok so how old is your Mom ... and is she still single ? I slay me Well doc I have a few hours in Lears but working medivacs :>) cheers

I found this ... as I am having some difficulty google " anti viral agents/ cleaning agents' It appears that Google is more interested in Computer Virus Cleaning and Removal. I am attemping to discover exactly how alcohol kills virus, I found this a small study never the less quite interesting. http://www.sciencedaily.com/videos/2005/12...d_flu_germs.htm cheers

Query: I read on the extensive NYC precations (agree with celticcare) Richard you owe me 10 minutes as well ...! Statement: So my 2 questions would be: 1- Are this alcohol based hand cleaners effective against this Virus (for that matter any other Virus) ???? My reasoning would be: that since the 70/30 % alcohol sanitizers are aimed at bacteria and using the mechanism of rupturing the cell wall membrane of bacterium ... the nature of a Virus is far different therfore my question. 2- Would these foam water based sanitizers be as effective or better in fact ? Any experts in virology out there ... or are we just getting the virus drunk and a false sence of security. cheers

Great Idea ... thanks. Oh did I forget to mention ... small bills non sequential and sorry no receipts .. I intend to ask for a government bail out after the first trip, hey only fair I figure. All Kiwis welcome if they bring beers. What is really funny is the adverts poping up on this thread ... cut rate Caribean tours, road kill T shirts I think we messed up the advertizers heads on this one !

itku2er: Sorry no insurance policys .. BUT for a minor fee I have some level 3 body armour.

Yes rather clear that the Brits have LOTS of Talent ! I seriously doubt that this young gal will make the headlines world wide as Susan Boyal ... with over 60 million views recorded on You Tube , astounding really really. Susan still has my vote, and I am waiting for her CD. cheers

I like quotes from this fella Obama personally and he is most likely is one of the most powerful people in the world as we speak, not a comic, Hey, I bet Hillary Clinton wishes she was black and looked like Hallie Barry and Micheal Jackson wishes he was black "again" too, poor Micheal J. he just can't get a brake ! Self Pity D.W. Lawrence I never saw a wild thing sorry for itself. A small bird will drop frozen dead from a bough without ever having felt sorry for itself. I believe Barack may have read D.W. Lawrence, I doubt very much that Chris Rock has taken the time, besides if there is not a double standard then I could tell the same joke's that Chris Rock does but that would be racest if it came from a "Whiteys" mouth. Reverse Discrimination is alive and well and political correctness is aimed at only one group. cheers

I am one of the Guides ...

So off topic and not even close to the same reasoning your knowledge level of world affairs is starting to show through quite clearly an uninformed statement, btw a few other countries receive aid that are dang near entirely black populations ... epic FAIL on this rationalization. I have worked on lots of 'reserves' the hand is always observed the palm up and tax exempt, some of our reserves the average worth per native is 23 million each, we don't get a lot of Mexicans up here they have a tendancy to freeze up stiff. Heck, I emailed Cesar Millan to train my dog, too damn cold he said ... but you insist on perpetuating other stereo types and try to draw them in your attempt to justify your position. Firstly that is a double edged sword ! So love/ sex/marriage has something to do with racism, best look in the US history mirror FIRST. Here we go again from a racist Euro-North American. I must be because I put my self through secondary education twice and I managed to pass the exams no government handout or rich parents help) ps I'm horny enough to bang a pile of rocks ... I digress. crotch YOU ? Who is You .. Me ? You crotch are blaming all whites for holding you back again Fail - 5 on the Dust Devil Scale. Hint: If my Father committed murder and was incarcerated and hung does that mean as his son I should be hung too, do you follow, guilt by genetics is not an tangible arguement. If it is not already quite clear by now that hiring or promoting based numbers / percentage / quotas (whatever group) is wrong and continues to promote racism, crotch you are guilty of fanning the flames, do you believe this argument will help any way to free "your people from oppression?" So continue to ignore what others are telling you ! crotch don't believe me when I tell you that you are more guilty of racism that "my people" Barf.

Group Rate available for EMT City Members. Unusual and outstanding family vacation: I found a Somalia cruise package that departs from Sawakin (in the Sudan) and docks at Bagamoya (in Tanzania). The cost is a bit high but it seems well worth it. What I found encouraging and enlightened is that the cruise is encouraging people to bring their own high powered weapons along on the cruise. If you don't have weapons you can rent them right there on the boat. They claim to have a master gunsmith on board and will have reloading parties every afternoon. The cruise lasts from 4-8 days. All the boat does is sail up and down the coast of Somalia waiting to get hijacked by pirates. Here are some of the costs and claims associated with the package: $800.00 US/per day per person, double occupancy (4 day minimum). - M-16 full automatic: rental $25.00/day ammo at 100 rounds of 5.56 mm armor-piercing ammo at $15.95 - Ak-47 rifle: no charge. Ammo at 100 rounds of 7.62 mm com block ball ammo at $14.95 - Barrett M-107 .50 cal sniper rifle: rental $55.00/day. Ammo at 25 rounds 50 cal armor piercing @ $29.95. - Crew members can double as spotters for $30.00 per hour (spotting scope included). - They even offer RPG's at $75 bucks and $200 for 3 standard loads. - Mounted mini-gun available @ $450.00 per 30 seconds of sustained fire. - Free complimentary night vision equipment. Meals are not included but seem reasonable. Coffee and snacks on the Lido (top) deck from 7pm-6am They offer group rates and corporate discounts, and even offer a partial money back if not satisfied. Text from the ad: Here are a few testimonials: FUN FOR THE WHOLE FAMILY!!" ---- Stan, Denver, CO USA "I got three confirmed kills on my last trip. I'LL never hunt big game in Africa again." ----Lars, Hamburg, Germany "Six attacks in 4 days was more than I expected. I bagged three pirates and my 12 yr old son sank two rowboats with the minigun. PIRATES 0, PASSENGERS 32! Well worth the trip. Just make sure your spotter speaks English." ----- Ned, Salt Lake City, Utah USA "I haven't had this much fun since flying choppers in NAM. Don't worry about getting shot by pirates as they never even got close to the ship with those weapons they use and their crappy aim--reminds me of a drunken 'juicer' door gunner we picked up from the motor pool back in Nam." ----"Chopper" Dan, Toledo, Ohio USA. "Like ducks in a barrel. They turned the ship around and we saw them bleed and cry in the water like little girls. Saw one wounded pirate eaten by sharks--what a laugh riot!! This is a must do." ---Zeke, Minnahaw Springs, Kentucky USA cheers

Conceptually a great idea (midlevel Dx and Treatment) The Government in Alberta believes that this will take the strain out of system, the end all and be all, but without very clear guidelines this could be akin to opening a Pandoras box. Motivation for the Independant Practitioner so what is the reward system, as one has to have incentive to take on more resposibility just why should I take on more responsibility and cost of independant malpractice insurance ? In some remote deployments "off shore" this concept is old hat, and the London Service and the NHS has had a lot of positive success. That Said: Implimentation in the US with Ambulance chasing Lawyers ... hmm? cheers interesting topic. Ah the old treat in the field suture senario ... we know that this enviroment is far more "unsanitary" the risk of infection increases, so just who takes it on the wrist when the patient developes infection and then becomes septic ?

As things progress here, it is now looking that this could become another wake up call ... I certianly hope that the things we learned from SARs will be applied .... I just wonder why EMSCC are getting acolades as the real experts advice should be Infectious Disease Control or HERT whatever, I have had dealings with this group and some have seriously lost the "reality" of the field applications, never the less, I have quoted this good advice again. I have seen EMSCC talk the talk but many times don't walk the walk, maybe there getting more proactive. Just thought I would highlight some issues that were clearly defined as "weakness" by EMS the last go around, assure that your cleaning agents are anti viral, check your inventory on N 95 and Hepa filters, Swine Flu has been reported in the US already .. and I cancelled my trip to Sunny Mexico with some of the updated stats and reports, but yet again the media has picked this up and will fan the flames. Observation: I was sitting in a ambulance bay for 3 hours one day on a "wait and return" and noted on transports Departing and considered Isolation (MRSA) that the driver would do stretcher handling gloved, then hop in the seat gloved, very few actually removed gloves or washed before hopping in the cab (thats is when they removed gloves) Then: Ambulances Arriving the Drivers would be gloved but rarely did I not see the Cab being cleaned after the call, maybe the steering wheel got a gentle wipe BUT the Gear Selector, Lights, Door Handles well all I can say is .... ICK! Being rather Harsh but Honest: With a background in ICU and with MRSA and VRE outbreaks most EMS providers are extremely poor in this area of isolation and reverse isolation. It is my hope that if this does become a pandemic that "dirty truck's" and "clean truck" will be established although based on present "Ambulance confusion here in Alberta" the resourses will just not be available to address this situation let alone Ambulance but Hospitals are presently operating with very few beds to spare, IMHO we are no where NEAR prepared for this if it does escalate. I bet the BS "I have a tooth ache" or "Boo Boo" visits to ER will drop off radically (I would hope) but I have a cough will skyrocket ! Redcell19512 If your operator is looking to order PPE right now ... well that is just scary. I will be looking to purchase shares in 3M and Roche cheers

Yes and as a side bar ... Spanish Flu was responsible for ending WW 1. Back on topic .. EMS Chiefs may be having (although good advice for any and all possible contact with any patient with increased temp) a bit of a knee jerk, we so missed the Boat with SARS in EMS. Just checked the Public Health Agency of Canada (PHAC) http://www.phac-aspc.gc.ca/alert-alerte/h1...n_swine-eng.php The sky is not falling just yet . cheers