zippyRN

sounds pretty much a fair assesment ... i've stayed onscene and on one notable occasion had an offer to help at a (just )established scene accepted , of course ID and approrpaite PPE helps ...

the appointing manager should never known what is on your Health screening, all the appointing manager should get is a yes / yes with adaptations / no decision from the occupational Health team

wasn't this filmed in aus ? penrethane or some such related to the volatile anaesthetia agents so working on the same kind of premises as entonox and sub anaesthetic doses of ket being good analgesics

law or National governing body regulation ? 'trackside' cover may not be covered by any particualr law but there will be requirements from the NGB for cover it might range from a BLS ambulance for small moto cross events through the hundred + personnel with numerous ambulances, rescue + extrication vehicles, physician repsonse cars and full blown trauma ED on site that the big money series like Formula one and Indy cars require just for the track cover crowdside cover is likely to be under the same rules as other mass gatherings in the Uk this could be green and /or purple guides - often for motorracing it;s a bit of both green guide for the grandstands and purple guide for the 'parkland' bits of the circuit and the associated funfairs, markets and campsites...

most UK EMS personnel on shifts are doing either 8/ 10 or 12 hour shifts ... the EU workig time directive has limits ofn shift time in that there are daily rest and weekly rest requirements and there should be 11 hours between shifts ... also in most of the Uk 24s simply wouldn't work because it just doesn't stop ( there's a lull between 0300 and 0500 but that's aobut it ... ) i think there were a few tations in rural bits of Scotland , wales and the North East Ambulance area that were doing on call working at night but IIRC even that has been stopped now...

<snip> surely that's a function of the services you've worked for ... good services don't have lots of RTCs becasue the drivers are trained and both peer pressure and the management keep the excesses under control ...

training and education has part of it as does operation policy look at the UK's emergency driver training , Police, Fire (full time and retained) and NHS Ambulance staff all do at least 3 weeks emergency driver training before being let loose on the public roads with lights and noise ... i don't know how much driver training Aussie ambos do , but the urban guys and girls are all peopel with substantive contracts and those out i nthe sticks really are i nthe sticks where the biggest RTC hazards are hitting a roo or being mown down by a road train if you venture on the highway air ambulance crashes - the UK safety record is so good because to- scene operation is daylight VFR only in twin engined aircraft with either 2 pilots or pilot + trained air observers, to scene at night either doesn't happen or is in military or military type 3 crew aircraft (e.g. sea king family or Merlin) with NVG, nite suns ... etc etc the only First responders in the UK responding with lights and noise are people who had the 3 weeks driver training - so a few FR groups and 'staff' responders ( i.e. people who work for the service) retained FFs don't respond to scene in POVs ...

the issue arises as thereis apresumption in a 999/911 orientated system that people ring because they either 1. ) need or 2.)want to be transported to the ED. Event cover is a whole different kettle of fish as people attend for stuff they simply would not call an ambulance for outside and of course depending on the event there's a far higher rate of certain presentations ... e.g. trips and falls on uneven ground , burns and scalds where peopel are camping and /or having informal barbeques on a site , plus the high levle of alcohol and illicit drug use at music festivals / concerts ... there is also a particular pattern of presentation at stadium sporting events in the UK.

event cover needs it's own guidelines as to what can be discharged at scene and by whom without needing a 'refusal ' and a suitable PRF needs to be in place rather than a transport/911 oriented one ...

the obvious question is why did the guy/gal at 'the big desk at the back ' (i.e. the control room duty officer /manager not reassign when a closer unit came available - the dispatcher on the sector may be 3 or 4 deep in calls ., if his / her screen is full of clock ticking e calls , he stuff with resources running is the least of his worries ... no doubt the dispatcher also told the crew " it' says noo yawk on the side of the 'bus and the calls in noo yawk "

even if it is shut down 1. it's still a 'fast road' 2. there are still vehicles moving or going to move ... as for the shorts WTF???????

not innovative 20 year old idea in the UK when van body ambulances were reinvented and 15 + years in coach builts

if you don't wear the PPE required by your employer - prepare to be ejected from scene by the safety officer and disciplined by your employer if you don't wear the PPE required by your employer kiss good bye to a significant part of any insurance / compensation payments if you have a booboo - contributory negligence aside from any potential prosecutions under health and safety legislation at a bare minimum for an RTC or other extrication type scenario, or even a call to a construction site this means - suitable safety footwear - workwear/uniform covering ankle- to wrist - to neckline - in an ideal world this would be fire resistant - gloves appropriate to task ( e.g. nitrile or latex when hands on with the patient, leather work gloves / specific extrication gloves when handling other stuff - approrpaite head protection ( rescue helmet if not a full FF helmet) - appropriate hi vis for working on the roads...

scara you've just described some of the uniform styles worn in the UK there http://www.stjohnsupplies.co.uk/products/l...roductId=U17075 http://www.stjohnsupplies.co.uk/products/l...roductId=U14450 http://www.raf.mod.uk/rafmarham/stationfac...es/uniforms.cfm http://www.tks-uniform-insignia.co.uk/pics/wreath-pip.gif http://www.tks-uniform-insignia.co.uk/casestudy.htm

it's also why those who attempt to compared RN salaries between the uk and the US fall down they forget aobut the package theat being employed by the NHS brings with it index linked pension of up to half your final salary a minimum of & , yes & ( seven) weeks of paid leave a year ( 27 'days' or Annual leave and 8 public holidays) with additional leave for long service at 5 and 10 years the sick pay as discussed free life assurance

if he's got enough service ( 4 or 5 years depending when you started ) - less than that less paid sick time - onto SSP / IB sooner the NHS can reclaim sick pay over and above Statutory sick pay if you sue and get 'loss of earnings' money... moving and handling is a big issue inthe uk ( well most of europe) due to the manual handling ops regualtions which have pretty big fines attached for employers who haven't trained and risk assessed (or taught employees how to do dynamic RA) - this also applies to voluntary organisations (after a situation where a SJA volunteer died during a training exercise becasue of the negligence of an instructor)

successful egal action would get both the lost earnings and some compensation ironically if there were no lights then there wouldn't be grounds for the legal action...

i forget the name of the US doc who set all the NAScar side of things uo ( i have his book somewhere) , i also have Prof Syd Watkins book about the development of Resuce /EMS in Formula 1 -

trackside medical cover for 4 wheel motorsport in the Uk is regulated by the MSA who have specific requirements for physicians, paramedics and 'medical assistants' ( primarily Ambulance techs, nurses and ODPs) trackside cover is provided by a mxture of 'rescue ambulances' - with a larger crew including extrication specialists and a paramedic +/- doctor and supplementary 'ordinary' A+E ambulances - big events with also have medical ('Doctor's car') and fire Rapid intervention vehicles '2 wheel' motorsport regualted by the ACU is less regulated primarily becasue the requirement for extrication is a lot small er with bikes so the vast majority if not all ambulance cover is just regualr ambulances plus the physician response vehicle

the UK experience - works in the 2 places Central London ( but not the very centre - that's covered by pushbike responder) and Cornwall for different reasons London becasue it's near gridlock much of the time ... Cornwall becasue many of the roads in the tourist areas are little more than farm tracks with a bit of tarmac on them - and trying to put thousands of tourists down tohse roads really doesn't work ... other places fundthe unavailability due to weather unacceptable - Cornwall's problem is summer only problem so unavailability due to weather was less of an issue

or use high pressure high tensile steel/ carbon fibre cylinders - do any of your main suppliers supply them as a stock item ? here in right pondia both BOC and LINDE do them (HX and ZX from BOC - 'f size' package HX 2300 l in O2 2200 l in entonox zx 3040 l in o2 3970 l in entonox powered stretchers is an evolutionary dead end - tail lift vehicle and hydrulic trolley is the way to go ( see 'british' Ferno pegasus)

the obvious answers are opiates and /or nitrous as well as careful cooling then clingfilm on the burns

like what we say to/about our registrars in hospital when they are winding people up "chief monkey or deputy organ grinder?"

ideal EMS call centre has 'call takeers' who will be using an AMPDS like system for the majority of calls, however calls that make them uncomfortable should be able to be listened -in or taken over by a Clinical Triage advisor - an experienced Paramedic. Nurse or ECP with the skills ,knowledge and experience to be able to be trusted to think outside the box... having the respource allocators / dispatchers from a road background is better than havign them from a call taker background - ideally thisshoudl be rotational or established as fixed posts for people who wish to have 50 %road time and 50 % allocating

or no 'roadside' SSM (except perhaps for short periods in the day in the urban centres ) look at the Staffordshire model of SSM with a few 'depots' and lots of stand-by points with facilities - a building with a toilet, a crew room and basic kitchen facilities define fugly? how about :- a common uniform for all operational staff that doesn't make you look like a cop is a good start ... but no doubt many peoiple would object to a restrained version of european style uniforms ( by restrained i mean the darker greens generally used on UK uniforms) demarcate grades by a name badge on the breast pocket , and text / colours on epaulettes with my inhospital provider hat on - for hospitals / units using a paper based initiall management document- the ePRF must produce a good quality and reasonably compact report ideally plain paper and no bigger than 2 A4/ foolscap/ legal pages whether it printso nthe motor of via wireless networking at triage in the Ed / in the Resus room or on the reception desk of the Assessment unit... i don't care ... ( what i don't want is 6ft of thermal printer toilet paper...) OR integrate with the electronic charting system in use i nthe recieving hospitals