zippyRN

all this means is that the frankly pretty poor automatic interpretation thinks there is too much artifact ... the cardiologists had the medical equipment people turn the automaticinterpretation off on everything in the Hospital with automatic interpretation because even with brilliant quality traces from a diagnostic machine running off interna l batteries etc etc etc it;s still usually wrong

so you aren't actually in a position to comment about training and education then are you?, as Phil points out to deliver training in the Uk you are required to have a at the very least NQF level 3 or 4 training qualifications and with those qualifications you can only deliver training and education upto NQF level 3 - and for many training and education roles in preparation for healthcare professional practice it's going to be NQF 6 or 7 award that is required as a comparision a level 3 qualification is university entry , level 6 is Bachelors degree (1st cycle Bologna completion) and level 7 is post graduate I have a level 6 training and education qualification specific to Healthcare Education - this particular 30 credit ( 1/4 of a year of university) is known as 'Supporting Learners in Practice'- however this doesn't make me 'an Educator' what it does allow me to do is supervise students and conduct assessments ... and becasue i hold a full Bachelors as well act as a sign off assesor up to degree level. those in education roles have or are working towards 'full sized' training and education qualifications and for health professionals this will be a Post graduate certificate in Education or a Masters in healthcare education as for 'most english citizens don't know fake emergency runs take place' only if they live in a cave , don't watch the TV, listen to the radio or read Newspapers ... plenty of coverage on the issue inthe UK as we work to reduce the already pretty low RTC rate involving emergency vehicles and the police work on ending pursuits sooner and safer ... including doing live 'practice' TPAC when the only 'stooge' is the vehicle that is going to get PACked ... Scott has posted the facts - now if the antis wish to rebutt .... bring it on which 'medical educators' ? Lecturer, Lecturer-Practitioner, and Practice Educator staff working for the service or a HEI provding pre and post reg courses for the service ? of course they are out in the field with students and with competent practitioners - how do they maintain their clinical currency otherwise, but equally students aren't always going to be with lecturer - a fair chunk of the time they will be with the Paramedic equivalent of my training education role as a Nurse - An experienced practitioner with a Supporting learners in practice award - different titles exist but quite a few UK services call the clinical team educators or field based assessors ... similar. emergency driving specialist instructors ? - they are going to have generally come from an emergency services background and hold the ADI award as well as the education and training qualifications - they may not be paramedics, they may not even be qualified beyond first responder if their emergency services background was police or fire ...

EU generic Answer If the vehicle has a MAM of greater than 3500kg the driver needs a cat C1 or cat C licence - and therefore has to meet the higher medical standards for commercial vehicles, if the MAM of the vehicle was to exceed 7500kg then a Cat C licence would be mandatory if the vehicle has an MAM less than 3500kg the driver needs a cat B licence which is a standard car licence, Uk specific points those of us with grandfather rights to C1 will be held to those medical standards by the employing agency if it's any good ( certainly the NHS and the VASes do) the NHS and the VASes hold people to the 'vocational driver' medical standards for cat B driving insurers will specify training in the legal gap of exemptions ( i.e. other than S.19 Road safety Act speed exemptions when the secondary legislation is passed) they will also as othershave stated refuse to insure people with valid licencnes but insufficient experience to too many / wrong types of penalty endorsements/ driving offence convictions

which is a symptom of how messed up the system in where you live, and why trumpton needs to get out and stay out of EMS

dustdevil with regard to the point of can't experienced medics act as supervisors on real runs whereare we expected to find the funding and the time to take experienced medics off the road for up to a year to become educationalists and a driver trainers or Approved Driving Instructors and develop their skills at instructing emergency driving ? Yes CTEs are educationalists to a degree but they are not emergency driver trainers there's a horrid little point here called " the level of skill of the ordinary man professing to hold the special skill" Suburban / urban issue - traffic volumes and densities across the UK are much higher than they are elsewhere - there are 'Cities' in the USA who would barely register as a Town in the UK... in terms of training runs being terminated if you are driving safely and to the System of car control the decision to terminate a particular manouvere of decision can be made at the go / no go point ... in terms of a lack of proof i think he road safety statistics from the UK tell all ...

it's not a 'fake' because the law doesn't require there to be 'an emergency' for a driver to claim exemptions and/ or use warning devices .... only that the purpose the vehicle is beingused for would be hindered if exemptions were not claimed and/or warning devices not used ... while the CPS and the Courts continue to accept training to be a valid purpose ... equally the levels of traffic in the Uk mean most emergency drives are 'suburban' in nature if not urban ... in terms of the Fire service and the Ambulance service the response times are tight ( remember the clock starts ticking when the call is connected to Comms - which means even if you dispatch the monent you have an address and the start of a presenting complaint you are going to eat up a minute of more of the response time - even if you are sat in the vehicle ). In terms of EMS calls volumes it is not unknown to have 10 mile urban rush hour blue light runs ... Dust either you are trolling or you have got a serious understanding issue this week ... a training run can be terminagted at any time by the Instructor - without detriment to service provision. This is not achievable with an in service resource as terminating a run and changing drivers will add minutes to the response time the point which you appear to fail to have grasped is that these training excercises are undertaken with a proper emergency driving trainer, someone who is either an experienced Ambulance officer and Educationalist assessed as competenent to teach and supervise emergency driving or an as defined by the law Driving Instructor who has emergency driving competencies. the alternatives suggested fail on the following reasons simulated traffic - its simulated - fail live runs - service pressures , absence of suitable supervisors once again it's abundantly obvious that no amount of reasoning will change the viewpoint of the dumbass leftpondians who believe that AmeriKKKa is always right and the the whiny liberal fags in Europe never get it right

you don't even need to move the roller clamp - just make sure it's shut before filling the drip chamber by squeezing

it's a decision the intelligent provider will make case by case ... depending o nthe what else found there are strong arguements either way and no amount of armchair quarterbacking will make the right decision ... there is also the issue of immobilisating the elderly becasue of the age related physiologicla changes ...

to the rest of the board i apologise if this seems to be personalised and instrusive towards Mr. gift , but his repeated inability to enter into meaningful debate leads to the need to ask these questions so Mister ( or is it Master ?) Gift do you actually have the slightest clue what you have been spouting about , because i strongly suggest that you don't your answers strike me as those of someone who those with experienced and knowledge of the theory of education and training delivery would call an 'unknowing incompetent' in that you do not understand that there is a awider field beyond that of your own limited training and experience and do not understand the processes underpinning the preparation for practice of those in other places or whose scope of proactice is different to your own you state that you are an emergency driving instructor are you 1. some who holds the necessary professional and legal accreditations to deliver ab -initio driving instruction for reward ? 2. someone who holds a nationally recognised teaching and assessing qualification which allows you to teach in post compulsory education? 3. someone who holds a nationally recognised teaching and assessing qualification which allows you to teach in Health professional education ? 4. do you hold a bachelors Degree from an internationally recognised Higher Education Institution or Higher Education Qualification awarding body which would be recognised as a First cycle completion award under the Bologna Process ? 4a. if you don't hold $ above do you hold a vocational or technical award from a recognsied educational awarding body which fits into the National Qualification Framework at the higher education level ( e.g. the UK BTEC 'Higher National' awards ? or are you just a proof by assertions 'Training Officer' ? this is not legal loopholes, this is well drafted legislation that you appear to be unable to comprehend can you ? when EMS - during a shirt period of third manning on an ambulance prior to being let loose as part of a 2 person crew with your preceptor? Fire - from the back row of seats in an appliance? Police - during a short period of working with an experienced officer before gettign independent status if it's not your driving it's 'armchair quarterbacking' and not of a huge amount of value - certainly not of as much value as 'real' practice whether as part of real as possible simulation or in actual practice you really are an utter tool if you think practicing procedures on cadavers is appropriate ... you continue to use the word 'fake' , which demonstrates that you have little or no understandign of what you have been told aobut the liegilsative position in the UK interesting definition of 'malpractice' as well if the risks were not acceptable then it would not be undertaken, especially given the maturity of Health and safety legislation in the UK and the EU as a whole compared to the Leftpond inconvenience measured in seconds and compared to some of the ignorant fools driving o nthe road far less inconveniencing ... you also seem to forget that as has been repeatedly stated because 'live training' using warning devices and claiming exemptions does not have the imperative of the clinicla and or organisational pressure to reach scene, that it can be stopped dead instantly if the the supervising Instructor feels that tthat is the most approrpaite course of action at that time. 'annoyance on the public' is only an issue in the kind of messed up system where senior managers have to win publicity contests ...

it's called the 'anaesthesia placement' - anaesthetists spend their days intubating patients without a medical need for airway control to facilitate surgicla procedures Reductio ad absurdum to trolling at best - 2 /10 Reductio ad absurdum to trolling at best - 2 /10 Godwin's law time there is no 'fake emergency' there is closely supervised and regulated practice of driving while usin g warning devices and/ or claiming exemptions, the legislation in the UK permits the claiming of exemptions where not claiming the exemptions would ' hinder the purpose of use' there is if you knickers are in that much of a knot make a UK FoI act enquiry to the respective driver training departments ( all 70 or so across police / fire / ambulance for the stat services will cover the vast majority ) about the number of RTCs they have had in training and how many of those were not the usual 'RTCs' found in the UK emergency services community of the endless toll of low speed oops when manouvering I can't remember a documented training RTC of any significance ... given that an Emergency vehicle RTC that results in a strategic route closure, hospitalisation of of crew/ patient / detained person or a fatality will be national news for day or two and regional news for several more days ... i'd suspect the figures are low. ridiculous tradition ? or valid training model ? you have so far failed to provide any reasoning why the model in the Uk should be changed and many of your arguements display ignorance of the realities of the situation in the UK, and many of us do so , but how exactly do you practice claiming exemptions if you can't claim those exemptions <snip> there's only one or two 'returning' in most EMS shifts inthe UK - returning for your longer break if you return to a station rather than taking the break at hospital or 'as a visble part of your community' same for police officers your hose monkey background shows you have hung on to the concept of 'fake emergent runs' a concept which simiply does not existin the UK becasue of the way in which the road traffic and warning devices legislation is written, there is no requirement for an 'emergency' for designated emergency vehicles to be able to claim exemptions and /or use warning devices ... only a burden of proof on the operator and organisation to satisfy the bench that the purpose the vehicle was used for would be hindered if exemptions weren't claimed and warning devices not used. ai also note how the lissue of the widespread use in the US of warning devices on POVs to respond to station hs been skirted around along with the far greater use of POV as emergency vehicle to respond to scene ... which as phil pointed out - good basic driving and the 'advanced' / 'defensive' driving techniques that is what the first week or so of 3 week driving courses is for and what the 'basic driver training' that none response / limited response trained personnel undertake is for.

people keep puitting great stock by EVOC how long a course ? how many hours on the road? how much time spent getting people used to the dimensions of the vehicle etc? how much time spent making sure people can drive these vehicles according to The System Of Car Control before being let loose in even none emergency conditions? how long in as controlled as can be emergency conditions ? ( which in the UK is achieved by the accepted and acceptable use of warning devices and the claiming of exemptions for training purposes as recognised by the law) if nothing this thread has demonstrated how much someone don't know they don't know. all of which a strictly against the clock, the 8 min cat A response standard and 14/19 minute hot send other Emergency response standard is from when the exchenge provider connects the call to Comms, not from dispatch, not from pressing 'red mobile' on the terriblefix ... the main advantage of live emergency driver training is that it can be stopped at any time by the instructor , the driving student or other students for safety reasons ( using dgood CRM techniques), there is 'no against the clock 'pressure

it's some what irrelevant 'right of way' is a set of rules for agreeing who goes first , not an absolute rigid code Uk emergency vehicles 'request' the right of way by use of warning devices and their positioning what happened to the rule of 'space and time to stop' for the umpteenth time the use of warning devices is a request for other road users to allow the emergency vehicle through ... but not in the UK unless they willfully obstruct a specificed Emergency worker or Police Constable in the execution of their duty ... 11 or 12 regional Ambulance services undertaking 2000 -4500 emergency and urgent details a day - a significant proportion of which will attract at least one if not more emergent responses ( one scene = one detail whether it;s a cut finger or 60 casualty Mass casualty incident with 20 front line vehicles, control and equipment tenders etc etc) 30 odd regional fire and rescue services, 30 odd regional police services plus coastguard, search and rescue, national blood service , various military vehicles ... plus the private and voluntary sector in EMS and Fire 100 k is a ball park figure, possibly a little optimistic.

are any of these studies relevant to the UK setting ? as has been posted in this thread previously individual Uk ambulance services run several thousand calls / day day in day out across the dozen or so Uk services , an emergency driving related fatality in the Uk is National News becasue iot happens so infrequently how can you do the same training without live emergency conditions runs do you really feel confident aobut the prosepct of the first time someone uses warning devices and claims exemptions on the public road being aginst the whatever arbitrary figure your service wishes to see on the stopwatch in Comms ? if these 'fake' runs were 'joy rides' and were being undertaken by unsupervised staff rather than being supervised by Training officers or Specialist instructors ther might perhaps be some justification in the criticism, but for anyone from the vast majority of the USA to suggest that any Uk practice regarding warning devices is excessive is living in a dreamworld. and the Ambulance run in the you tube clip is not in the UK looks to be France , based on -LHD vehicle -French Registration plates - the type of bus that passes the other way ... the EFAD run is in the Uk the maximum speed noted on the video i saw oin the first stretch of single carriageway road is 67 mph the speed limit for a car on that road would be 60 , for a none emergency vehicle HGV 40 mph, the average UK fire appliance even if it; is Volvo or Scania is a custom designed and built vehicle and enginerred to perform appropraitely under EFAD conditions aslo note that the heavy, standing traffic at 2:58 they Stop dead, and switch off warning devices rather than blow through the temporary traffic lights ( no exemption same as when you reach a railway crossing) it is also notable that the in town stretch following the temporary traffic lights is condiucted at below the speed limit although other exemptions are claimed 6:02 another dead stop as for the camera view , that is the camera you would get from any Operational vehicle in the locla fire service fleet as they all have them ... to aid accident investigation and provide evidence against those who obstruct them

I hate to break it to you but UK emergency vehicles and warning devices legislation doesn't require an 'emergency' for a driver of certain classes of vehicle to permitted o claim exemptions and/ or use warning devices , only that the purpose the vehicle is being used for would be hindered by not using warning devices and/or claiming an exemption. The Services, CPS and Courts accept that live training is an appropriate purpose. if you have a collision while claiming exemptions whether training or real you will be prosecuted to the fullest extenent of the law and the accident investigation from a criminal point of view will be exemplary becasue the Specailst crash investigators from the the Raod policing Unit will investigate it in the fullest becasue they realise that their investigations are a significant part ofthe evidence base of what is and isn't acceptable behaviour when claiming exemptions and driving using warning devices. which is patently untrue sadly the services, CPS, courts and professional bodies feel otherwise i'd go and read the relevant legislation or even the Uk Highway Code, the Uk does not have mandatory yield legislation, instead relying on intelligent use of Obstruction legislation rather less than every whackerin the township running lights and noise to fire house or scene for a 'cat up tree' they will get laughed out the courtroom, irrelevant to the discussions, yest we all spend part of our basic none-operational driver training on a car park with cones and that can it ? well in Whackersville where 16 hours training is considered excessive ... irrelevant

so real as possible simulated training is moronic is it ? so it's moronic for give you supernumerary ride time with preceptor in the back as well ? the main benefit of this training activity is that the plug can be pulled there and then by the supervising instructor with no disbenefit to service ... perhaps it's Moronic for your first live emergency drive to be a simulation or tasked as an supernumerary resource, and with a qualified Emergency Driving Instructor in the passenger seat and 2 other students observing your performance for their own and your benefit. and as an FYI UK emergency vehicles do not 'TAKE' right of way it is given by other traffic , if you'd done a little research you've also know that UK Emergency vhicles treat Red (permanent) traffic signals as 'give way' signs and many services have a policy that the stop line must be crossed at <10 mph or even that the vehicle must come to a stop before crossing the line. funny definition of 'joy ride' -planned training excercise -OiC the vehicle is a driver trainer / driving instructor - routes, safety camera activitations and any near miss or actual incident has to be logged with control and with the police. any actual incident (training or real) when warning devices are used and /or exemptions claimed will be fully investigated by the service and the Roads Policing Unit. depends if we are talking about whackers with little or no training or people with several weeks of drver training in addition to a full EU Driving licence for the class of vehicle ... or you have properly specc'd vehicles with single button/ switch / slider emergency warning system controls and foot pedal/ horn ring siren tone change controls 3 to 5 days of the three week driving course undertaken by full time emergency services is emergency driving the first two weeks are aobut good basic driving and good 'davanced' driving ... the course spread far and wide my brother is a police officer on his police response course they touched both coasts ina day beginning from pretty near the middle of the country i currently live approx 5 miles away from my local police force driver training and development centre ... on average 1 or 2 days a week ( but not every week) i see driver training cars on blues for perhaps an hour or so vs, the several hundred emergency responses a week from the local police station and the Roads Policing unit based there

DO NOT REMOVE THE PATCH ! any predominatly agonist opiate / opioid couldbe used for breakthrough / additional pain relief

who would you rather regulate the use of ambulances ( and ambulance like vehicles) and ambulance techniques for none emergency work ?

well other than the resource implications of tying up 5 personnel ( 3 or 4 of whome are extraneous on scene , but the appliance is offthe run becasue it's tasked) and a 250 thousand GBP piece of apparatus ... a Community FR responding ( at raod speed) in their own vehicle costs the cost of kit, training and comms a response vehicle costs around 30 - 40 thousand GBP and delivers a provider in the same manner as the fire appliance but with no extraneous personnel , no loss of fire + rescue asset and with a smaller carbon and financial footprint replace your one misused fire appliance with 4 or 5 EMS response vehicles, a mixture of EMS response vehicles and ambulances or tens of CFRs to provide essential early links ofthe chain of survial ...

usual factors local legislation may make it hard to get novel systems approved the inbuilt resistance there appears to be on the left pond to changing working practices, and becasue USAn manual handling legislation has nothing to say on ambulance trolleys .... cost is an issue as the system runs to something like 9000 gbp for cot and mount (pennies compared to the kind of settlements people get i nthe Uk for manual handling related injuries ) but becasue EN1789 compliance is often specified in contracts iot's a price that has to be paid.

answered as a Nurse a direction to adminster is organisationally required for certain classes of medication, and legally required for other classes of medication and Blood and Blood products - this direction to adminster can be in a number of forms , not all forms require the 'signature' of a registered medical practitioner ( a patient specific direction generated by someone with independent prescribing rights stands as regardless of the profession of the prescriber, certain of the organisationally required guidelines do not require a medical signature, where a patient group direction does at present but the legislation surrounding PGDs pre dates the exapnsion of prescribing ) other 'treatments' Nursing guidelines are written by Nurses for Nurses, Medical staff are involved in writing some of of these guidelines but equally other professions are involved where the guideline is applicable to those other professions. the UK does not have the (billing related) requirement for medical devices to be sold 'by or on the order of a physician' a simialr situation applies with regard to who is authorised as a medicla imaging referrer although the 'practitioner' responsible for the overall management of imaging may well not be a physician as it is possible for a number of other professions to obtain 'practitioner' status under IR(ME)R it's most commonly Radiographers and dentists who are practitioners other than radiologist doctors

whivch is why in the civilised world EN1789 requires proper construction standards for ambulance vehicles including all strucural elements of the body and that all locker facings and closures and equipment mounts must withstand 10 g impacts

Ferno CEN 6 series cots and 'lock and load' mounts solve many of the manual handling issues in one was well with decents cots a ramp / lift as wellas a 10 g crash stable locking system http://www.ferno.co.uk/products/ambulance/Trolleys http://www.ferno.co.uk/viewproducts/ambula...ing-Systems/25/

a Physician does not 'outrank' a Nurse or any other health professional in civilian life unless they are a General Manager or Executive Director of the organisation in addition to being a Physician ... in terms of radio Nurses it;s a pure symptom of the messed up way Pre hospital care in the USA is organised, professionalise paramedics and put them in a position to work to proper clinical guidelines on the strength of their own professional registration rather than under the licence of another health Professional ...

like what ? nothing that any other Als provider can or can't do with suitable operational guidelines for SCA of no value compared to an EJ perpherial line or IO open cardiac massage has no place in SCA with a 'medical' aetiology ... there may be a place in trauamtic cardiac arrest but you really need a field physician to do that ( e.g. successful field thoracotomies on patients with pentrating chest trauma as performed by london HEMS ... ) which is why leftpondian healthcare is so messed up banjos is banjos, doctors is doctors and paramuppets don't need none of that book learnin'

it's just the bass-ackwards way things are done on the left pond , here in rightpondia, there's one police comms centre per force area, one or two ambulance comms centre per service ( bearing in mind that services cover 3 ,4 or 5 UK counties) and the hosemonkeysare going to regional comms centres becasue they do that little compared to EMS and police