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  1. Clare

    Obestetrical Scenario

    I agree she does not need immediate referral or transport anywhere. She can see her GP.
  2. Clare

    Powdered Succinylcholine Question

    The suxamethonium in our kits is not refrigerated and we simply replace it every 3 months
  3. Clare

    Pediatric Arrest: parents wishes

    Ambulance personnel are obligated to do what is in the best interest of the patient, and if the patient is a child that must be in-line with the wishes of the parents. The exception to this being if a court orders treatment against the parent's wishes. This has been very rare and usually...
  4. Clare

    Scope of Practice Question

    If you really want to think of what will be clinically significant in terms of the biggest impact of saving a life then I'd say the following: - Arrest arterial haemorrhage (CAT or equivalent) - Defibrillation of VF and pulseless VT, and cardioversion of VT - Open and maintain an airway (OPA...
  5. Clare

    Foaming At The Mouth

    My diagnosis is intracerebral bleed until proven otherwise. I see nothing to indicate seizure, ischaemic stroke, meningitis, meningococcal septicaemia, traumatic brain injury or poisoning which are on my differential list. Treatment? Well, regardless of cause, from the pre-hospital...
  6. Clare

    Would benadryl help anaphylaxis any?

    Hmm ... here's a list of drugs what we call an Emergency Medical Technician can administer: Aspirin GTN spray Oral glucose IM glucagon Paracetamol Ibuprofen Oral tramadol Entonox Methoxyflurane Loratadine Oral ondansetron Salbutamol nebules Ipratropium nebules Oral prednisone Adrenaline IM and...
  7. Clare

    Would benadryl help anaphylaxis any?

    Personally I would not administer it. The single most effeitve treatment for anaphylaxis is adrenaline. H1 histamine antagonists such as loratadine or diphenhydramine are useful in providing relief from localised symptoms such as rash or itching but I know of no evidence showing they are...
  8. Clare

    the 100% directionless thread

    I hate being single more than anything ever and desire nothing greater than to be in a stable long term relationship. I am increasingly skeptical same will be realised. Compared to singledom, whatever other problems I have pale in comparison.
  9. Clare

    the 100% directionless thread

    Wow! It's Christmas, I'd best get to sleep before Santa comes, otherwise he might not bring me that spouse I've been hoping for!
  10. Clare

    Penthrox

    At Emergency Medical Technician level in New Zealand we have entonox, methoxyflurane, paracetamol, ibuprofen and tramadol I have never personally administered methoxyflurane. We carry it either as an alternate to entonox (if it is contraindicated) or where physically carrying entonox is not...
  11. Clare

    Medical Director Clearance

    For Emergency Medical Technician, you are automatically issued authority to practice (ATP) upon completion of the National Diploma. For Paramedic and Intensive Care Paramedic, there is a three-stage graduate internship once you are employed with the BHSc degree or PGDip (for ICP). 1)...
  12. Clare

    Help? Advice??

    The internship program to transition somebody from being a graduate to gaining ATP at Paramedic will become available in more locations, but you will still need to have the degree, which is available only through AUT or Whitirea. The additional locations for the internship will be limited to...
  13. Clare

    "Mercedes" Ambulances Sending the Wrong Message?

    We have two exterior doors - one is for access and the other is for the equipment cache where the response kit, LP15, portable oxygen, combi carrier, Mark 11 and stair chair are stored. On the drivers side there is an external door for access to the compartment where the bulk oxygen is stored.
  14. Clare

    Help? Advice??

    Emergency Medical Technician is either a Diploma in Paramedic Science (AUT) or the Diploma in Ambulance Practice (St John) and Paramedic is the BHSc through either AUT or Whitirea. You might get a paid position as an EMT with DipPSc or NDAP but yeah, competition is pretty stiff (especially in...
  15. Clare

    "Mercedes" Ambulances Sending the Wrong Message?

    The entire fleet is Mercedes. This is the latest variant. It's a custom module on a Sprinter chassis. Great piece of kit to work in.
  16. Clare

    Mental problems on the rise?

    Yes. A significant number of patients call for an ambulance for mental health issues. Clinical Control will often code these as orange or green which means these patients can wait extended periods for an ambulance, sometimes several hours when it's really busy as a patient with a mental...
  17. Clare

    What do you do in this situation...?

    Is there something makes ambulance personnel inherently incapable of making a logical clinical decision? No? Then why "pass the buck" and "let somebody else make it" - isn't that just poor form, pointless and lazy? If I called the Duty Shift Supervisor or my Territory Manager and asked them...
  18. Clare

    What do you do in this situation...?

    The answer here depends very much on your local legislative arrangements regarding competency and informed consent. If what they took did not need immediate assessment or treatment in ED (for example, they have not overdoses on benzodiazepines) then I would refer this patient to the community...
  19. Clare

    Identify yourself as an EMT to dispatcher when off duty?

    Clinical Control Call Handlers use a modified triage process for Doctors, Registered Nurses, Midwives and Ambulance Officers who are call 111 provided that a complete patient assessment and clinical diagnosis has been made. It's called the SEND Protocol. It asks something like: what is the...
  20. Clare

    EMTs doing Cardiac Monitoring???

    All emergency ambulances have either a Lifepak 15 or an older MRx (being replaced with 15s). All levels including Emergency Medical Assistant can acquire 12 lead ECGs. Three lead interpretation is taught to EMTs, 12 lead to Paramedic and ICP. In essence however, 12 lead interpretation is...

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