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  1. SpecialK

    Atypical STEMT Treatment

    Why? GTN doesn't treat STEMI. There's your answer.
  2. SpecialK

    EMS Changing Names

    In the rest of the world you'll just find it's called "Ambulance". To us "EMS" has always been a strange American term.
  3. SpecialK

    65 year old female

    What if we move her out of the sun and look again in 10 minutes, what do we see? Does she have any history of h hypertension? Wait 15 minutes and repeat get blood pressure?
  4. SpecialK

    Loadings and penalties

    Currently ambulance personnel receive a flat rate (which is not very high) regardless of whether working days, nights, weekdays or weekends. The only difference is the stat days which have to be paid at time and a half because the law says so. My friend who works for ASNSW can, on some...
  5. SpecialK

    Loadings and penalties

    I am curious to see who else gets paid what in terms of loadings and penalties? The current situation is essentially we get nothing apart from stat days. Most were abruptly removed decades ago with the first renegotiation post labour market deregulation and the few that remain are only for...
  6. SpecialK

    Favorite Manufacturer

    I've only ever been in Mercedes ambulances; both the walk-throughs and newer vans. They are very nice.
  7. SpecialK

    Chest Pain

    Oh deary me this patient is crook AF. He is having a nasty inferior STEMI which is likely to have taken out his right ventricle. The pressure gradient through the RV is very small (from memory it's about 10 mmHg at most) and because it can now no longer pump effectively that is causing his...
  8. SpecialK

    Let me ask you about uniforms...

    That is a neat idea, it is in effect what the hospitals do; staff are supplied their clinical dress by a centralised process. For Ambulance I suppose that could work; provided of course staff all started and finished in a central location. In a city or large urban area that could work very...
  9. SpecialK

    Post Intubation Sedation (pre-hospital)

    Sounds like you are using suxamethonium. This is good for elective anaesthesia requiring neuromuscular blockade but personally I think it's a poor choice for pre-hospital use. Why not use rocuronium (or another long-acting neuromuscular blocker) and a combination of midazolam and fentanyl?
  10. SpecialK

    Let me ask you about uniforms...

    Most ambulance services I know of use green (except one or two in Australia). I don't know of any cops who wear green, the ones I've seen all wear blue. If you want to not look like police constable I suggest green. You will also clearly see the shirts say "AMBULANCE" on the front which is...
  11. SpecialK

    Question to the experienced

    Agreed. If the fastest way to get a specific skill which the patient needs is by helicopter then use the helicopter, if it's by backup coming on road then use that. Of course remembering to factor in the time to get to the helicopter, get airborne (assuming crew are immediately with the...
  12. SpecialK

    Let me ask you about uniforms...

    Wouldn't black be too ridic stinking hot in the summer? If you have "AMBULANCE" in big letters it's not very hard to see the difference between police and ambulance personnel. It would be nice if the shirts had "AMBULANCE" in big letters on the back.
  13. SpecialK

    Question to the experienced

    Suctioning is over-rated and overused. Most patients you can turn on their side and they will actively keep blood or fluid out of their own airway by spitting it into a vomit bag. If there's a lot or the pt has a decreased level of consciousness then a bit of suctioning the mouth is usually...
  14. SpecialK

    Let me ask you about uniforms...

    For decades the uniform was a business shirt and pants. The colours of the patches and epaulettes changed but the basic design stayed the same. About five years ago this changed from a white shirt/black trousers to green shirt and green cargo pants. Practice level was taken off patches on...
  15. SpecialK

    Uk EMT coming in to say hi

    I didn't think you had Ambulance Technician anymore? When I talked to the LAS about going to London they said you had replaced them with an Assistant person?
  16. SpecialK

    Patient Advocay

    In the past it was the norm for more senior personnel not to be questioned, indeed, it was expected you would not question them. With the move away from the old vocational system to tertiary education, there has been a significant decrease in the average age of staff and a much improved...
  17. SpecialK

    Thoughts on High Flow O2

    I've never been taught to give everybody oxygen; in-fact, I was specifically taught first-off NOT to do so. Perhaps I am too young. Something like 98% of arterial oxygen saturation is carried on Hb; and about 1% or so dissolved in blood plasma. Under normal circumstances the Hb are fully...
  18. SpecialK

    Ondansetron as primary antiemetic?

    NZ dumped ... whatever the old antiemetic was, about a decade ago. I can't even remember what it was. Ondansetron oral for EMT, and Paramedic and ICP have IM and IV. EMTs will soon get IM too. Great stuff.
  19. SpecialK

    Overseas employment

    I know the LAS were hiring internationals but a quick Google seems to say this has stopped. I don't know about if any other English Trusts are doing it still. I think you'll find Australia doesn't do it anymore either but I could be wrong; they had a bit of a push to get Kiwi and English ambos...
  20. SpecialK

    To Degree or Not to Degree. That is The Question.

    You blokes are still arguing about needing a two-year qualification for paramedics? australia was doing that in the 70s and a bit of searching said we needed that in 1996. I guess you need to quickly decide if you want to come up to par with other first world countries or not then eh ....
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