# ::EMS-> South Africa::



## Rangat (Aug 20, 2005)

Well, Matt EMT-B asked me to open a thread on RSA EMS... so hows about this...:

First, our levels: 

*First Aid Level 1,2 &3
*Level 4 expired, integrated into Levels 3&5
*Level 5 = Basic Ambulance Assistant (BAA)  (1Month Course)      MEEE!
*Level 6 = Ambulance Emergency Assistant  (4Month Course)
*Level 7 = Critical Care Assistant = Paramedic (1Yr Course)

Then, for further info, you will have to ask me!  :lol: 

But basically we operate completely on our own from the hospital, they don't tell us what to do al all. We give the drugs we want, and the hospital only knows, say, "Young Male Respiratory Distress, Priority 2, ETA 3mins".

So what else might I interest you in knowing?


----------



## MMiz (Aug 20, 2005)

Welcome (again)!

Does South Africa have Private / Public EMS?
What type of response times can one expect?
What are typical treatments / objects on an ambulance?
What kind of status do you have in society?  What kind of job would people compare you to?
How is EMS paid for?  Cash?  Insurance?  A mix?
What kind of oversight do you have?
Do you do any rescue work?
Cant kind of meds do you have on board?
Are you considered an ambulance with 1 trained person and a driver, or do you need 2 trained people?
What types of calls do you see a lot of?  Car accidents?  Cardiac arrests?  or is it varied?
How are patients that require dialysis, or non-emergent transport to a hospital transferred?  Do you have a private or non-emergency service?

Okay, that's enough for now, I look forward to hearing what you have to say


----------



## Speed (Aug 20, 2005)

I've always been interested in how EMS is carried out in desert regions, especially in the US, having watched "Emergency!" Snake Bite as a child. The Middletown Funeral Home Ambulance shows up, etc. I've been through the South West, and the desert regions, most of them are covered by SouthWest EMS and AMR; lots of helicopters. But the best place to find car chassis ambulances, that are still in good shape, reason being; no road salt. Big key player in rust in Northern US vintage ambulances. 

So, I 'googled' the topic, and found some info on wrecks in deserts in Africa, etc. They have some ill-equiped ambulances, and some odd ball ones. But otherwise it looked basically the same as we have here, except for the styles of gurney. Or as they called it, "the four wheeled trolley".  :blink:


----------



## Speed (Aug 20, 2005)

We also want a complete list of all of the equipment carried on your ambulances, like an inventory.

Seriously. I really want to know. If it's like the British and you have "ambulance dressing No. 2, 3, etc." Define what that means. 

I ask the same thing to old timers, to find out what ambulances were equipped with around the US anywhere from the 50's till now. Everyonce in a while, you find ambulances that have really odd named equipment, interesting too see and hear about.


----------



## Rangat (Aug 20, 2005)

I'm Flattered 






*Q: Does South Africa have Private / Public EMS?*
Both, I might just as well tell you beforehand that I am not a racist, but I will be making comments on different societies in SA (Effect of Apartheid). The Provincial EMS are slow responding, and mostly on the ambu's, badly disciplined. They don't have sufficient supplies, etc. Private services are the type of people that give 1st world countries uphill at EMS competitions. They are run as bussinesses, and have excellent infrastructure. They are the ones you call. The Provincial EMS mostly serve the Black community, although they overlap a lot. Thus they get the most experience.





*Q: What type of response times can one expect?*
In an urban area, with Private services, anything between 2 and 6 mins. They have Response Cars/  





*Q: What are typical treatments / objects on an ambulance?*
Suction; O2; Scoop; Spine board; 2 types of IV fluid; OP tubes, kernspregd* device; Defib... thats mainly.
Treatments: ALL trauma pts get cspine treatment, then most get IVs, and some get Morfine. 





*Q: What kind of status do you have in society? What kind of job would people compare you to?*
White ppl think we are heroes, and want to help, and ask questions, etc.
Black ppl (generalizing) think we are the police, they hate the police, thus they shoot at us, and disrespect us.





 <--- Ambu window h34r: 

*
Q: How is EMS paid for? Cash? Insurance? A mix?*
Mostly, contracts, paid per month. Not so big on Med Insurance and stuff.
Anything between R3000 and R22 000 p/m. Exchange rate= R/$: 6.45/1

*Q: What kind of oversight do you have?*
As in supervision? Provincial can do what they want basically, but private are quick to fire you if you screw up.
*
Q: Do you do any rescue work?*
Myself? Just assistance in extrications etc. Otherwise, the FD handles high-angle, and that sort of thing.





*Q: Cant kind of meds do you have on board?*
*What kinds?
Not sure. Not on that level. I can only give oral glucose, and assist in other things. The paramedics have dozens of drugs with them. And they administer without permission.

*Q: Are you considered an ambulance with 1 trained person and a driver, or do you need 2 trained people?*
There are the disgraceful companies. But are in the minority. All other ambu's have at least 2 qualified full time crew (at least one level 6), and perhaps a volunteer.
*
Q: What types of calls do you see a lot of? Car accidents? Cardiac arrests? or is it varied?*
A LOT of MVA's, mostly drunk teen's. And a LOT of minibusses. They are the taxi's of the Blacks. They alway's have place for one more- thus in such MVA's, there were usually about 20-40 people in the taxi. (Record=84)







Then there are the assaults. mostly blacks. Bicycle spokes, knives, GSW's, pipes, etc. But under that falls the rapes. These ppl are so perverted im not laughing now. There has even been a number of infant, and neonate rapes. God-Awfull.  

*Q: How are patients that require dialysis, or non-emergent transport to a hospital transferred? Do you have a private or non-emergency service?*
We don't really have non-emergency ambu's, the sucky companies do this, or otherwise, the private services make a good job of it.





 <---Sucky     <_< 



Hope you enjoyd my ESSAY!!!!     sorry about all da pic's. B)


----------



## Rangat (Aug 20, 2005)

> _Originally posted by Speed_@Aug 20 2005, 03:48 PM
> *Seriously. I really want to know. If it's like the British and you have "ambulance dressing No. 2, 3, etc." Define what that means. *


Havent you heard about FAD Dressings, SOS Dressings, Bomb Bandages...?





I Think they just have other names there... :huh:


----------



## TTLWHKR (Aug 20, 2005)

> *I Think they just have other names there... :huh: *


Son of a B-Scratch. I accidently hit the report button, and posted my reply... I meant to hit the "quote" button.  :blink: I took a couple vicodin, so I'm kinda loopy. ANYHOo



> *Havent you heard about FAD Dressings, SOS Dressings, Bomb Bandages...?*



Nope, you'll have to define those too. I call everything over 8x10 a 'universal dressing'.

*edit* I had my w's confused with my O's and the P button is too damn close to the O... I need a key board w/ like large keys w/ at least 1/2" between each key.


----------



## Firechic (Aug 21, 2005)

Thank you Rangat! That was a very interesting presentation. I appreciate it.


----------



## Rangat (Aug 21, 2005)

OK, their all the same thing...
FAD= First Aid Dressing. Size 1-7
SOS Bandages. Size 1-7
Bomb bandages. Slang, came from the IIWW, They used them there more than anything.     Basically they look like this when rolled open:

   ===►=========================


----------



## Jon (Aug 22, 2005)

> _Originally posted by Rangat_@Aug 21 2005, 04:14 AM
> *  OK, their all the same thing...
> FAD= First Aid Dressing. Size 1-7
> SOS Bandages. Size 1-7
> ...


 that sounds like the "bloodstopper" bandages that galls sells... a 5x9, folded over, glued to a roll of kling...

Jon


----------



## Jon (Aug 22, 2005)

Here's a question..... Has EMS service advanced in the 10+ years since the end of aparthiad? I'm not trying to get into a really political discussion, but are your services rather intergrated, or mostly white still??? you talk about being shot at by some of the umm, darker skinned folks who seem to ysee you as the Police  h34r: (and after years of opression by the goverment, are probably more than a little bitter  h34r: )

Jon


----------



## Rangat (Aug 22, 2005)

HA!, worthy question.

Just for the record, I am not at all touchy on naming, or any other topic- So, yes, the *Blacks*, are anti-officials.

To asnwer you Q, since the New South Africa, the Rainbow Naition, there has developed an official policy called _Black Empowerment_. Which was a good idea and all, exept it's like eleven years later, and it hasn't stopped. <_< 

Thus, effect, ppl getting jobs are as follows:

1. Impaired ppl
2. Black women
3. Black men
4. other coloured races
5. White women
6. White men....... (ME!) B) 

Thus, effect, economy collapse, tech collapse, everything took a dip. 
And because we didn't give them proper schooling, there is hiper-unqualified Black ppl in very high jobs. :blink: 





So, enough background... EMS has considerably Blackened, espesially Provincial (90%). But they don't have the insight to be good medics- don't get me wrong, there are very good black medics, but all of them are on level 5 or 6. You don't really get them on Paramedic level, they gust can't make it... :unsure: 

So, overall, I think SA EMS is better than 10 yrs back. But if you want supervised world class treatment- you call Private.


----------



## Cap'nPanic (Aug 22, 2005)

Sounds like SA version of American Affirmative Action policies, mostly a bunch of BS if you ask me. Hire whoever is the most qualified for the job REGARDLESS of color, ethinicity, etc. If the black man is more qualified than the white man, then hire the black man. If the white man is more qualified than the black man, then hire the white man. THESE ARE PEOPLES LIVES THE GOVT IS PLAYING WITH!

My two cents.

-Capn


----------



## Rangat (Aug 22, 2005)

Yeah, it's exactly the same. The official name is also Affirmative Action here.   

Only, now, all goverment staff are black. oops.   

 It just didn't stop. :huh: 

And please don't mind me saying that it is VERY frustrating when your countries' bussinesses fold because all top management were fired, and the Black ppl they chose to put there has an ID of about plus minus give or take approximately    '60'.  <_< 

BUT this is turning very political.  

So, yes, there are worse pt care because of this...  h34r:


----------



## Rangat (Aug 23, 2005)

What? Is my presentations sooooo good, that you don't wan't to know anything more?  :lol:     B)


----------



## TTLWHKR (Aug 23, 2005)

Still need a complete list of what is carried... :lol: 

and wtheck is aparthiad?


----------



## Cap'nPanic (Aug 23, 2005)

TTLWHCKER-

Apartheid is where you seperate races w/o making them equal.

IE- used to, ALL blacks in SA had to carry a "work permit" to be able to go to work in another part of town from where they lived. And blacks could only live in certain areas, usually the slums. Their rights were limited. And the funny thing is during the SA civil rights movement there were MORE blacks than whites. The minority group had all the control. After Nelson Mandela took over things kinda got switched around. Im sorry things were bad for blacks back in those days, but as I said in my earlier post, whoever is the most qualified to do the job should be hired, regardless of skin color or ethnic background.

-Cap'nPanic


----------



## Rangat (Aug 23, 2005)

Actually in principle, Apartheid is not a bad thing, since all it means is You stay there, We'll stay here, and we live out our cultural differences seperately of each other.

Only it couldn't be done so clean because the Blacks wouldn't stay peaceful, they want the whole Africa for themselves deep down.       It's getting better.

And it all wouldn't have happined if slavery wasn't implimented in the first place.

Lots of healing needed.


PS. Apartheid is Afrikaans for 'Apart'. The -heid meaning like apartdom/apartion.

'Seperation' being a good English alternate.


----------



## MMiz (Aug 23, 2005)

Rangat,

Oh come on now.  On a political note, the black majority maintained almost no political leverage or control.  America too tried the whole "Separate but equal" thing, and you and I both know it WASN'T equal.

Access to education, medicine, and almost every other social function was limited or restricted to blacks.  

Lots of mending to do


----------



## Rangat (Aug 23, 2005)

Yeah true, I never said it was done right, I mean, even when I was small I knew the Blacks shouldn't be treated like that.  

All I said was that if carried out correctly, Apartheid is a system making both parties equal, self-sufficient, and uninfluenced. Although it will take a genious mastermind to plan it correctly, with everyone happy. It didn't happin. :unsure: 

And i'll tell you now that even with a mastermind it won't work if there are feelings of revenge and racism on either side. A war will eventually errupt, like in the Gaza strip. But hey, more work for us. h34r: 

As, you and I said, it never was equal.


Im working on an Equipment list...


----------



## Rangat (Aug 23, 2005)

OK, first off, most of the ambulance co's don't really have too much stock on the ambu itself, they have more than enough of everything that they need in jump bags.

Stock list (BLS):

gause + sterile g.
variety crepe bandages
variety SOS dressings
eye patches
triangular bandages
Tampons
CPR barrier devise
BVM
variety O2 masks + tubing
AED
Childbirth kit
burnshield
Anti septic stuff
Natural Tears
Stet + BP
Strapping, steri-strip, etc.
and then band-aids and all that small stuff.
OP tubes

Equipment list:

KED
Scoop
Spineboard + spider straps
PVC cervical collars
Suction
Space blankets etc
Traction Splint
Half spine board


Personal gear:

ER scissors
LED pupil torch
Dorcy Spider Xenon torch
Cold Steel L&S Rescue knife
pen


OK, the ALS list is much more extensive, but i'll try and get it for you if you wish.

Next Q?


----------



## Rangat (Aug 23, 2005)

HA, I found the Paramedic Jump Bag Contents:

SAFETY/RESCUE
5 Pairs Dermagrip High Risk Gloves
1 Rescue Scissors
1 Rescue Blanket
1 Aids Shades

AIRWAY
2 Yankauer Suction Catheter
6 Assorted Soft Suction Catheters
1 Oropharyngeal Airway Size 000
1 Oropharyngeal Airway Size 00
1 Oropharyngeal Airway Size 0
1 Oropharyngeal Airway Size 1
1 Oropharyngeal Airway Size 2
1 Oropharyngeal Airway Size 3
1 Oropharyngeal Airway Size 4
1 Syringe 20ml
3 Trachy Tape
5 Sachets KY Jelly
1 Magills Forceps - Adult
1 Magills Forceps - Paed
1 Scissors Sh/Sh
3 ET Tubes - Assorted Sizes - Uncuffed
3 ET Tubes - Assorted Size - Cuffed
1 Halogen Laryngoscope 4-Blade
1 Large Introducer - Disposable
1 Small Introducer - Disposable

BREATHING
1 Resuscitator - Adult
1 Oxygen Tubing
2 Rebreather Masks
2 Nebuliser Masks
2 Elephant Tubing

WOUNDS AND BLEEDING
2 Trauma Pads
6 First Aid Dressing No 5
3 First Aid Dressing No 3
1 Gauze 75mm 100's
5 Sterile Gauze 5's
1 Adhesive Tape 50mm
1 Antiseptic Solution 50ml

BURNS
3 Burnshield 20 x 20
6 Burnshield 10 x 10

FRACTURES, SPRAINS AND STRAINS
5 Triangular Bandages
2 Crepe Bandages 75mm
2 Crepe Bandages 100mm

I.V. THERAPY
1 Ligature
3 IV Cannulae 14G
3 IV Cannulae 16G
6 IV Cannulae 18G
3 IV Cannulae 20G
3 IV Cannulae 22G
3 IV Cannulae 24G
2 Blood Administration Sets (10 Drop)
2 Solution Administration Sets (60 Drop)
2 High Capacity Administration Sets
2 NaCl 200ml
2 Ringers Lacate 1000ml
2 Gelofusine
20 Alcohol Swabs
1 Pressure Infuser
4 3L Transparent Dressing 60x70

DRUGS AND ADMINISTRATION
     NO DRUGS SUPPLIED

20 Alcohol Swabs
30 Assorted Needles
10 Syringes 20ml
5 Syringes 10ml
5 Syringes 5ml
5 Syringes 2ml

DIAGNOSTIC EQUIPMENT
1 BP Cuff
1 Stethoscope
1 Pupil Torch with Batteries
1 Rectal Thermometer
1 Oral Thermometer
1 Haemoglukotest

MATERNITY
1 Baby Swaddler
3 Scalpel Blades
2 Dr Whites
1 Plastic Bag
3 Cord Clamps
1 Scissors Sh/Bl
1 Mucous Extractor
2 Linen Savers


Satisfied?


----------



## MMiz (Aug 23, 2005)

What do you do with the tampons in the BLS kit?  Seriously I can't think of a real medical need for tampons.


----------



## Rangat (Aug 23, 2005)

Thought someone would ask...

They work very effectively for GSW's, since they swell, and fill up the hole nicely.


----------



## MMiz (Aug 23, 2005)

I can see it now.  Medic to Hospital: I have one GSW to the head.  Applied one Light tampon but bleeding continued.  I've gone ahead and upgraded to a Super tampon and bleeding is now controlled.

 :lol:


----------



## Rangat (Aug 23, 2005)

LMAO...

HAHA, You should try it sometime!!!  



No, it really works hey.


----------



## Jon (Aug 24, 2005)

> _Originally posted by Rangat_@Aug 23 2005, 06:04 PM
> * LMAO...
> 
> HAHA, You should try it sometime!!!
> ...


 I get the Brigade Quatermaster catalogs.... they include several pages of thank-you letters and "war stories" from Iraq and Afganistan..... they are like Galls, only more Military stuff....

They had a story last month... apparently, they have donated "goodie bags" that go out with orders going to combat zones / troops..... stuff that has been donated by "whoever" and is shipped over with an order.... Apparently one of the "guy" soliders with a funny name (like Leslie) got a "girl" goodie bag... had some tampons.... good for a laugh, and he didn't know what to do with them, so he threw a few in his pocket, figuring he might find a use for them.... Ended up with a buddy getting shot in the chest, lots of blood, pnumothorax, etc..... he plugged the hole with a tampon and the bleeding stopped.... saved the guy's life, and apparently one of the wives sent a large package over for the unit soonthereafter....

Jon


----------



## TTLWHKR (Aug 24, 2005)

> _Originally posted by Rangat_@Aug 23 2005, 12:52 PM
> * OK, first off, most of the ambulance co's don't really have too much stock on the ambu itself, they have more than enough of everything that they need in jump bags.
> 
> Stock list (BLS):
> ...


 Much like what I -used- to carry in the back of my SUV...   Except for the scoop. I do have one, but I fear it is rusted in place, inside the backboard box atop my 75 Criterion Cadillac.


----------



## Rangat (Aug 25, 2005)

Tampons?


----------



## Jon (Aug 25, 2005)

> _Originally posted by TTLWHKR_@Aug 24 2005, 08:16 PM
> * Except for the scoop. I do have one, but I fear it is rusted in place, inside the backboard box atop my 75 Criterion Cadillac. *


   :lol:     B)  B)  :lol:  :lol:


----------

