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  1. SpecialK

    Any UK Paramedics out there?

    The show Paramedics followed NSW Ambulance vocational trainees. I've crewed out of two of the stations they filmed at. ASNSW is the only ambulance service in Australasia to still offer the old-vocational Advanced Diploma, all other services now require a BHSc or equivalent prior to commencing...
  2. SpecialK

    Any UK Paramedics out there?

    Yes, essentially the UK simply has "Paramedic" and that's it. A bit like Nursing, some Trusts have added various bits and pieces fo it and called them e.g. a Critical Care Paramedic (particularly SECAmb) and London has "Advanced Paramedics" which are an LAS-specific thing however most every...
  3. SpecialK

    Any UK Paramedics out there?

    http://www.hcpc-uk.org/apply/international/ and http://www.hcpc-uk.org/publications/standards/index.asp?id=48
  4. SpecialK

    Ketamine for RSI in hypertensive patients

    Bit late on this one, sorry chaps. My thinking is broadly I'm not overly concerned about it; the balance of risk is going to favour a secure airway and control of ventilation and oxygenation er any transient hypertension even in the case of Nana who we think has had a dirty big subarachnoid...
  5. SpecialK

    EMT Opportunities in New Zealand

    For Paramedic and Intensive Care Paramedic, you have zero chance as an international except for maybe one or two incredibly hard to fill posts in the middle of nowhere. The only way of obtaining authority to practice at Paramedic or ICP is through the internship and it's brutally competitive...
  6. SpecialK

    Psych pts

    Patients with a psychiatric problem, in the absence of an immediate threat to themselves or others, are an ambulance problem, not a police problem. The police are not routinely required. These patients often have had bad experiences with the police before and it just makes things worse! Many...
  7. SpecialK

    EMT Opportunities in New Zealand

    For EMT level, as long as they have worked at equivalent practice then I don't see it being a problem. If it's not exactly equivalent level then that's fine, it just needs to be substantially similar less any specifics. They'll still need to pass the clinical and operational appraisal to...
  8. SpecialK

    EMT Opportunities in New Zealand

    The only realistic option you may have is as a casual Patient Transport Officer. You can pretty much forget any chance of working frontline; most vacancies are filled by the degree graduates and those that aren't are usually filled by one of the experienced casuals or somebody moving. The...
  9. SpecialK

    What does QA/QI look like at your department/service?

    1,200 paid and 2,000 volunteer officers; approx 500,000 patients p.a. Single national electronic PRF Some types of cases automatically audited e.g. RSI and something like 5 or 10% of others randomly audited by peer reviewers. Of these a portion of audits are themselves audited. Audits can...
  10. SpecialK

    International to USA

    You do have an appropriate work visa right?
  11. SpecialK

    Choking pt becomes unconscious...inserting an airway?

    Me too ... but the Crown could honestly care less it seems. They recently ponied up a couple million for full crewing, but eh, with Emergency Medical Assistants who are barely allowed to do anything without direct supervision.
  12. SpecialK

    Choking pt becomes unconscious...inserting an airway?

    No, I sad it's a case of not having the money to spend on some form of CPAP considering the cost of replacement consumables and oxygen. A $50 disposable set of laryngoscope and forceps which statistically, per ambulance, will take five to seven years to be used (if my math is correct - about...
  13. SpecialK

    Choking pt becomes unconscious...inserting an airway?

    That's it mate, have a good old squiz and if it's not obviously removable try to shove it down a main bronchi with an ETT and if you can't ventilate the other for gawd sake don't arse around just do a bloody cricothyroidotomy. Somebody once said I had big balls for being a little bit keen to...
  14. SpecialK

    Long distance comfort during transport

    This is why I liked having entonox; it was good for long transports as there was hundreds of litres in the cylinder. MOF doesn't last as long.
  15. SpecialK

    Choking pt becomes unconscious...inserting an airway?

    A timely opportunity to say I learnt the other day a couple of personnel recently hooked a giant obstruction out a bloke's airway using the disposable laryngoscope and forceps introduced about 10 months ago. Had this not been introduced to all personnel, they would not have had access to and...
  16. SpecialK

    Airway Management in Head Trauma (Scenerio)

    .... because?
  17. SpecialK

    Airway Management in Head Trauma (Scenerio)

    If the major trauma hospital is 40 minutes away by road ambulance, and the patient can leave in said road ambulance without undue delay (less than say, 15 minutes from now) there is no benefit in calling the helicopter unless either the only way to get an RSI Officer is by helicopter (which is...
  18. SpecialK

    Alerting process?

    It is far less common for a crew to be on-station now than it was; the old addage of station>job>station has been replaced with station>job>clear>cover move or redirection>job>repeat>end of shift. If a crew is on station; for a high acuity response (lights and sirens) then Control tone call...
  19. SpecialK

    Choking pt becomes unconscious...inserting an airway?

    Why piss-arse around with an OPA or bag and mask ventilation? How is the insufflatory volume supposed to get past the obstruction in the larynx? As for CPR, yes, CPR is the go-to for an unconscious person; why? because good, hard CPR will decrease the thoracic volume and raise PA above PB which...
  20. SpecialK

    IYO: Which EMS system has the most strict vs most laxed protocols?

    I can't see a need for writing down "use clinical judgement" that's kind of fairly screamingly obvious. New CPGs are published every two years (so there are only twelve months between reviews) and I cannot say there's want of anything; even in some of the older versions, maybe a couple of minor...
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