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  1. M

    Why Burn first aid is as important as any advanced life support treatment and why US EMS stinks at burn first aid.

    Being disappointed at the response to my original post on this topic and quite willing to say I have an agenda I've decided to throw some sand around to get some attention. US EMS is among the worst in the world at local utilization of an evidence based burn first aid model. At the same time...
  2. M

    Cooling of burns - why US EMS (and first aid responders) needs to change its practices

    I wrote to N.A.S.E.M.S.O. recently suggesting the burn first aid component of their latest guidelines (below) should be reviewed and changed to incorporate a 20 minute water cooling model with basic dressing such as use of clingfilm wrap. There is a preponderance of dry dressing approaches among...
  3. M

    Burns management

    Hi troops, Doesn't get discussed much these days - almost completely overlooked in fact, but can colleagues give me some idea how US EMS is treating burns these days especially the burn first aid aspect. This is a big issue in the UK and elsewhere relative to dressing choices like hydrogels...
  4. M

    Hydrogel Dressings in Burn first aid - published systematic review available

    Hi all - as promised, my systematic review is now available for download for those interested in the subject. There is a lot of confusion about burn first aid. If the clinical picture for burn victims wasn't so dire the poor level of standardisation of practice might not raise so many eyebrows...
  5. M

    First aid management of burns

    Hi all, Haven't been on the forum for a while. Have been working on burns issues for some time and I am interested in your local regions burn first aid protocol, particularly whether you cool and/or dress burns with Hydrogel dressings (eg WaterJel, BurnShield, Burnfree). The US in particular...
  6. M

    Hydrogel Burn Dressings

    Hi all, Haven't been on the forum for a while. Have been working on burns issues for some time and I am interested in your local regions burn first aid protocol, particularly whether you cool and/or dress burns with Hydrogel dressings (eg WaterJel, BurnShield, Burnfree). The US in particular...
  7. M

    Hydrogel burn dressings

    Interested to hear any thoughts on the clinical value of these types of burn dressings beyond "soothing" wounds. Cost effective? Proven efficacy based on quality evidence? Effect on burn management approach by EMS - ie are staff now approaching a burn this...
  8. M

    RSI Guidelines and audit process

    Hi troops I appreciate the RSI topic is a common one but could I ask for your assistance on particular issue. I am working in our education department and the audit process for RSI cases is being streamlined. Our department is trying to design an audit template that is based upon a...
  9. M

    Drug 1/2 dose limits in the elderly obese patient

    G'Day all Pondering a bit of a dilemma at the moment. The situation is this. Under our adult guidelines a number of drugs such as Midazolam are given under dose for weight parameters with which everyone will be familiar. eg with Midaz its 0.1mg/kg. You'll use that parameter for treating...
  10. M

    Clinical Work Instructions

    Hi all I'm not sure of your local terminology but I'm refurbishing our "Clinical Work Instructions". These are the instructions which describe how to carry out all the procedures. They are not the prototcols/guidelines such as give drug A at 0.5mcg/kg/min in the patient with inadequate...
  11. M

    Using adult pads on 1-8yo's

    Working in education department at the moment. We have to give some very clear instructions to our staff on pad placement on kids around the 10kg/1yo but have a very interesting problem with exactly where to put the pads - adult pads that is. Read on. The problem is this. First, we...
  12. M

    Health Care Reform

    Everyone has probably had enough of mulling over this topic but I started a thread on Health Care issues quite awhile back - Nov 2008, well before Obama was elected. How does evryone feel about the reforms now looking back at the situation? I appreciate this is a loaded topic with some strong...
  13. M

    What was that device?

    Out of interest in a purely clinical sense, in the photograph of the late Michael Jackson when he arrived at hospital, he had a blue attachment to his ETT . Was this just a clamp to secure the tube or was it in fact part of another type of airway device like a combitube. We only secure our ETT's...
  14. M

    Oh&s

    I was wondering if ambulance and firefighting staff in the US and Canadian EMS systems are covered by a system of workplace and staff protection from injury and illness like the Occupational Health and Safety system that operates here in Australia. OH&S here is very powerful legislation...
  15. M

    EMS Crewing Levels 1, 2, 3.....?

    Posts in another thread have brought up the issue of mixed and solo ALS crewing versus models with 2 person BLS and ALS crews. Mixed crewing here has been viewed with much scepticism by staff and was tried in 1998 with very poor results. The main issues that have arisen revolve around the...
  16. M

    Universal health care peaking round the corner again

    Information from a major US health study released this week - the number 3 leading cause of death in the US today after heart disease and cancer????? Lack of private health insurance. I kid you not. (I will try and find the details of the study - I heard this info from an ABC...
  17. M

    Fires in Australia

    I thought readers may be interested to hear a perspective on the recent but ongoing fire catastrophe here in Victoria, Australia. I work in Melbourne but was fortunate not to be directly involved in the fires which were centred to the east and north east of the city and elsewhere in country...
  18. M

    Forum goals

    I have a suggestion. There have been some great threads here at EMT Life.com as there are at many of the EMS forums. Some of the more intense debates have focused on philosophy, roles of EMS, future directions, current problems etc. Unfortunately so much of this intelligent debate disappears...
  19. M

    A little off topic

    This may be a little off topic in a medical forum but at least in a narrow historical context of the idea of universal health care in the US now to be reborn under the Obama administration, I found this article illuminating. It was from "the Age" newspaper in Melbourne reprinted from The...
  20. M

    Obama and EMS - the roll-on effect of universal health care

    I was wondering what the impact of trully universal health care will have in the US should Obama become president and and go on to introduce such a scheme. In Australia we have had universal health care since the early 1970's. The "Medicare" system here is free to every Australian. It is...
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