Melclin
Forum Deputy Chief
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Smash, see this thread for a comparison of the systems. Don't take wunda too seriously, he hates everyone 
http://www.emtlife.com/showthread.php?t=14919
As far as I can see, most Australian services are more progressive than their NZ counterparts. Certainly further along the track in terms of education.
I don't know about the other states, but certainly here, the majority are not doing the double degree, and of those that are, most I know want to work in EMS, but wanted the nursing degree as well for s**ts and giggles, or to travel and work.
We have some things that would be considered progressive and others that our trans-pacific cousins would not be very impressed by.
-We have road based RSI (have for a while) approved for many clinical problems.
-Post ROSC hypothermia.
-Our BLS provider operates at a level somewhere between you ILS and ALS and is now required is to have a university degree or equivalent training.
-Pre-hospital fibrinolysis (ALS).
-Sepsis protocols and excellent scope for hospital bypass (BLS).
-Many aspects of our ALS section are well integrated with ICU/cathlab management (the upcoming TBI trial will start with paramedic induced hypothermia that will last for up to five days; ALS can triage directly to cath labs).
-Progressive pain relief options: Methoxyflurane, Morphine, Fentanyl and probably Ketamine soon enough.
-Surgical Cric.
-Chopper medics have ultra sound, arterial lines, iStats (sometimes), blood, a range of pain relief options, a range of other induction and paralytic agents, noradrenaline, mannitol and a few other little tricks.
On the other hand:
-even our ALS guys have much fewer pharmacological options than Americans.
-Any addition to scope or pharmacotherapy is slow going because of the difficult and expense of rolling out a new drug/procedure as well as training 2500 paramedics to a high enough level to confidently use it without medical control.
-Even ALS doesn't have IV nitrates making precise management of ACS, esp RVIs rather difficult.
-No Trans cutaneous pacing.
-Because of the nature of funding, it is very difficult to get equipment/drugs that are very expensive, without overwhelming evidence for their use (although methoxyflurane would seem to be against that grain).
-We lack a lot of drug options, that many progressive US services have, that are no strictly necessary as best practice but would be nice and probably help; or drugs that can wait for the emergency department, but would be nice to have and probably beneficial to give earlier (again this is a funding and training issue I think) eg.. Vasopressin, Adenosine, Magnesium Sulfate, activated charcoal, calcium chloride, Diphenhydramine/phenergan/any antihistamine, dopamine, procainamine, bretylium, Diltiazem, Methylprednisolone, Esmolol, isoproterenol, etc.
http://www.emtlife.com/showthread.php?t=14919
As far as I can see, most Australian services are more progressive than their NZ counterparts. Certainly further along the track in terms of education.
I don't know about the other states, but certainly here, the majority are not doing the double degree, and of those that are, most I know want to work in EMS, but wanted the nursing degree as well for s**ts and giggles, or to travel and work.
We have some things that would be considered progressive and others that our trans-pacific cousins would not be very impressed by.
-We have road based RSI (have for a while) approved for many clinical problems.
-Post ROSC hypothermia.
-Our BLS provider operates at a level somewhere between you ILS and ALS and is now required is to have a university degree or equivalent training.
-Pre-hospital fibrinolysis (ALS).
-Sepsis protocols and excellent scope for hospital bypass (BLS).
-Many aspects of our ALS section are well integrated with ICU/cathlab management (the upcoming TBI trial will start with paramedic induced hypothermia that will last for up to five days; ALS can triage directly to cath labs).
-Progressive pain relief options: Methoxyflurane, Morphine, Fentanyl and probably Ketamine soon enough.
-Surgical Cric.
-Chopper medics have ultra sound, arterial lines, iStats (sometimes), blood, a range of pain relief options, a range of other induction and paralytic agents, noradrenaline, mannitol and a few other little tricks.
On the other hand:
-even our ALS guys have much fewer pharmacological options than Americans.
-Any addition to scope or pharmacotherapy is slow going because of the difficult and expense of rolling out a new drug/procedure as well as training 2500 paramedics to a high enough level to confidently use it without medical control.
-Even ALS doesn't have IV nitrates making precise management of ACS, esp RVIs rather difficult.
-No Trans cutaneous pacing.
-Because of the nature of funding, it is very difficult to get equipment/drugs that are very expensive, without overwhelming evidence for their use (although methoxyflurane would seem to be against that grain).
-We lack a lot of drug options, that many progressive US services have, that are no strictly necessary as best practice but would be nice and probably help; or drugs that can wait for the emergency department, but would be nice to have and probably beneficial to give earlier (again this is a funding and training issue I think) eg.. Vasopressin, Adenosine, Magnesium Sulfate, activated charcoal, calcium chloride, Diphenhydramine/phenergan/any antihistamine, dopamine, procainamine, bretylium, Diltiazem, Methylprednisolone, Esmolol, isoproterenol, etc.
