tag:blogger.com,1999:blog-307224872024-03-14T23:26:31.608+13:00Stories from a NZ ParamedicI wrote an autobiography about my time as a frontline Paramedic. This blog shares some of the stories from the frontlineAucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.comBlogger53125tag:blogger.com,1999:blog-30722487.post-75350264886185810292016-05-26T16:01:00.000+12:002016-06-15T17:32:05.712+12:00<div style="text-align: center;">
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<span style="font-family: "arial" , "helvetica" , sans-serif;"><u>My experience as a patient</u></span></h2>
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<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">It seemed like just another
Monday night. Standing in a cool winter breeze under a light drizzle I was
waiting for the player of the day award to be announced at my eight year old daughters’
hockey game, when I suddenly felt that uncomfortable sinking feeling in my
chest. My heart skipped a beat and was suddenly beating irregularly. </span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">It’s always an uncomfortable feeling,
but initially I wasn’t too worried, as previous episodes had only lasted
seconds, and I knew I was prone to them when I was tired, dehydrated and had
recently drunk coffee. Tonight all three criteria were in play so, it wasn’t
surprising my heart was rebelling to my poor dietary choices. Previous runs had
lasted just seconds before self-reverting and I was hoping like hell this would
be the same. Unfortunately, it wasn’t to be.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">My daughter didn’t receive
player of the day, even though she totally deserved it. The award had to be
shared around and she received it the first game. Now she was begging me to go
get some hot chips from the café which was the last thing I wanted to do. The
palpitations were still happening and I was now becoming increasingly anxious,
as my usual tricks of gulping down copious amounts of water and trying a covert
Valsalva manoeuvre had failed to stop the irregular beats. I snapped at her and
said we needed to get going. </span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">As we walked to the car I was silently trying to work out how serious this was and whether I should drive home,
drive straight to the hospital, ring my wife to come get us, or call an
ambulance. Fortunately the palpitations, although uncomfortable, were not
causing any major problems. I had no chest pain, I wasn’t overly short of
breath (although the anxiety did make me feel that way), and I wasn’t light
headed or dizzy. I decided on the first option and headed home to reassess the situation. We made it
home safely and I did my best to explain the situation to my now very concerned wife.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">After attempting further
Valsalva manoeuvres and drinking iced water, I decided it was time to seek
help. My clinical training meant I was well aware of the complications arrhythmia's can
cause, including stroke or even cardiac arrest. I dissolved and swallowed down
an Aspirin and made the call I needed to make<span style="font-family: "arial" , sans-serif;"> and t</span></span></span><span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">hen waited nervously for help to arrive.</span></span>
</div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">It is always a little
disconcerting when you have to ask your colleagues for help. I had no idea who
would show up or what their reaction would be. All I knew was that I needed to
see my rhythm on a monitor and decide on the next course of action.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">The vehicle soon pulled up
outside my house and I walked into the ambulance to greet the surprised crew
and explain my predicament to them. </span></span></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Fortunately I knew one of the
paramedics and after explaining the situation they awkwardly attached me to the
monitor and printed out an ecg strip for me. As an ICP and University lecturer,
I understood they may have felt intimidated treating me, so I tried to keep it
light<span style="font-family: "arial" , sans-serif;">-</span>hearted and disguise the internal anxiety I was feeling with some
external smiles and light humour.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">The 12 lead ecg confirmed I
was in a rapid and irregular atrial fibrillation (AF) rhythm with a ventricular
response of around 150 beats per minute. I then asked the crew to please insert
an intravenous line into my arm and to give me some fluids. Dehydration can precipitate
tachydysrythmias and I personally have had around a seventy percent success
rate at reverting patients in these rhythms with fluids alone, so it was worth
a shot.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">My wife and kids had popped into
the ambulance to see me so I tried to make light of the situation and explain
everything was going to be fine and that I would likely be home that night.
Ironically this was the only reassurance that was uttered during the entire
experience that night.</span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio80WUqoARd0mTMuhhKXU9yfEqTLsWMDUzCLdsg3UEJKa0SuaSU1QcLZCiZfNZpeofTBJQTTr084WVRKpt2c7QzqZsveWTXnRTwf4u9t4Eug-ecbebgaoHeyqA8YYRb9Ny6nGP/s1600/ambulance.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEio80WUqoARd0mTMuhhKXU9yfEqTLsWMDUzCLdsg3UEJKa0SuaSU1QcLZCiZfNZpeofTBJQTTr084WVRKpt2c7QzqZsveWTXnRTwf4u9t4Eug-ecbebgaoHeyqA8YYRb9Ny6nGP/s320/ambulance.jpg" width="320" /></a></div>
<div class="MsoNormal" style="text-align: center;">
<span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;"> <span style="font-size: x-small;">Inside the ambulance. Smiles outside, freaking out on the inside</span></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">The crew were friendly and did
most of the things they were supposed to do during the short trip and it wasn’t long before I was walking
into the Ambulance bay of the Emergency Department, waiting to be seen by the
triage nurse. </span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">There was a female patient in
the isolation room that adjoins the bay and she was nutting off, shouting out threatening
expletives and obscenities to the psychiatric team that were trying to deal
with her. Just hearing her scream and yell made my anxiety shoot up a notch or two and my heart skipped a few more beats. </span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">I was soon triaged appropriately
and sent through to a monitoring room, thankfully towards the back of the
department. The thought of seeing all my colleagues walk past me and stopping
to find out what had happened was not a thrilling prospect.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">I got to my assigned bed in a
monitoring cubicle and waited for a nurse to come along. At least lying semi
reclined on a hospital bed felt a little better, although my rate had not
subsided at all. I started firing off texts to my boss, family and friends
letting them know of my predicament.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">After ten or so minutes a
nurse came and introduced herself and gave me the compulsory, but ugly and awkward, hospital gown
to put on. The litre of IV fluid was now well on board so when she left I
quickly shot off to the toilet to vacate my bladder which was now ready to burst its banks.
By the time I came back she had the monitor turned on and was ready to hook me
up. With a stern face she told me that if I needed to go again, I needed to use the urinal, especially
with a heart rate of between 140 and 160 beats, which the monitor was now colorfully showing.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">The nurse was actually very pleasant
and thorough, and took all the usual baselines, drew blood samples and made
small talk in-between writing down her findings. She then took the chart away
and informed me the doctor would review the ecg and come and see me sometime soon. Although
polite and professional, she didn’t mention the words I was waiting for – that
everything was going to be ok.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Meanwhile I was researching
all I could about AF. Causes, cures and treatments. Dr Google was continuously presenting
cardioversion as being a treatment option which was rather disconcerting.
This would involve being sedated and a synchronous shock being delivered from a
defibrillator to try and stun my heart back to a normal rhythm. We only administer this for seriously compromised cases so I decided I
would not opt for that treatment should it ever be offered. The reassuring
thing, however, was that according to most of the clinical literature I could
actually find, AF seemed to spontaneously self-revert within 24 hours in the majority of
acute cases. I decided that I was going to be one of those cases. It was time for
some positive mental affirmations.</span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">The IV fluid the ambulance
crew gave me was sure doing its job and I was onto filling my second cardboard urinal
already. As I stood up to awkwardly pee into the fragile container, I suddenly felt my
palpitations stop and my heart resume into a normal rythm. I looked up at the monitor, and to my delight, I
had self-reverted back into a sinus rhythm, although it was still a little fast
at 115 beats per minute. I lay back on the bed with a sigh of relief as the
anxiety left me for good. </span></span></div>
<div class="MsoNormal">
<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Suddenly, a visitor pulled back
the cubicle curtain and popped his head in. Tony, my boss, had made a surprise
visit to come and see me. It was a welcome relief to have someone familiar to
chat to, especially when they are also a clinician. We spoke about our work and
my condition and he told me to call if I needed anything.</span></span><span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;"> With my wife stuck at home with my two young children in bed, his visit was the boost
to my morale that I desperately needed and I genuinely thanked him for taking
time to pop in. I doubt he realises even to this day what a positive impact his
short visit had.</span></span></div>
</h2>
<h2 style="text-align: left;">
<div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;"> After Tony’s visit, the doctor
came in next and introduced herself. I gave her the history and explained I had
just self-reverted about twenty minutes ago. She did her examination and said
she would check the bloods, ecg, chat to the cardiologist and decide on a plan.
Although pleasant and professional there were still no words of reassurance, not
one, although the condition had normalised.</span></span></div>
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<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Shift change came around and a
new nurse introduced himself. Apparently the blood results showed I was
slightly dehydrated and slightly low in potassium so he gave me a fizzy drink
with potassium to gulp down and attached another litre of saline to my IV.
Given that my heart rate was now slowing down, I didn’t really mind what he did. I
was finally starting to relax and fired off some more texts to let everyone
know I was now ok. I even managed a few selfies in between reading a magazine
article. </span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv-0AyeoPpbzT77WLPKr5vGUEDjnbhxIVZiWEWF4Og445TiEXsxtt90G-ZnmX5fyRNkQZlvR9PPLdKJkzD8k6IBPmd1OWzAGRojvioe-QrNLJIbYuacD1nwF-bDwyGwOBmDa9j/s1600/meined.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiv-0AyeoPpbzT77WLPKr5vGUEDjnbhxIVZiWEWF4Og445TiEXsxtt90G-ZnmX5fyRNkQZlvR9PPLdKJkzD8k6IBPmd1OWzAGRojvioe-QrNLJIbYuacD1nwF-bDwyGwOBmDa9j/s320/meined.jpg" width="294" /></a></div>
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<span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;"> <span style="font-size: x-small;">Second bag of fluid running after reverting to NSR</span></span></div>
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<br /></div>
<div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">After another twenty minutes
the doctor returned and gave me the all clear. Bloods were back to normal and
the ECG had normalised too. She kindly gave me discharge notes and copies of my
ECG’s and said my risk factor for stroke was zero which was great news. Four
and a half hours after being admitted, I was finally free to go. After
painfully removing the ECG electrodes, along with a decent amount of chest
hair, I headed home.</span></span></div>
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<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Being a patient was a sobering
experience for me. For someone who has operated on the other side as a
clinician, it was both educational and insightful. </span></span></div>
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<br /></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">As a lecturer, I teach my
first year paramedic students that reassurance is a vital part of the treatment
process. Our patients are literally hanging out for us to utter those magic words
– “things are going to be ok”. It is a fundamental principle we learn as
children, when a hug from mum or dad cured any amount of anxiety, or injury and
although it’s not necessary to hug our patients, uttering that simple sentence
can make a world of difference. Despite being a clinician, as a patient I felt
vulnerable and those words would have reduced my anxiety and my heart rate, had
they been uttered by any of the clinicians that treated me.</span></span></div>
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<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">I have made a vow to ensure I
continue to reassure my patients and also their relatives, explaining the
medical condition, providing options for treatment and reinforcing any positive
baselines that I record. I will also ensure I shave hairy chests before
attaching ECG electrodes, as removing them was the most painful part of the
entire experience. </span></span></div>
<span style="font-weight: normal;">
</span><div class="MsoNormal">
<span style="font-weight: normal;"><span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;">Finally, I bought myself a
large drink bottle and will make it gospel to drink at least two of those each
day. Despite the great insight, I much prefer to stay on the clinical side of
the patient fence. </span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRNTG-HSdsMHTfa6DjbiAdD6kI1kGiCfNPg0si4cO5K5hZNARPdHiptZqUXrwkRL4NoqScnOa_DlsW8WGoAIFUKqSgSMdnUOzlyhucGOWGTjjINIEDgLVnb2VRgfxkZv-Xb7rM/s1600/icp.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="231" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRNTG-HSdsMHTfa6DjbiAdD6kI1kGiCfNPg0si4cO5K5hZNARPdHiptZqUXrwkRL4NoqScnOa_DlsW8WGoAIFUKqSgSMdnUOzlyhucGOWGTjjINIEDgLVnb2VRgfxkZv-Xb7rM/s320/icp.jpg" width="320" /></a></div>
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<span style="font-family: "arial" , sans-serif; font-size: 14pt; line-height: 107%;"><span style="font-size: x-small;"> Back where I belong - treating patients</span></span></div>
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</h2>
Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-28966680295364143742016-02-01T13:48:00.000+13:002016-02-01T13:48:01.906+13:00StoriesI always enjoy reading about other peoples lives, particularly from those in the medical field. I think it really gives one an appreciation of how we are all working together in the field of medicine to help maintain or repair other peoples health.<br />
<br />
Paramedicine is quite unique because we typically work in pairs in the public. There are generally no senior consultants peering over out shoulders instructing or telling us what to do. We just have to get on with doing what we do best. Of course we can always call for backup but that is not always an option.<br />
<br />
One of things I love the most about paramedicine is the freedom from hierarchical interference that you typically find in a hospital or medical settings. I have heard of many stories of junior nurses or doctors being bullied or harassed by their seniors. It always seems strange to me that people who embark on an empathetic career could become such unpleasant people to be around. I have a theory around that and it relates to burnout...but thats another topic.<br />
<br />
So I have read many biographical accounts from paramedics, nurses, doctors, surgeons, medics etc and I really enjoy hearing their stories. I can always relate to them and of course can usually picture what they are talking about.<br />
<br />
So if you are on the lookout for a great read then check out this rich list list of medical autobiographies:<br />
<br />
<a href="http://astore.amazon.com/priorityone08-20" target="_blank">Great medical autobiographies</a><br />
<br />
<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-3522665622452900292015-06-19T10:24:00.002+12:002015-06-19T10:24:35.098+12:00Emergency Doctor Calls for legalisation of MDMASo a Wellington based ED doctor has created a controversial storm by daring to suggest that pure MDMA should be legalised in NZ:<br />
<br />
<h1>
John Key unconvinced by emergency doctor's call to legalise MDMA
</h1>
<div class="story__byline-block social__story-content u-f-left">
<div class="story__byline" itemprop="author" itemscope="" itemtype="http://schema.org/Person">
<span itemprop="name">MATT STEWART</span>
</div>
<div class="story__dateline">
<span content="Thu Jun 18 05:07:18 UTC 2015" itemprop="datePublished">
Last updated 17:07, June 18 2015</span>
</div>
</div>
<br />
<img alt="Ecstasy tablets contain MDMA, though they usually have a mix of other ingredients too. Pure MDMA remains rare in New Zealand." class="photoborder" src="http://www.stuff.co.nz/content/dam/images/1/5/c/t/k/f/image.related.StuffLandscapeSixteenByNine.620x349.15ctue.png/1434604038895.jpg" title="" /> <br />
<br />
<a href="http://www.stuff.co.nz/dominion-post/news/69462806/John-Key-unconvinced-by-emergency-doctors-call-to-legalise-MDMA" target="_blank">article</a><br />
<br />
His rationale? Well according to Dr Paul Quigley, an emergency medical specialist and toxicologist, pure MDMA is actually one of the safest intoxicants around and significantly safer than alcohol which is not only a known <a href="http://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet" target="_blank">carcinogen</a> but its abuse is also responsible for many ED admission on Friday and Saturday nights.<br />
<br />
I have to say that personally I entirely agree with him. When party pills first came on the scene in NZ there was a public outcry. Naysayers predicted kids would die with overdoses and there would be chaos as drugged kids went out of control. What actually happened was the total opposite. When large rave parties initially happened there was a large contingent of police and medical services present...and they were pretty much bored out of their brains. The kids were on mood enhancers, out for a good time and a good time they had! Sure there was the occassional OD when inexperienced people mixed drugs or combined it with alcohol but once the effects became known Friday and Saturday night alcohol related call outs plummeted and with it a massive reduction on police, ambulance and hospital resources.<br />
<br />
Fast forward 10+ years and party pills have been banned in NZ. The kids have reverted back to alcohol and the violence and associated call outs have returned. Dr Paul Quigley has been outspoken on this <a href="http://www.stuff.co.nz/searchresults?Search+Site=Search+Site&cof=FORID%3A9&cx=006730714154542492986%3Aoh6vl0ybuqy&ie=UTF-8&q=paul+quigley&siteurl=www.stuff.co.nz%2Fdominion-post%2Fnews%2F69462806%2FJohn-Key-unconvinced-by-emergency-doctors-call-to-legalise-MDMA&ref=www.google.com%2Fcse%3Fsearch%2Bsite%3DSearch%2BSite%26cof%3DFORID%253A9%26cx%3D006730714154542492986%253Aoh6vl0ybuqy%26ie%3DUTF-8%26q%3Dpaul%2Bquigley%26siteurl%3Dwww.stuff.co.nz%252Fdominion-post%252Fnews%252F69462806%252FJohn-Key-unconvinced-by-emergency-doctors-call-to-legalise-MDMA%26ref%3Dwww.google.com%252Fcse%253Fcof%253DFORID%25253A9%2526cx%253D006730714154542492986%25253Aoh6vl0ybuqy%2526ie%253DUTF-8%2526q%253Dmdma%2526search%252Bsite%253D%2526siteurl%253Dwww.stuff.co.nz%25252F%2526ref%253D%2526ss%253D635j145531j4%2526ad%253Dn9%2526num%253D10%2526rurl%253Dhttp%25253A%25252F%25252Fwww.stuff.co.nz%25252Fsearchresults%25253Fcof%25253DFORID%2525253A9%252526cx%25253D006730714154542492986%2525253Aoh6vl0ybuqy%252526ie%25253DUTF-8%252526q&ss=2504j755950j12" target="_blank">topic</a>, witnessing the carnage first hand in his ED. With the banning of party pills, all sorts of drugs are coming out on the black market as kids seek out their weekend fix. His argument that legalizing and licensing MDMA would fix this issue definitely has merit and I for one would be supportive of such a move. I have seen too much destruction with alcohol, even amongst colleagues. What are your thoughts?Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-21694071975220275522015-05-29T09:45:00.003+12:002015-05-29T09:47:35.568+12:00Air BagsSo I went to a minor motor vehicle accident which occurred at fairly low speed. There were no injuries thankfully but one of the cars appeared to be full of smoke. I promptly called the fire brigade who dutifully turned up, opened the doors and let the 'smoke' out. It turns out the 'smoke' was just a talculm powder cloud that had been released and had filled up the car when the air bag deployed.<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBg836P8sO-rpntJ8MW2O3MSna3pJOugBRg5Z0S2gLewzjFaLlyscd0LkR1MWaYWSm0e5ZVMvJnZTMq2iP33wW1Xoxn9tmDsT1VWBgKqZe3HFsVDEo8JJQUU60gv5vy-0NxXoW/s1600/IMG_2566.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjBg836P8sO-rpntJ8MW2O3MSna3pJOugBRg5Z0S2gLewzjFaLlyscd0LkR1MWaYWSm0e5ZVMvJnZTMq2iP33wW1Xoxn9tmDsT1VWBgKqZe3HFsVDEo8JJQUU60gv5vy-0NxXoW/s400/IMG_2566.JPG" width="400" /></a></div>
This got me thinking. If the powder had filled the car enough to appear it was full of smoke, how would that affect a patient inside who had inhaled it? According to manufacturers the air bags are inflated with harmless nitrogen gas but they do use talcum powder to lubricate the bag. In theory this shouldn't be toxic although breathing that much powder into your lungs in an enclosed space is bound to cause some respiratory problems. Then I can across this news story<br />
<br />
<h1 id="ext-gen46">
Killed by an airbag: Husband in minor crash got pneumonia after breathing in 'noxious' gases and powder when the bag burst</h1>
<div style="background-color: white; border: medium none; color: black; overflow: hidden; text-align: left; text-decoration: none;">
<br />
Read more: <a href="http://www.dailymail.co.uk/news/article-2151150/Killed-fumes-airbag-Father-59-died-crash-glass-pierced-bag-releasing-noxious-chemicals.html#ixzz3bTKgQsYO" style="color: #003399;">http://www.dailymail.co.uk/news/article-2151150/Killed-fumes-airbag-Father-59-died-crash-glass-pierced-bag-releasing-noxious-chemicals.html#ixzz3bTKgQsYO</a>
</div>
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<div style="background-color: white; border: medium none; color: black; overflow: hidden; text-align: left; text-decoration: none;">
Now I am no toxicologist but it now has me wondering about the effect that clouds of powder may have on both rescue workers and patients? What are your thoughts?</div>
Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com1tag:blogger.com,1999:blog-30722487.post-34507819399959128642014-08-18T16:41:00.002+12:002015-05-29T08:23:08.287+12:00A great smartphone AppAED location is an awesome smartphone app that lets you locate where the nearest AED is located in an emergency. Download it now for free and be prepared to save a life! The link is <a href="http://www.aedlocations.co.nz/" target="_blank">here</a><br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxByWi2l7sUbn3xZe5tYTME6c1ZmDdj_mkTKcvNyEKepigFU3JnmpswpLQY6QC20Zo1e12GfddagJFe08w74WyJd6LPjOEn2O4W3qpMp7bs9cF3WUaQvxXYiTXzjlSY0iUuiXE/s1600/aed.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="166" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxByWi2l7sUbn3xZe5tYTME6c1ZmDdj_mkTKcvNyEKepigFU3JnmpswpLQY6QC20Zo1e12GfddagJFe08w74WyJd6LPjOEn2O4W3qpMp7bs9cF3WUaQvxXYiTXzjlSY0iUuiXE/s400/aed.jpg" width="400" /></a></div>
Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-75488791252026846082014-04-15T23:03:00.001+12:002015-05-29T09:50:03.522+12:00NZ road fatality and injury statistics plotted against average road speeds<br />
We are often sold the message that 'speed kills' and that 'speed cameras save lives'. So I was interested in what the actual government statistics showed when it came to speeds and the injury and fatal statistics.<br />
<br />
I utilised data from NZ Government websites to plot these values against each other. Interestingly enough, while there is an initial trend showing a reduction of speed did reduce injuries and fatalaties, the direct trend didnt seem to match. For example, although the average speed has continued to decline, the injuries and fatalaties have been both up and down. Sometimes increasing and sometimes decreasing. In fairness however it could be said that the trend overall has been in a downward manner and a decrease in both injuries and fatalities is always a good thing. Surely however if speed was such a major factor and speed kills then we should have had a linear trend of injuries and fatalaties matching the reduction in speed?<br />
<br />
Unsurprisingly I didnt find this data being plotted anywhere on any NZ Government websites and given they are about to introduce more of the new digital speed cameras (up to 200 of them @ around $100k each) and lower the speed tolerance for fining people to just 4 km/h over the speed limit I am not surpirsed why! See for yourself. <br />
<br />
Speed cameras have been in use in NZ since 1993 and initially netted $80m in revenue. In 2009 the revenue from speeding fines was down to $36m but in 2010 the revenue was up to around $50m after 43 new digital speed cameras were introduced in 2009, supposedly in effort to reduce the road toll to 300. Now that the average road speed has come down to below the 10 km/h tolerance that the NZ Police said was safe, revenue is also declining and hence we are seeing a move to lower the speed tolerance to withing a few km/h over the speed limit.<br />
<br />
Data is taken from Statistics NZ (www.stats.govt.nz motor vehicle casualties) and NZ Ministry of Transport (www.transport.govt.nz speed survey results - car speeds) Injuries and deaths are not broken down by urban or open road speeds so these have been plotted against both to identify the trend and compare them against the various speeds.<br />
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<i>Number of fatals per 100,000 population vs urban and open road speeds. Road speed is on the left vertical axis and number of people per 100k on the right</i></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbRkY9R3g6T8vaNmYvj8fu8JMbWUk_D0EK3kbg1jKWk-zknDtHvw6kUcgiypKNxqo5fObsQbkKsLr23lVAb1bZrPOnWjZKrxzCcae8sOflG4YY8ntubnP_udJrwC9dKrQVsMWk/s1600/speed1.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="250" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbRkY9R3g6T8vaNmYvj8fu8JMbWUk_D0EK3kbg1jKWk-zknDtHvw6kUcgiypKNxqo5fObsQbkKsLr23lVAb1bZrPOnWjZKrxzCcae8sOflG4YY8ntubnP_udJrwC9dKrQVsMWk/s1600/speed1.JPG" width="400" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHxmnJhITZJXTYcgRhHvM51SOEg69MscFZmciUwKW7Ck7pWmNgYiGJvJxZnfnHbASv2w0HBNR3fqYJ7ko9IrQpRnROhBmfjZaFeaQgpY5M_3gJ9XUpgJwXwXBrORuW2yNtgMoQ/s1600/speed2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="241" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHxmnJhITZJXTYcgRhHvM51SOEg69MscFZmciUwKW7Ck7pWmNgYiGJvJxZnfnHbASv2w0HBNR3fqYJ7ko9IrQpRnROhBmfjZaFeaQgpY5M_3gJ9XUpgJwXwXBrORuW2yNtgMoQ/s1600/speed2.JPG" width="400" /></a></div>
<br />
<br />
<br />
<div style="text-align: center;">
<i>Number of injuries per 100,000 population vs urban and open road speeds. Road speed is on the left vertical axis and number of people per 100k is on the right</i><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXAJ4_Wn4TUoGU2OpEanoZGk5rzsfIU48VGAoKok0h2cAZRSVIN8YywEmt3bWvCNqptST3umKjc7Xnh_xn7Q1XnP3NppoJ8iZiBX3WLK63Zquron5Eecy82TPrlshHyXaoXdGT/s1600/speed4.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="251" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXAJ4_Wn4TUoGU2OpEanoZGk5rzsfIU48VGAoKok0h2cAZRSVIN8YywEmt3bWvCNqptST3umKjc7Xnh_xn7Q1XnP3NppoJ8iZiBX3WLK63Zquron5Eecy82TPrlshHyXaoXdGT/s1600/speed4.JPG" width="400" /></a></div>
<br />
In 2009 when the new digital cameras were instigated the NZ Police had to refund a bunch of tickets for drivers of trucks and high side vehicles as the cameras were over-estimating the speed of the vehicle sometimes doubling it! I don't know if this has ever been fixed? That certainly puts pay to the old saying - don't speed and you wont get caught! See the article <a href="http://www.stuff.co.nz/national/crime/2405868/Cameras-record-incorrect-speeds" target="_blank">here </a><br />
<br />
The digital camera systems do have the ability to be upgraded to include automatic number plate and facial recognition although apparently this technology will not be utilised yet. The NZ Police do however have 2 vans with cameras capable of reading vehicle number plates as they drive past and 4 mobile units which can be used in a patrol car. The technology raises concerns with privacy and has been discussed in articles <a href="http://www.stuff.co.nz/dominion-post/news/7884609/Numberplate-tracker-may-be-illegal" target="_blank">here</a> and also <a href="http://techliberty.org.nz/an-introduction-to-automated-number-plate-recognition/" target="_blank">here</a> and there is a question over whether the use of the technology is even legal given that a warrant is usually required for surveillance. <br />
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In a report by the Auditor General in 2002 on the Speed camera Program, the auditors admit that <i>excessive</i> speed was only a factor in 30% of accidents yet the focus on speed is what generates the most income. The report also spoke about revenue raising envy because in Melbourne their prosecution rate was well above what NZ was and there was a suggestion NZ should be getting more prosecutions (and hence more $$). The Melbourne speed camera system as I understand it is run by a private corporation who is only interested in revenue so it makes sense that they go after anyone and everyone whereas the NZ system is run by the NZ Police by the Road Safety department so perhaps that's why there was such a difference.<br />
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A report by Ian Wishart into speeding fines argued that raising speed limits actually decreases death rates. See that article <a href="http://www.investigatemagazine.com/july00speed.htm" target="_blank">here</a><br />
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NZ is also considering point to point speed camera detections systems. These work by having a device which captures your entry point and exit point. They can be km's apart (such as on a motorway) and they work out your average speed by calculating how long it took for you to get from point A to point B. A consultants report into utilising these cameras identified key areas where they could be utilised - mostly on the motorways and some main highways. I think as long as these are well sign posted (as they do in the UK) this is probably a fairer system than just arbitrarily fining you for an instance of a certain speed. Somehow I don't think they will advertise the fact they are there though.<br />
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So what is the answer? I think a sensible approach to road safety should prevail. Nabbing Joe average driver for exceeding the posted road speed by 4 km/h does nobody any favors. I think the best campaign the government ever came up with was <br />
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<i><b><span style="color: blue;">Drive to the conditions and when its changes reduce your speed.</span></b></i> </div>
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This is sensible stuff. Sometimes its not safe to do the posted speed limit and sometimes its safe to exceed it. Better driver education and safer roads are also key and given they make up 60% of the reason for serious accidents surely they should be the focus - not revenue gathering.<br />
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As a paramedic I have seen my fair share of road trauma but at most car accidents speed was NOT the <u>cause</u> of the accident - rather inattention of the driver, following too closely, driver distraction (don't text and drive!) poor road design, bad driving decisions or simply failing to drive to the conditions. The ambulance service in NZ travels thousands of kilometers every year and often its at high speeds racing to an emergency, yet their accident rate is actually very low and the serious accident rate is almost non existent thanks to driver education and an improved and modern fleet of vehicles. So why cant this work with other drivers? Education is the key.<br />
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<i><b>Disclaimer</b>: the statistics shown were taken from NZ Government websites. I am not a statistician and do not claim that my representation is anything other than my own interpretation of these figures. Views expressed here are my own and do not represent that of the NZ Ambulance service or any other organization.</i>Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-71220740387223711912014-04-12T18:06:00.003+12:002014-04-12T18:06:55.178+12:00MedivacMedivac by the Careflight rescue helicopter team. Worth their weight in gold in the Aussie outback these people.<br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-1596126714666218442014-01-27T14:53:00.003+13:002017-04-22T17:13:02.861+12:00Paramedic Registration in NZ - A double edged sword?<br />
Paramedic registration in New Zealand has been on the sector 'to do' list for some time now. While it now looks inevitable within the next few years, and many in the industry are hailing it as an empowering thing, I cant help but reflect on the concerning parts that may also come with it. I am skeptical, to say the least, of the proposed benefits associated with registration and while I recognise that it will be a step forward and undoubtedly provide greater opportunities for paramedics I really feel that many paramedics are not fully aware of all the implications that registration will bring. This is my take on it.<br />
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<u>New costs just to do the same job</u><br />
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Government Registration essentially means we will have to 'pay' for the privilege to do what we currently do now for free and it will also come with total personal liability for doing it.Individuals will need to have indemnity insurance and pay for an annual practicing certificate as well as possibly association with the governing body and ongoing education.Practicing cerrtificates are set to be in the region of between $600-1500 per annum with the main ambulance services already saying they will not pay for this.<br />
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<u>Learning on the job may take on a whole new meaning</u><br />
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Practicing pre-hospital medicine, like other areas of medicine, has always included that very component - practice! That means, that like doctors, sometimes we get it wrong, and just like doctors the outcome can even have serious consequences. I personally believe the current scheme of working under an approved protocol and essentially practicing under the license of a Medical Director(s) has provided a more positive learning environment without the pressures of being subject to an external industry body watchdog and the possibility of fine and censure. We have in the the industry recently moved away from a punitive approach to one of learning and improving where it is finally safe to admit you made a mistake so everyone can learn from it. Registration will potentially set that back, as the risk of reporting an error could mean a large fine or even the end of your registration and job.<br />
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All health practitioners are currently subject to the Health & Disability Commissioner (HDC) Act Code of Rights in New Zealand, ensuring quality of healthcare in the sector. This includes paramedics and there have even been some investigated by this body for mis-demeanors in the past. This consumer watchdog gives our customers an avenue to complain and have an independent investigation carried out. Although there is no punitive punishment associated with an investigation, other than a recommendation for improvement from the commissioner, past investigations have resulted in positive changes to the industry. Where criminal liability was found, this has been passed onto the police for prosecution.<br />
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Registration will change this situation altogether. As well as being subject to an HDC investigation, paramedics who are under investigation will need to also potentially face the disciplinary panel under the Health Practitioners Competency Assurance Act. They will possibly need to hire a lawyer to defend themselves and may face fines, censures or even de-registration. Even an unjustified complaint from a consumer or their relative may see a paramedic face the stress of this tribunal - something that cannot currently occur as non registered health professionals.<br />
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<u>It may become a barrier for student practice</u><br />
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Currently student paramedics are able to carry out skills on the road under supervision of a qualified practitioner. Invasive skills such as IV therapy, IO, intubation, LMA, drug administration etc aassociated with it. How would a qualified paramedic now feel about allowing a student to practice those skills under their registration! Who carries the can if they stuff up? Will you face disciplinary action - fines or censure if it goes wrong? Would you want to take the risk? Potentially it could mean students simply can't practice these skills on the road because staff are unwilling to risk the potential adverse consequences if it went wrong and this would potentially have a significant impact on the future training of trainee paramedics.<u> </u><br />
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<u>A barrier to volunteers or those wanting to progress</u><br />
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Approximately eighty percent of the paramedic workforce in NZ are voluntary and we are absolutely reliant on some of these volunteers in very remote areas. With the introduction of additional personal responsibility and cost of registration this may dissuade volunteers from providing their services, or at least have the effect of a barrier to gaining higher qualifications (the proposal was for registration only for paramedic level and above). What if a significant amount of current volunteer paramedics simply opt to lower their ATP to non-registered EMT level because of the extra cost and responsibility that registration will bring. What impact will this have on our ability to provide sufficient clinical skills across NZ? Has any workforce planning being carried out around this potential situation?<br />
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Annual proof of competence and practice will be part and parcel of the registration process, but what happens if this prevents a significant number from gaining registration, or causes them to become de-registered? Competence and de-skilling has always been a challenge, particularly for remote and rural areas and while this is being addressed more now than ever before it is unlikely that it will be solved by the time registration appears. This could further impact the numbers of volunteer staff obtaining paramedic qualifications.<br />
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Now I hear what you are saying - if you cant make the grade you shouldn't be doing the job and that makes sense. However the fact remains, we are totally reliant on a volunteer workforce across the country and some of these people are old, potentially with low experience levels, low workloads and will find it challenging maintaining their competency. By insisting on registration we will either force these people into a lower, unregistered skill level or force them out of the industry altogether. This will leave a coverage gap where previously it was covered and potentially add costs where previously there was none. While we may consequently have better clinicians as a result, we may also have a severe shortfall of them. If you were a volunteer paramedic and suddenly had to fork out over $1000 per annum in practicing certificates and education with the possibility of facing fines, censures and other costs if you made a mistake would you want to continue doing it?<br />
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A recent published study by the NZ Paramedic Industry body, looking into paramedic attitudes towards professionalism (including registration) showed many in favour of registration, as many of the pro's are blatantly promoted (see <a href="http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1437&context=jephc" target="_blank">here</a>) but I wonder how many think about the down sides or actually question whether the pro's will actually eventuate? These are some of the proported benefits of registration out forward and my (skeptical) view of them.<br />
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<u>Registration will increase respect from other registered professionals</u><br />
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The notion that simply being registered will somehow automatically increase respect from industry colleagues is an interesting one. If this were true, all registered health professionals would be well respected by each other but I know this simply isn't the case. I have heard many GP's make scathing remarks about physiotherapists, osteopaths and chiropractors - all registered professions that dont necessarily garnish the respect of the medical fraternity. It only takes bad publicity of a few poor practitioners to bring the industry into question. Midwifery too has had it critics yet these professionals too are registered and for the most part do a wonderful job in a very challenging environment. So registration alone does not make an industry instantly respected. That comes from publicity, publications and collaboration, something the industry has made huge inroads with and as a result we are more respected now than ever before, although much more could be done. Simply being registered does not itself entitle an industry to be respected.<br />
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<u>Registration will increase competence</u><br />
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The requirement for an annual practicing certificate will undoubtedly require proof of competency, likely through continuous clinical education, similar to GP's, although this is likely only to be needed at Paramedic and above. This is definitely a positive thing but also something that is currently in place in NZ. All ST John and WFA ambulance staff are currently required to undertake annual continuous clinical education modules. The fact that paramedicine is now a university degree based system is also leading to increased competency. Simply becoming registered however does not guarantee competency. If this were the case then there would be no HDC complaints against incopmetent practitioners yet we see published complaints involving poor competency across many different registered health professionals. Continuous education increases competency. Registration by itself does not.<br />
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<u>The public will be more reassured by registration and it will rid the industry of cowboys</u><br />
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I have to say that for the most part the public still has a very poor understanding of what paramedics actually do. The fact we are constantly referred to as ambulance drivers, even by other healthcare professionals demonstrates that our job and skills are, on the whole, unappreciated and misunderstood. Simply being registered will make little difference. To many we will simply be registered ambulance drivers. What is needed is a huge ongoing public education campaign to teach the public what we actually do. This was one of my aims for writing my book <a href="http://www.priority-one.co.nz/" target="_blank">priority one</a>.<br />
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The notion that the public will only want to be treated by registered paramedics makes me laugh. If I am in intractable pain with broken legs in the middle of the road I really wont care whether the paramedic treating me is registered or not. Although registration may prevent rogue operators from calling themselves paramedics, they will likely still have a shirt or reflective vest with Medic on it and the public will still be none the wiser. <br />
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With a split qualification system (BLS, ILS, ALS) and the aim of only registering paramedic at ILS and above, we will end up with basically a two-tiered system of ambulance officers - registered vs non-registered - on par with Registered Nurses vs Enrolled Nurses but both groups will essentially be doing the same job from the public's perspective. If you asked the general public what the difference was between an enrolled nurse and a registered nurse most would be unable to tell you. I believe the same will stand for paramedics. If an ambulance turns up I doubt the public will demand to know whether the ambulance officer is registered or not, just like they generally have no idea what BLS, ILS or ALS means. All they care about is an ambulance has turned up!<br />
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In a similar fashion, those who are labeled cowboys in the industry will still continue to be cowboys. They may no longer be able to call themselves paramedics but that won't stop them wearing a sign saying 'Medic' or 'First Aid' nor will it stop anyone needing first aid from seeking it from them. They will likely be practicing at BLS and so be bellow the level of registration anyway. Besides, has anyone actually quantified this issue? How many rogue practitioners are out there? Is it really such a huge issue that registration is needed to get rid of them all or are we only talking about a fraction of people here?<br />
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<u>It will be easier to work overseas with registration</u><br />
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Countries who currently have registration (UK, USA, Canada, South Africa) still require an individual to re-register in that country. Simply having registration in one country does not mean you can automatically get registration in another. Even in Australia, it is possible that individual states may set up their own registration process meaning that paramedics may have to register in individual states to practice there, similar to the way Australian state Police forces work. This is seen too in medicine where doctor registration in one country is not automatically accepted in all countries. On top of this, most providers also have their own Authority to Practice (ATP) system so there will likely still be two hoops to jump through. What has made a difference is the degree programme with reciprocating countries respecting each others qualifications but it may or may not apply to registration.<br />
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We do have the advantage of learning lessons from the UK registration process and a good comparisons of some of the pro's and cons can be found <a href="http://www.ambulancenz.co.nz/overseas/uk/" target="_blank">here</a><br />
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Whatever the outcome, I know we have to embrace the fact registration is coming and will be here to stay. I just hope that the industry goes into this with their eyes wide open, with realistic expectations and a budget to meet the increased costs that undoubtedly will tag along with it. Although I am playing the devils advocate role here and am probably very much a lone voice, I hope I have balanced the debate to some degree and made people more aware of some of the implication that may follow. I dont claim to be right I simply want a robust debate on the issue.<br />
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Feel free to leave your views, comments, responses below.<br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-82818399793943749652013-09-28T14:31:00.001+12:002013-09-28T14:31:24.447+12:00ParamedicoParamedico is a book and film written by an Australian Paramedic who travelled around the world visiting and working for ambulance services all over. A fascinating story and now a downloadable film. Who knew that much of the world still has non existant or third world ambulance services! Check out the short for the film - cant believe a paramedic would do routine mouth to mouth using a handkerchef haha!<br />
<a href="http://vimeo.com/65453441" target="_blank">http://vimeo.com/65453441</a><br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-14915113692594553812013-09-06T19:40:00.001+12:002013-09-06T19:40:31.858+12:00Fun in the sunAmazing how hot sunny weather can lift your mood! Working remotely in the Australian outback. Can be tedious at times but spending time in the sun is very refreshing, especially when its still rather wintery back home in NZ!<br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-19569560670564279652013-06-10T15:19:00.001+12:002013-06-10T15:19:09.160+12:00Verbal first aidReading an excellent book at the mo called verbal first aid for kids.<br />
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I cant believe I have been practising as a paramedic for 16 years and I have only just cottoned onto how what we say to a patient (or dont say) can have such an impact on their recovery process.<br />
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Ive just read a book called <a href="http://verbalfirstaidthebook.com/about-judith-acosta/" target="_blank">The worst is over</a> by Judith Acosta who is trained psychotherapist, hynortherapist and trauma counsellor. She emphasises how the language we use directly influences the recovery process for children. They look to adults for emotional cues. If they injury themselves and mother is a blubbering mess they naturally think the worst. If on the other hand mum acknowledges but downplays the event and remidns the child they are a quick healer then its no big deal. And guess what, the kids actually does heal up faster!<br />
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The same applies to adults. We go to routine chest pains which is no big deal for us as paramedics, but for the patient they probably think they are about to die! While we run off an ecg and chat to our collegue about it they are waiting with baited breath on whether we think they are going to live or not....and we probably dont even reassure them they will!<br />
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I have started using proactive and positive language in my patient care and wow what a difference. Patients are definately less anxious. So check out the book and see for yourself how what you say can be as important as the medicines you administer.<br />
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You can read more about the book and author <a href="http://verbalfirstaidthebook.com/about-judith-acosta/" target="_blank">here</a><br />
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Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-5708673028281449722013-01-22T11:40:00.001+13:002013-01-22T11:40:29.424+13:00Getting home from hospitalThis is a question I get asked a lot by people who have called an ambulance.<br />
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"How am I going to get home from hospital?"<br />
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Now I dont know about you but if I decide I need to go to hospital then part of my decision making will include how Im going to get home again. Our job is definately to take you to a medical facility (if we warrant that you really need to go to one) but our job is definately not to tell you how to get home again. Thats something you should really think about when you call an ambulance. We are a one way trip provider!!<br />
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<img alt="" height="252" src="http://www.goldcoast.com.au/images/uploadedfiles/editorial/pictures/2009/08/06/taxi-hospital.jpg" title="" width="344" />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-81774403903650371562012-11-18T01:35:00.002+13:002012-11-18T01:35:12.474+13:00<span style="font-size: x-large;">The practice of medicine is the practice of compassion........however this is not taught in any medical school. Patch Adams. MD</span><br />
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<span style="font-size: x-large;"><span style="font-size: small;">Dr Patch Adams <span style="font-size: small;">worked as a physician for free for 12 years. He had a night time job to <span style="font-size: small;">support himself. He said he paid to practice medicine because it was such a priveledge to do so! His practice included spending 4 hours with every <span style="font-size: small;">patient during his first consult so he could truly know and <span style="font-size: small;">understa<span style="font-size: small;">nd what was wrong with the patient and thereby provide assistance. His treatment included using love, compassion and humour<span style="font-size: small;">.</span></span></span></span></span></span></span></span><br />
<span style="font-size: x-large;"><span style="font-size: small;"><span style="font-size: small;"><span style="font-size: small;"><span style="font-size: small;"><span style="font-size: small;"><span style="font-size: small;"><span style="font-size: small;"><a href="http://www.patchadams.org/">http://www.patchadams.org/</a> <span style="font-size: small;"> </span></span></span></span></span></span></span></span></span> Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-68068039122022649002012-09-03T01:19:00.001+12:002012-09-03T01:19:42.381+12:00Book is now published and available on Amazon<div class="separator" style="clear: both; text-align: center;">
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Well its been years in the making but the book has finally arrived. Available for download at just $0.99c from Amazon.com. Click on the little rotating widget on the sidebar to find it. Print version to follow. To keep the price of the book down I am printing in B&W only. Photos will be available on the website and facebook page (see links in sidebar). Happy reading!Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com1tag:blogger.com,1999:blog-30722487.post-73549741661670666232012-08-27T11:35:00.001+12:002012-08-27T11:35:27.122+12:00Lady LuckIt never fails to amaze me how some people involved in serious motorvehicle accidents manage to escape relatively unharmed.<br />
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I have lost count of the number of accidents I have been called to where the vehicle was wrecked but the patient was somehow pretty much injury free.<br />
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The very first one involved a car that somehow went off the road into a ditch, coming to a sudden halt at the bank at the end of the ditch in a head on collision. The driver was knocked out and flung sideways. When I looked in the drivers compartment the steering wheel was up against the seat. He would have likely died from chest injuries. Instead he somehow got flung sideways out of the way!<br />
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More recently I went to a van with 7 passengers which rolled on a country road. One of the passengers had a hand injury but the rest walked away pretty much unharmed. No head injuries, no c spine injuries. Nothing!<br />
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Anotherone involved a driver who most likely fell asleep at the wheel and rolled his car on a bend on another country road.<br />
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When I pulled up the car was upside down and his legs were poking out from the passengers door. I immediately thought this was going to be a fatal but as I walked over to the car he wiggled out and stood up He had been looking for his mobile phone!! Once again he was unharmed and refused to come with us so he went to the police station for a breath test instead!!<br />
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Yes Lady luck was shining on these people.Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com1tag:blogger.com,1999:blog-30722487.post-28353117646666737662012-08-26T10:48:00.001+12:002012-08-26T10:48:36.953+12:00Everything is going to be okI just watched an episode of Rescue 1 which follows a rescue helicopter crew to jobs. The Advanced Paramedic had responded to pick up a rugby player with a suspected neck injury. The patient had been packaged onto a stretcher with stiff neck in place. He was lying there with a worried look on his face.<br />
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The Advanced paramedic leaned over him and put a hand on him and uttered those magic words. <i>"Everything is going to be ok"</i><br />
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He went on to explain what had happened, why they had packaged him that way and what was going to happen next. <i> </i><br />
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Why am I making a big deal about this?<br />
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Because I have been a patient and I know how terrifying it is lying there imagining all the terrible things that you think is happening or going to happen to you. Your lack of knowledge or understanding, even as a clinician, results in you thinking the very worse and fear can really overtake you.<br />
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Hearing those words of absolute reassurance that <i>everything is going to be ok </i>from the ER doctor simply melted away all my fear.<br />
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As paramedics we often attend the same types of jobs over and over again. Chest pain patients for example become a routine call out for many of us, yet for most of these patients it is their first ever cardiac event and something that is probably very terrifying. Its hard not to think the worst possible scenraio when your heart is the source of your illness. Even worse, there is a general misconception that heart attack=cardiac arrest/death (which is only sometimes true!)<br />
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Yet how many of these routine patients do we attend to and forget to include in our standard treatment regime some simple reassurance of the patient that <i>everything is going to be ok</i>?<br />
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It is probably one of the single most effective parts of our treatments. Alleviating fear reduces heart rates which in turn reduces myocardial oxygen demand so not only does it have psychological effects, it also has positive physiological effects.<br />
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Now it may well be true that the patient is very ill and my deteriorate but the fact is, while they are in our care we have all the tools to help them, so for the patients benefit everything will be ok and they need to know this.<br />
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So next time you attend that patient and are busy sticking IV's in them, hooking them up to your monitor, taking their blood pressure and sticking an oxygen mask on their face, dont forget those magic words.....<i>everything is going to be ok</i>. Trust me, your patient will thank you for it.<br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-83036810557220228462012-07-10T12:00:00.000+12:002012-07-10T12:00:02.519+12:00Drugs and Patients<div class="separator" style="clear: both; text-align: center;">
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Recreational drugs get a bad rap in the press mainly because there are some nasty ones out there which can create havoc in the wrong individual (or even the right one).<br />
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Recreational drugs basically fall into two categories - uppers and downers although there are subcategories in each of these.<br />
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I remember when party pills first came on the scene in NZ. It arrived with the rave scene. Before its arrival we were guarenteed to go to alcohol fuelled assualts, drunk drivers, beatings or PFO's (Pissed and fell over) and the occasional riot every Thursday, Friday and Saturday night without fail.<br />
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When the recreational party pills came on the scene this largely dissappeared. We were all intrigued by it. Suddenly we were going to overdoses of a substance we knew nothing about. The patients, instead of being violent, aggressive and vomiting all over the place were usually sedated or spaced out but usually compliant.<br />
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Fast forward 12 months and the groups using these drugs had gotten used to how they worked and that it wasnt a good idea to either mix the drugs or take them with alcohol. As a result our call rates to drunk, aggressive, assaulted and PFO patients on Thursday, Friday and Saturday night significantly dropped off.<br />
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Even the Police noticed a change. At a large party event they would stage the usual nunbers of police with the paddy wagon at the ready. They soon realised that the mood enhancing drugs put people is a good mood instead of an agressive one and eventually the Police stopped attending the smaller raves altogether.<br />
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Then along came the legal 'herbal' highs. Once again we had the few who experimented and overdosed but after a while we had few callouts to these legal pill poppers.<br />
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Unfortunately the gangs realised the money to be made from recreational party drugs and started importing and suppling more lethal drugs. P, E, Meth even Heroin soon made its way to the streets and the occassional nutter that took them ended up creating havoc which made the national headlines.<br />
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Politicians, seeing this as an opportunity to boost their ratings jumped on the moral bandwagon and publically damned these 'evil drugs' and insisting that all party drugs be made illegal including the herbal ones. They seemed to ignore the fact that alcohol had created far more chaos and cost the country huge amounts of dollars in rehab and healthcare expenditure or that they had closed our psychiatric institutions and put the mentally unstable in the community with little supervision or support.<br />
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As a result the legal BZP containing herbal party pills were banned. The youth soon turned back to what they used to use - alcohol and underground drugs (E, P, Dope) and Thursday, Friday and Saturday nights have gone back to booze fuelled bashings, drunk drivers, PFO's and the occasional riots. Not only that, the government lowered the legal drinking age and allowed the increase accessibility of alcohol which fuelled the problem.<br />
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The reality is that people will always seek an escape from reality. Personally I would rather see people taking regulated, legal herbal highs than alcohol. I have yet to go to a party pill popper who as a result of taking a herbal high turned around and gave his Mrs the bash, or got into car and smack into an innocent victim or become super aggressive when they fall over and get peeled off the pavement. Alcohol on the other hand does all of this on a regular basis.<br />
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Thanks to politicians and their alter motives, they can safely sit back and sip on their malt whisky while our crews and emergency departments fill up again with vomit covered drunks, aggressive intoxicated patients and their assault victims and the occasional nutter who trips out on some underground illegal substance.<br />
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Thanks for making our job that much harder!! <br />
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Well thats my take on it. Be interested to hear your views.<br />
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<br />Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-78566379744921612302012-07-05T14:59:00.001+12:002012-07-05T15:19:40.638+12:00Priority One DrivingPriority One Driving is when you drive fast with your lights and sirens going. It is used when the job you are attending is deemed urgent by the control room. They decided this based on the information they receive.<br />
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Unfortunately some people think this is a free license to drive wrecklessly and see what limits the vehicle can handle on the road. I have seen some absolutely shocking P1 driving, mainly from the Police. Once I was almost taken out by a Police car which came to a handbrake slide stop at an accident I was at. They literally stopped 1 ft away from me. If Joe public did this they would be arrested and charged with wreckless driving but because its the Police they seem to be immune.<br />
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Its a funny thing but there seems to be a direct link for some people between turning on the lights and siren and switching on a speed demon channel in that persons head. They become this completely different person who think they are totally invinsible and immune from danger. They transform to a racing car driver who's main aim is to drive as fast and wrecklessly as they can, wheelspins included. Its actually quite frightening sitting next to them.<br />
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Now I, along with most other people that drive emergency service vehicles, love driving prioity one, but I tend to do so with resepct for other road users and do it with the main aim of arriving at the job safely. Crashing an emergency vehicle on the way to a call is definately not a cool thing to do and although it happens a lot less than it used to, it does still happen.<br />
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The vehicles are so much safer to drive these days with ABS brakes, air bags, power steering, uprated suspension and even stability control and I suspect this has had a lot to do with the crash rate being lower than before rather than less people driving wrecklessly.<br />
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Below was a video I shot of some Police cars driving down Auckands Queen St. This is an example of some good, safe P1 driving. They read the road ahead (and avoid crashing into a bus that does not see them until he goes around the corner), do not drive excessively fast for the conditions and even stop at the red traffic light to make sure everyone has seen them before proceeding! Most importantly, they arrived safely at their destination!<br />
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<iframe allowfullscreen="" frameborder="0" height="270" src="http://www.youtube.com/embed/-i-aaWOpEmI?fs=1" width="480">&lt;p&gt;&amp;amp;amp;amp;lt;p&amp;amp;amp;amp;gt;&amp;amp;amp;amp;amp;amp;amp;amp;lt;p&amp;amp;amp;amp;amp;amp;amp;amp;gt;P&amp;amp;amp;amp;amp;amp;amp;amp;lt;/p&amp;amp;amp;amp;amp;amp;amp;amp;gt;&amp;amp;amp;amp;lt;/p&amp;amp;amp;amp;gt;&lt;/p&gt;</iframe>Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com1tag:blogger.com,1999:blog-30722487.post-66315806479061148682012-06-27T06:41:00.000+12:002012-06-27T07:15:41.525+12:00Paramedic Registration - Good or Bad?It seems inevitable that paramedics will eventually become registered practitioners when the registration process is implimented. Australia is lobbying hard for it as is the NZ Ambulance board. So will registration be a good or bad thing? Here are the pro's and Con's as I see it.<br />
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<h2>
<b>Pro's:</b></h2>
<ul>
<li>Your qualification will be more internationally recognised / portable</li>
<li>Increased public awareness of a paramedic qualification</li>
<li>Standardisation of skill sets nationally</li>
<li>Potentional increase in skills</li>
<li>Less influence from any single Medical Director on protocols</li>
<li>Skill sets should be based on best practice from panel of experts</li>
<li>Right to practice will not necessarily be dictated by an ambulance service </li>
<li>In theory should lift level of expertise in the industry </li>
<li>Should be a fairer system in deciding right to practice (less subjective) </li>
<li>Rogue practitioners will be weeded out</li>
<li>Broader opportunities for employment across the sector</li>
<li>We get to wear another pretty badge</li>
</ul>
<h2>
Con's</h2>
<ul>
<li>WAY more personal accountability (not everyone ready for this)</li>
<li>We will have to pay for the priveledge to do something that currently costs us nothing</li>
<li>We will need to provide annual proof of practice which may mean relying on an ambulance provider to employ us (unless this is broadened to include other medical practice)</li>
<li>Legal accountability will fall on individuals and not Medical Director as it does now</li>
<li>Consequences of mistakes are far more serious and may result in suspension of registration during investigation instead of being delat with 'in-house'</li>
<li>We currently rely on a large proportion of volunteers who may not want the responsibility of being registered and result in decrease numbers of volunteers</li>
<li>The cost of registration may not be met by employers particularly for casual employees</li>
<li>Unsure how an appeal process would work if board decision does not seem fair</li>
<li> False accusations or complaints from patients resulting in board investigations could ruin a career</li>
</ul>
Obviously this is not an exhaustive list and just my thoughts. Im not sure NZ is ready for registration yet and we have a long way to go to prepare for it. It would appear however that registration is coming whether we like it or not.<br />
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<span style="color: #999999;">Baby bump fitness - Quick & efficient exercises for new and soon to be mums</span> <a href="http://e1db9-v6mgfhi800g286w72p8j.hop.clickbank.net/" target="_top"><span style="color: blue;">Click Here</span>!</a>Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-89851261579847752932012-05-20T23:06:00.000+12:002012-05-20T23:06:29.271+12:00Taking ownership of your healthIt saddens me that many elderly people simply surrender ownership and responsibility of their health to our so called medical professionals. It would appear that very few doctors are willing to actually look into the cause of illness and actually treat it. Instead they seem intent on reducing symptoms by prescribing drugs and then more drugs to reduce symptoms caused by the first lot of drugs. For instance, many elderly patients (and adults in general) are chronically dehydrated, yet so many are on diuretics. This can lead to other issues which are then treated by yet more drugs. The pharmaceutical industry must love it. How many doctors actually enquire about the state of hydration and nutrition of their elderly patients, which can be the cause (or cure) for many ailments? Instead they reach for the pen, write a script and increase the profits of pharmaceutical companies. Thanks goodness for the internet and freedom of information :)
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFVMcfrwkci3futVpRpUXNOD1OAtbPsVLd-p6NGQxFOcAdcJQfrRjuOavduYzelbwQ0MwN7X_oUQxm7sM6t4ElQsbHclrSgn_9tUz_KhAqfFai7DZihOdV3zEEoa_QEglLhW1u/s1600/card_002.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="214" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFVMcfrwkci3futVpRpUXNOD1OAtbPsVLd-p6NGQxFOcAdcJQfrRjuOavduYzelbwQ0MwN7X_oUQxm7sM6t4ElQsbHclrSgn_9tUz_KhAqfFai7DZihOdV3zEEoa_QEglLhW1u/s320/card_002.jpg" width="320" /></a></div>Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-28434753411346969222012-05-15T10:44:00.000+12:002012-05-15T10:44:06.146+12:00Sensational mediaAnother case of sensationalisation from the media. Went to a car v truck. Driver of said car had to be cut out and the fire service did an awesome job of cutting off the roof and door so we could extricate. Along comes newspaper photographer who reports that the crash was so violent that the roof and door flew off and were lying meters away from the crash. lol.
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9tzchK1ZtliwbwaPDT1rTlE960CL9WHDJ1CPlEgrgttUI4tW1BpJjSZja66Nt1LvhzxXRYct-PHiqV_XjpmJln-KugcezOtC-z4HLm6BExb_7xEDv4T06jEvXgLiFAnpn7Awj/s1600/horror_fct304x280x33_t300.jpg" imageanchor="1" style="margin-left:1em; margin-right:1em"><img border="0" height="276" width="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg9tzchK1ZtliwbwaPDT1rTlE960CL9WHDJ1CPlEgrgttUI4tW1BpJjSZja66Nt1LvhzxXRYct-PHiqV_XjpmJln-KugcezOtC-z4HLm6BExb_7xEDv4T06jEvXgLiFAnpn7Awj/s320/horror_fct304x280x33_t300.jpg" /></a></div> Imgae courtesy of Hawkes Bay TimesAucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-47395315602737236592012-02-11T12:10:00.000+13:002012-02-11T12:10:52.711+13:00Air ambulanceAW139 Ambulance. Lots of room and no traffic lights to negotiate. Medivacs are great when you have a stable patient :)
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijwgUSnONakeYWwog5Nth9sqqpQHoQGVrryK6i5HQWCU8GCDGygK2fPnPRfLyR4MfXWcl7rHsRwTjz2HC1Sf1-K8IClk9K5HxGLTY89VgwZx_ObSwSfpEjKlLOFXjqjDebz9ah/s1600/11022012625.jpg" imageanchor="1" style="clear:right; float:right; margin-left:1em; margin-bottom:1em"><img border="0" height="240" width="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijwgUSnONakeYWwog5Nth9sqqpQHoQGVrryK6i5HQWCU8GCDGygK2fPnPRfLyR4MfXWcl7rHsRwTjz2HC1Sf1-K8IClk9K5HxGLTY89VgwZx_ObSwSfpEjKlLOFXjqjDebz9ah/s320/11022012625.jpg" /></a></div>Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-30997704404795390262012-02-11T04:21:00.000+13:002012-02-11T04:21:20.392+13:00Being able to give IV pain relief really is the most wonderful thing. Relieving suffering has to be one of the most satisfying feelings even if its just while they are in our care.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwztUCusCUYr8jtRiUOLDt2RAdo9yIIPanZ6lGNjVbWgo6LpK7gchVR3_EBuLEO-5zTLMP120wLzbY7ZPQmcwmEHUSmkjGfd-R2O-Ak4WaVqqh-pBiKaOo5xPBfdydlmKs3A6Y/s1600/syringe.jpg" imageanchor="1" style="clear:right; float:right; margin-left:1em; margin-bottom:1em"><img border="0" height="264" width="191" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgwztUCusCUYr8jtRiUOLDt2RAdo9yIIPanZ6lGNjVbWgo6LpK7gchVR3_EBuLEO-5zTLMP120wLzbY7ZPQmcwmEHUSmkjGfd-R2O-Ak4WaVqqh-pBiKaOo5xPBfdydlmKs3A6Y/s320/syringe.jpg" /></a></div> Today we are more spoilt than ever with two inhalation analgesics, three intravenous analgesics and an oral analgesic. It always makes my day when I can take someones pain away :)Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-80411058157080294622012-01-27T10:38:00.001+13:002012-02-09T05:58:22.545+13:00We live in a topsy turvy worldI have come to realise that the world we see is actually inverted. The health system is actually not interested in health but sickness. Imagine if people were actually well and didnt need drugs, hospitals, surgery, doctors, nurses...there would be a lot of unemployed people and broke business's. Im sure thats why holistic and natural medicine is on the outer. It looks to fix the problem and create a cure rather than just treating symptoms and making people dependent on the system (think long term medications, hospital follow ups, ongoing surgery etc). <br />
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Even the supporting societies are not there to help but to maintain the status quo. Hence the Asthma Society is not actually interested in curing asthma - they would cease to exist. Same with the Cancer Society, Arthitis foundation, Heart Foundation etc. I read of a woman who found a natural cure for her arthritis after suffering in agony for 30 years. Delighted, she contacted the arthritis foundation, which she had been an active member of, only to be told they were not interested in hearing about her miraculous cure. I also find it interesting that Cancer charities who raise millions of dollars towards research and supporting cancer sufferers never seem to mention the simple fact that cancer cant survive in an alkaline environment which can be bought about simply through dietry changes.<br />
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But it doesnt just stop in the Health area. Police are not there to protect us against crime. If there were no crime there would be no need for a police force. They have a vested interest in the very existence of crime. Imagine if there were no burgularlies anymore. What would the giant insurance companies do? They dont mind paying out on claims becuase it gives them repreat business.<br />
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Governments are not there to represent the people anymore(their orginal pupose). They now represent the giant corporations and try and to control the people instead of answering to them.<br />
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I think finding out that Santa wasnt real was just the beggining of discovering that the world is actually nothing of what you think its about.<br />
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Still, knowledge is power, and armed with this knowledge I know I can now make a real difference.Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0tag:blogger.com,1999:blog-30722487.post-5193047921557563622012-01-27T10:24:00.000+13:002012-02-08T06:31:02.483+13:00A breath of fresh airI worked with a veteran paramedic the other day. He has been doing the job for 30 years, yet he still enjoyed the job and was great to his patients. He had excellent clinical skills and was a really great teacher / mentor. I told him he had a great attitude and that if only we had more people like him the place would be all the better for it. He said it was a personal choice. Working with him was a total breath of fresh air and an inspiration.Aucklandirhttp://www.blogger.com/profile/04277299805991060265noreply@blogger.com0