Author Topic: Clinical?  (Read 11400 times)

Knackers

  • Guest
Re: Clinical?
« Reply #25 on: February 20, 2008, 09:19:50 AM »
Jaff,

To be a Paramedic now you pretty much have to do a Degree, then follow up with an internship. There used to be an internal Diploma but that is now gone from SAAS and most other services.

So you do 3 years at uni (Paramedic degree, there about 8 in Aust), then an internship of 1-2 years.

With SAAS they now have an RSDP (Regional Sponsored Degree Program) in which people from ATS and Volunteer apply and then (if get in) do the Flinders degree externally while working with SAAS full time. This takes about 5 years to complete the Degree and Paramedic Qualification.

The ICP course is 12 months long and you must be a Paramedic to apply. They have a higher skill set and are more autononomus. The course I think is about to change within the next 2 years, heard rumors, but not sure what going on.

An SOT, which stands for Special Operations and Tactics Paramedic (Referred to as a Special Operantions Team Paramedic) is an ICP who has done Aeromedical and rescue training, such as verticle etc. There guidelines are same as an ICP, they just have specilist training and a whole lot of experience.


As for treatment options, difficult to discuss on line, but an ICP has more options and additional skills like intubation (airway), pacing (increasing heart rate), cardioversion and some more drugs. A Paramedic has more than an ATS (transfer services) and volly, inculding cannulation, IV morphine, IV adrenaline (cardiac arrest), fluid for trauma etc.

at the end of the day though, no matter who you are and what whiz bang skills and drugs you can use, the basics still apply.

Am sure the more experience ambo's like boredmatrix can add or fix if I missed something.

Hope this sheds some light.

Offline Firefrog

  • Administrator
  • *****
  • Posts: 792
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #26 on: February 20, 2008, 12:26:36 PM »
And now back to the topic.

Can a seperate SAAS agency forum be created like SES, so that they are seperated & can grow....hint to moderators.


Your wish is my command! :-D


Offline boredmatrix

  • Forum Lieutenant
  • ****
  • Posts: 644
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #27 on: February 20, 2008, 08:29:53 PM »
squiddy - thank you for your comprehensive reply, which to most would be informative.

as for me - you may well have thrown an egg at me and told me how to suck it!  filtered

yes - the RN's on retrievals may be experienced and qualified, but can still not initiate immediate measures such as intubation or IVT (Infusions OR Drugs)for example -  of their own volition!

while I haven't read the paper- the anecdotal evidence is all around us - you only need to open your eyes and see it.

You only need to speak to Retrieval Docs from much larger companies such as Careflight - who will unanimously agree that PRIMARY TRAUMA retrievals (yes - as my previous post clearly stated) shouldn't be the domain of retrieval nurses!

Offline Pipster

  • Forum Captain
  • *****
  • Posts: 1,269
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #28 on: February 20, 2008, 09:01:56 PM »
Would I be correct in saying that the retrieval nurses do more medical retrievals, than primary trauma retrievals?

Pip
There are three types of people in the world.  Those that watch things happen, those who make things happen, and those who wonder what happened.

Offline squiddy

  • Forum Senior Firefighter
  • ***
  • Posts: 115
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #29 on: February 21, 2008, 06:01:30 AM »
Would I be correct in saying that the retrieval nurses do more medical retrievals, than primary trauma retrievals?

Pip

A retrieval job comes up, a doctor and nurse go out the door. Sometimes we don't get specifics until they are up in the air or on the road.

Offline squiddy

  • Forum Senior Firefighter
  • ***
  • Posts: 115
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #30 on: February 21, 2008, 06:19:28 AM »
squiddy - thank you for your comprehensive reply, which to most would be informative.

as for me - you may well have thrown an egg at me and told me how to suck it!  filtered

yes - the RN's on retrievals may be experienced and qualified, but can still not initiate immediate measures such as intubation or IVT (Infusions OR Drugs)for example -  of their own volition!

while I haven't read the paper- the anecdotal evidence is all around us - you only need to open your eyes and see it.

You only need to speak to Retrieval Docs from much larger companies such as Careflight - who will unanimously agree that PRIMARY TRAUMA retrievals (yes - as my previous post clearly stated) shouldn't be the domain of retrieval nurses!


Don't get snippy, Matrix... the answer was intended in part for you, and in part for those who had asked questions. After all, this is a forum where people ask questions. Just because you know the answers, doesn't mean you need to have a go.

And I suggest you find a copy of the paper and read it before you have a go next time... as it states that nurses are an integral part of retrieval, but the current situation of having three teams in three places is not working, so they need a smaller team based in one spot with a broader skill mix. It is the skill mix that is causing problems, because the paper is blurring the lines between emergency pre-hospital care and retrieval nursing.

Offline Firefrog

  • Administrator
  • *****
  • Posts: 792
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #31 on: February 21, 2008, 05:07:08 PM »
Let's play nice in the sandpit :-P

rescue5271

  • Guest
Re: Clinical?
« Reply #32 on: February 21, 2008, 05:25:04 PM »
well when you get to the job you could always push the nurse out and put the ICP in the chopper..... :roll:

Offline squiddy

  • Forum Senior Firefighter
  • ***
  • Posts: 115
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #33 on: February 22, 2008, 05:58:35 AM »
well when you get to the job you could always push the nurse out and put the ICP in the chopper..... :roll:

If it is certain nurses, can we push them out of the chopper on the way?

Offline boredmatrix

  • Forum Lieutenant
  • ****
  • Posts: 644
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #34 on: February 29, 2008, 09:24:50 AM »
squiddy - now I'm thoroughly convinced you can't read......or at the very least - don't understand what you read!!


nowhere in the paper does it talk about cross-training paramedics or nurses in each others roles!  In fact  - the paper only discusses creating an entire new role in which each will bring their own expertise and clearly defined clinical guidelines for both, while the domain of rescue (sic - of rotary wing response) will still remain solely with SOT.  credence to this again when the question was asked- why should nurses be doing primary trauma retrievals?

it's been clearly identified in this paper that there are roles for both nurses and paramedics which need to be far more acutely focused in order to deliver appropriate service in a much more efficient manner! Is this not what you slammed in my former comments? 

This paper has been a long time coming - and there are those out there who've been empire building who don't like it because now their Lego Castles are coming tumbling down!  for too long has SA managed most of their health system in a primarily Ad Hoc fashion - but I guess this happens when you put people in roles who focus purely on the immediate issues, and give no thought for sustainability and longevity of any project.

as for pushing certain nurses out of the chopper - where can I send the list?!   :evil:


sesroadcrashrescue

  • Guest
Re: Clinical?
« Reply #35 on: February 29, 2008, 07:33:49 PM »
as an ambo i have seen retrieval nurses stop ambos and paramedics from decking doctors. i had a job last Saturday near stockport which we had three ambulances on scene two ambulance and one Intensive care paramedic crew. then we also had retrieval come to play along with the Special operations team intensive care Paramedic and a few times the nurse had to stop some ambos from smacking the doctor one so sometimes it is good to have a nurse to keep a bit of a buffer between the doctor and ambos.

in saying that i have worked with some great doctors and nurses oh and keep the nurses on the choppers as it keeps my mate in a job.

(used the big words for those that are not quite sure what some things mean)       

Offline boredmatrix

  • Forum Lieutenant
  • ****
  • Posts: 644
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #36 on: March 07, 2008, 09:45:41 AM »
yeah fair call - but we all know there are clowns in every circus, and then there's EGO's in medicine!

I know there's some ambo's out there who have much maligned ideas about their capabilites, and don't know when to sit back and take direction!

at the end of the day, it's still about working together, but more importantly - being aware of your capabilities and knowing what you can contribute as part of a much larger "system".

The biggest change in retrieval services in the past 15 years will be what this paper has discussed...IF the RP role comes to fruition!  granted, there will be loads of politics involved, but as I've maintained - nurses are not good at dealing with primary trauma in the pre-hospital environment and it's time for a change.

A broad statement I know, and probably primarily anecdotal - But I'm yet to see one retrieval nurse who could do so effectively without losing their cool at some point!!

Offline jaff

  • Forum Captain
  • *****
  • Posts: 848
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #37 on: March 08, 2008, 11:09:54 PM »
Boredy ,how many ambulances are there in metro Adelaide? How many Ambos And Paramedics? Do you Guys have a GPS in your vehicles?
Adelaide airport plane splatters onto runway, possibly hundreds requiring immediate transport and care, could SAAS and Local hospitals cope?

Cheers Jaff
Just Another Filtered Fireman

Offline Zippy

  • Global Moderator
  • *****
  • Posts: 2,540
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #38 on: March 09, 2008, 09:09:53 AM »
There is a Taxi Rank, at the airport  :evil:, dont forget about the buses to the city that do happen to go near the RAH.

Offline OldOne

  • Forum Senior Firefighter
  • ***
  • Posts: 66
  • Karma: +0/-0
  • Long time SES member
    • View Profile
Re: Clinical?
« Reply #39 on: March 09, 2008, 09:28:00 AM »
There is a Taxi Rank, at the airport  :evil:, dont forget about the buses to the city that do happen to go near the RAH.

Yes I have been involved in a number of mass casualty exercises at Adelaide Airport and buses are always used for the "walking wounded" after triaging at the scene with normally a dozen ambulances for stretcher cases and SAPOL for overall command.  They normally hold a full practical exercise every second year and a "desktop" on the in-between year.  Same as Parafield AP in a smaller scale (normally 5 to 10 casualties size).

cheers.
SES Communications trainer

Offline Sam

  • Forum Senior Firefighter
  • ***
  • Posts: 83
  • Karma: +0/-0
    • View Profile
    • Scanning South Australia
Re: Clinical?
« Reply #40 on: March 25, 2008, 05:09:34 PM »
RFDS send a nurse and a pilot on the plane for retrievals and if really bad a doctor will also come.

The nurse is there to organize and make sure that he the patient is stable enough for flight, and obviously monitor the patient during flight.

Offline RescueHazmat

  • Global Moderator
  • *****
  • Posts: 1,174
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #41 on: March 25, 2008, 10:05:17 PM »
It depends Sam where the Retrieval team is activated from. - I have been involved with some that have had 2 Nurses, 2 RAH retrieval members (1 was a Doctor) and a Pilot.

Offline boredmatrix

  • Forum Lieutenant
  • ****
  • Posts: 644
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #42 on: March 25, 2008, 10:18:44 PM »
erm - depends on the context and location. 

Retrieval generally(sic) refers to a Doc and Nurse from an ICU (FMC or RAH) going out to retrieve a patient - be it either from the roadside or a medical facility in order to get said pt safely back to ICU.

This is not to be confused with primary response - which is the role of SAAS and RFDS. SAAS is most often primary, with exception of remote locations or stations in which case RFDS is.

Retrieval generally happens in conjunction with SAAS and/or RFDS being the transport mediators(ie: taxi)

Offline JC

  • Forum Lieutenant
  • ****
  • Posts: 417
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #43 on: March 26, 2008, 02:24:21 AM »
Yep, when we get retrievals up here its the whole road show RAH or FMC retrieval crew ,like Bored said to provide Intensive Care (but they dont happen that often), but in most cases the RFDS flyouts (prob 2-3 a week) are just a RFDS nurse, due to the fact the patient needs services RDMC cant provide but doesn't need Intensive Care or treatment.
Roxby Downs CFS
Lt 2
BHP ESO

Offline jaff

  • Forum Captain
  • *****
  • Posts: 848
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #44 on: March 26, 2008, 10:04:27 PM »
Are RFDS restricted by Adelaide Airports curfew or exempt?
Just Another Filtered Fireman

Offline boredmatrix

  • Forum Lieutenant
  • ****
  • Posts: 644
  • Karma: +0/-0
    • View Profile
Re: Clinical?
« Reply #45 on: March 26, 2008, 10:08:16 PM »
exempt - trust me on that one!  many a cold windy winter night spent on that tarmac at 3AM!