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RE: ALS course?

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Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

I personally would like to see a course that is tailored to the environment most

medics currently work in i.e. Remote, without good / timely access to higher

medical facility, and wide variations in types of equipment available for use.

The course should assume that little or no qualified help will be available to

the student at location and should train accordingly. I favor a course more

tilted to pre-hospital care, being an offshore medic myself.

Cheers, Kishore.

From: Colin <cjmartin11@...>

Subject: RE: ALS course?

Date: Monday, 6 December, 2010, 1:50 PM

 

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

Hi Kishore,

Completely agree but unfortunately we can winge and moan as much as we like

until we are blue in the face but until the accredited training providers wake

up and do something about it we are left with the sub standard non FFP courses

that are currently available to us!!! Just a sub point here maybe the agencies

might also like to get someone who has actually worked offshore to write or edit

protocols to because the one's usually written by some Occupational Health

Doctor are usually crap!!! and they usually haven't even bothered to read the

list of meds carried offshore!!!

Rant over!!!

Ian.

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>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > > > Hello Everyone,

>

> >

>

> > > >

>

> >

>

> > > > I'm an Off Shore medic.

>

> >

>

> > > >

>

> >

>

> > > > Where oh where can I do an ALS course in the UK as the places I've

>

> >

>

> > > tried

>

> >

>

> > > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> >

>

> > > >

>

> >

>

> > > > Regards,

>

> >

>

> > > >

>

> >

>

> > > > Witty.

>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > > >

>

> >

>

> > >

>

> >

>

> > >

Link to comment
Share on other sites

Kish,

I am not sure whether you’ve taken a look at the DipROM? It’s a course that

was developed by the guys on this board. You can get more information on the

following site:

http://www.diprom.rcsed.ac.uk/

Rgds

J

From:

[mailto: ] On Behalf Of Kishore H

Sent: 06 December 2010 10:52 AM

Subject: RE: ALS course?

I personally would like to see a course that is tailored to the environment most

medics currently work in i.e. Remote, without good / timely access to higher

medical facility, and wide variations in types of equipment available for use.

The course should assume that little or no qualified help will be available to

the student at location and should train accordingly. I favor a course more

tilted to pre-hospital care, being an offshore medic myself.

Cheers, Kishore.

From: Colin <cjmartin11@... <mailto:cjmartin11%40hotmail.com> >

Subject: RE: ALS course?

<mailto:%40>

Date: Monday, 6 December, 2010, 1:50 PM

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

A course that sounds like what you want is the IMCA dive-medic course. It is a 2

week course, consisting of BLS, including intubation technique, cannulation,

suturing, giving meds via all routes, fracture immobilization, recognizing and

treating heart attacks and strokes, haemo/pneumo thorax, abdominal complaints,

burns and shocks etc.  After the written exams the guys are taken to a

provincial hospital for practical.  These are literary " guys of the street "

(international commercial divers) who work pretty much on their own out on sites

and rigs, with a doctor at the end of the phone-line. 

Cheers

Barbara

________________________________

From: Kishore H <kishorep1914@...>

Sent: Mon, December 6, 2010 12:52:27 PM

Subject: RE: ALS course?

 

I personally would like to see a course that is tailored to the environment most

medics currently work in i.e. Remote, without good / timely access to higher

medical facility, and wide variations in types of equipment available for use.

The course should assume that little or no qualified help will be available to

the student at location and should train accordingly. I favor a course more

tilted to pre-hospital care, being an offshore medic myself.

Cheers, Kishore.

From: Colin <cjmartin11@...>

Subject: RE: ALS course?

Date: Monday, 6 December, 2010, 1:50 PM

 

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

Thanks , I have heard about this DipROM course, I will check out the

website for details. Regards,

Kishore.

From: Colin <cjmartin11@... <mailto:cjmartin11%40hotmail.com> >

Subject: RE: ALS course?

<mailto:%40>

Date: Monday, 6 December, 2010, 1:50 PM

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

>

> >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> > > Hello Everyone,

>

> > >

>

> > > I'm an Off Shore medic.

>

> > >

>

> > > Where oh where can I do an ALS course in the UK as the places I've

>

> > tried

>

> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

>

> > >

>

> > > Regards,

>

> > >

>

> > > Witty.

>

> > >

>

> > >

>

> > >

>

> > >

>

> > >

>

> >

>

> >

Link to comment
Share on other sites

Many thanks Barbara for the suggestion. Will definitely check it out.

Cheers, Kishore.

From: Colin <cjmartin11@...>

Subject: RE: ALS course?

Date: Monday, 6 December, 2010, 1:50 PM

 

Sorry a few typo's in that one fat fingers today but you get the rift ops

mean drift

Hi All

Ian I agree completely, but the question then becomes which professional boy

and in which country and under which set of standards and curriculum do we

use and which English language is used English English, Australian English

or American English?

I agree that procedurally we are for the most part on our own and have to

cope with the clinical presentation as best as we can, however the concepts

and fundamentals of physiology, patho-physiology with regards what is

actually happening in our patient does not change these are key basic core

concepts of advanced care and practice, so my patient has a head injury and

has signs of RICP and Cushing's triad or my patient has blunt chest trauma

and has signs of Becks triad or my patient who has suffered an Ant-Lat MI is

now showing signs of CCF and fluid overload.

What I am saying is that the core concepts of critical and emergency care

are for the most part the same with the exceptions of environmental exposure

and other industry related issues, prolonged holding times, prolonged

retrieval times, but a hypoperfused, hypotensive or hypertensive, hypoxic,

hypercarbic patient is exactly that ect. ect.

So my question is what is it we are talking about when we say training, do

we mean procedures, skills sets, core concepts and knowledge and are we

talking pre-hospital care versus prolonged patient care in a clinic?

I agree with everyone so far as they are parts of a massive puzzle, my

question is, as we are the providers and clinicians who work in the unique

and challenging environment how do we address this and then work together to

fix it? How do we develop a course that works and I mean really works and is

accredited and recognized across the vast waters of the world????

What does the list think?

Hi All,

Just my two pennies worth here, let's face it we all know that virtually

none of the training establishments currently providing offshore medics

tickets have got it right!! What we are all looking for is an

internationally recognized accredited course specifically designed for our

working environment, the likes of Capita have the ALSS course but as

previously discussed not recognized by some? Would it be recognized in court

for example!! So at least they have tried to make the effort. The Nottingham

course very good but again is teaching to the standard hospital run

emergency with lots of specialist on call to help you out!!

Someone out there in the training world must recognize that these are not

FFP and write a course that understands the meaning of the lone remote medic

in the emergency situation who at best in most cases has someone who can

just about recognize the piece of kit he is asking for when he is hands on.

Something accredited by the Royal Collage would be a great start!!! and a

course that has been vetted by a long standing reputable offshore medic who

can add in the realities of the offshore environment, equipment and

medication limitations.

Then all we have to do is get the agencies to front up and allow us to

attend the course and change their protocols to fit!!!

Probably never in my offshore career!!!

Ian.

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> > > Hello Everyone,

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> > > I'm an Off Shore medic.

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> > > Where oh where can I do an ALS course in the UK as the places I've

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> > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

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> > > Regards,

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> > > Witty.

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________________________________

From: Kishore H <kishorep1914@...>

Sent: Sun, December 5, 2010 10:54:45 PM

Subject: RE: ALS course?

Lots of interesting things being said in this discussion. I agree that the

remote site medic does play the role of the team leader, but it's my humble

opinion that we don't really get much of a team to work with in most places.

Yeah we do train the galley hands in basic first aid, being part of stretcher

party and all that, but in an emergent situation, it's usually the medic all by

himself trying to juggle ten things at a time.

Maybe it's just been my experience and others have had better.

*********************

I am teaching an ACLS this week

I am tempted to give them

Just that scenario  ;-)

Guarantee he will Fit it UP

This said

Most of us have a CPR manekin

We HAVE to train our F-A in CPR anyway

But

Really what we need to do

Is run scenarios with them on a true ACLS code

The Medic should not have to :

Do CPR

Connect AED

Connect oxygen

PUsh AED D-fib button

Ventilate a intubated (LTD) Pt

Heck you can teach them to draw and prepare drugs

The Medic should have to :

Determine cardiac arrest

Lead FA team

Place a laryngeal tube (We have no time to intubate (E.T.)

Fix the laryngeal tube

Start an IV

PUsh drugs

Call top side

Clinical case :

Young fat cardiac arrest in stairwell of rig (2 AM)

Medic TRANSPORTED with bystanders Pt to infirmary

BEFORE using the AED

AED = 2 Kg

Pt = 100 Kg

Easy to make thaty mistake if you have not thought about it too much

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I have come across a commercial outfit that teaches nurses

Tio be extended role remote nurse in the north

http://www.solutionsnursing.ca/

Not PARAMEDIC oriented

But cover all the other stuff, us paramedic are not too good at

Otherwise

In french

http://www.usherbrooke.ca/cfc/activites-de-formation/cours-de-reanimation/

Ateliers pratiques de techniques utilisées en médecine d'urgence 

Is cadaver lab which is a good idea for US low volume medics

Or

You do like must of us

You work on large land base remote clinics

With some good docs (or not)

And learn and study as you go

 

________________________________

From: ramc606 <ianjamesdenton@...>

Sent: Mon, December 6, 2010 4:18:11 AM

Subject: Re: ALS course?

Hi Kishore,

Completely agree but unfortunately we can winge and moan as much as we like

until we are blue in the face but until the accredited training providers wake

up and do something about it we are left with the sub standard non FFP courses

that are currently available to us!!! Just a sub point here maybe the agencies

might also like to get someone who has actually worked offshore to write or edit

protocols to because the one's usually written by some Occupational Health

Doctor are usually crap!!! and they usually haven't even bothered to read the

list of meds carried offshore!!!

Rant over!!!

Ian. 

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> > > > I'm an Off Shore medic.

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> > > >

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> > > > Where oh where can I do an ALS course in the UK as the places I've

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> >

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> > > tried

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> >

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> > > > require that I have to be a Doctor,nurse or Paramedic/EMT to attend?

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> > > > Regards,

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These courses

As far as I am concerned

Are frauds

Commercial frauds

Medico-legal frauds

Just plain bad all over

Cheap, useless plasters

Really teaching enough to get people in trouble

And avoiding to hire somebody

That does not need to be tought IVs, Intubation, ACLS, etc.

Again

Endotracheal INTUBATION in most of the TCN staffed clinics is a medico-legal

crime

Laryngeal tubes should be the main advanced airway device

http://www.larynx-tubus.de/larynx-tubus/content/blogcategory/14/45/lang,en/

Teaching and expecting ET intubation in these groups

Just show how criminaly delusional or deceptive these people are

CCEMT-P have no problem having the laryngeal tube as my primary advanced airway

control

________________________________

From: Barbara Amor <brbramor@...>

Sent: Mon, December 6, 2010 5:41:50 AM

Subject: Re: ALS course?

A course that sounds like what you want is the IMCA dive-medic course. It is a 2

week course, consisting of BLS, including intubation technique, cannulation,

suturing, giving meds via all routes, fracture immobilization, recognizing and

treating heart attacks and strokes, haemo/pneumo thorax, abdominal complaints,

burns and shocks etc.  After the written exams the guys are taken to a

provincial hospital for practical.  These are literary " guys of the street "

(international commercial divers) who work pretty much on their own out on sites

and rigs, with a doctor at the end of the phone-line. 

Cheers

Barbara

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Agree with you , ET tube in inexperienced hands is bordering on criminal,

and guess how many times in one's offshore career, is one going to get an

intubation situation.

From: Brault <c_brault@...>

Subject: Re: ALS course?

Date: Monday, 6 December, 2010, 10:58 PM

 

These courses

As far as I am concerned

Are frauds

Commercial frauds

Medico-legal frauds

Just plain bad all over

Cheap, useless plasters

Really teaching enough to get people in trouble

And avoiding to hire somebody

That does not need to be tought IVs, Intubation, ACLS, etc.

Again

Endotracheal INTUBATION in most of the TCN staffed clinics is a medico-legal

crime

Laryngeal tubes should be the main advanced airway device

http://www.larynx-tubus.de/larynx-tubus/content/blogcategory/14/45/lang,en/

Teaching and expecting ET intubation in these groups

Just show how criminaly delusional or deceptive these people are

CCEMT-P have no problem having the laryngeal tube as my primary advanced airway

control

________________________________

From: Barbara Amor <brbramor@...>

Sent: Mon, December 6, 2010 5:41:50 AM

Subject: Re: ALS course?

A course that sounds like what you want is the IMCA dive-medic course. It is a 2

week course, consisting of BLS, including intubation technique, cannulation,

suturing, giving meds via all routes, fracture immobilization, recognizing and

treating heart attacks and strokes, haemo/pneumo thorax, abdominal complaints,

burns and shocks etc.  After the written exams the guys are taken to a

provincial hospital for practical.  These are literary " guys of the street "

(international commercial divers) who work pretty much on their own out on sites

and rigs, with a doctor at the end of the phone-line. 

Cheers

Barbara

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Ah yes the dive medic course the course for the Clayton's Medic the medic

you have when you really don't have a medic.

on the airway management side I completely agree that the use of any

advanced airway is less than optimal when being taught to a novice or

moreover lay provider, but it is a very, very bold statement that intubation

has no place in remote site health care, when being carried out by an

experienced qualified high end provider, and for my part I have tubed a

number of patients outside of my normal in country work while working

remote.

Please do not get me wrong the LMA especially the Pro-seal LMA are a

fantastic bit of kit and have a major role to play in pre-hospital care and

in the cardiac arrest, but unless the airway has definitive control as in a

properly placed, checked and secured ETT we risk the long term recovery of a

patient if the aspirate. I have looked after patients who has aspirated and

died a long painful death in ICU/HDU all for the want of a definitive airway

and a decompressed stomach!

Of course the reverse is also true patients do not die from a lack of

intubation they die from a lack of oxygen because we spent 2 minutes trying

to jam a tube in!

I would certainly never ever try to AME retrieve any unco casualty until he

has a tube in, stomach is decompressed, 2 x Big IV and an IDC are all

insitu, checked, secured and rechecked.

Again we are coming back to what is it we want in training? Is it Skills,

Procedures, Core Concepts of Advanced Care ect. ect.

So my question is where is the middle ground what is best practice, what is

safe practice, what is in the best interest of the patient and in our

professional best interest, from as many of you put the medico-legal

monster?

Cheers Colin

These courses

As far as I am concerned

Are frauds

Commercial frauds

Medico-legal frauds

Just plain bad all over

Cheap, useless plasters

Really teaching enough to get people in trouble

And avoiding to hire somebody

That does not need to be tought IVs, Intubation, ACLS, etc.

Again

Endotracheal INTUBATION in most of the TCN staffed clinics is a medico-legal

crime

Laryngeal tubes should be the main advanced airway device

http://www.larynx-tubus.de/larynx-tubus/content/blogcategory/14/45/lang,en/

Teaching and expecting ET intubation in these groups

Just show how criminaly delusional or deceptive these people are

CCEMT-P have no problem having the laryngeal tube as my primary advanced

airway

control

________________________________

From: Barbara Amor <brbramor@... <mailto:brbramor%40> >

<mailto:%40>

Sent: Mon, December 6, 2010 5:41:50 AM

Subject: Re: ALS course?

A course that sounds like what you want is the IMCA dive-medic course. It is

a 2

week course, consisting of BLS, including intubation technique, cannulation,

suturing, giving meds via all routes, fracture immobilization, recognizing

and

treating heart attacks and strokes, haemo/pneumo thorax, abdominal

complaints,

burns and shocks etc. After the written exams the guys are taken to a

provincial hospital for practical. These are literary " guys of the street "

(international commercial divers) who work pretty much on their own out on

sites

and rigs, with a doctor at the end of the phone-line.

Cheers

Barbara

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________________________________

From: Colin <cjmartin11@...>

Sent: Tue, December 7, 2010 2:12:49 AM

Subject: RE: ALS course?

****************

Bold I agree !

 Who said that ?

    Not I

Please do not get me wrong the LMA especially the Pro-seal LMA are a

fantastic bit of kit and have a major role to play in pre-hospital care and

in the cardiac arrest, but unless the airway has definitive control as in a

properly placed, checked and secured ETT we risk the long term recovery of a

patient if the aspirate.

*****************

In our context

Single provider

Laryngeal Airways are probably best

The ET gold standard is emotional and over-rated

When compared to resus situations

And to LT + Gastric tube + Suction

Less time to intubate

No interuption of CPR

Less neck manipulation

Not sure you need an ET on the short run

I have looked after patients who has aspirated and

died a long painful death in ICU/HDU

 *************

50% death rate

on the airway management side I completely agree that the use of any

advanced airway is less than optimal when being taught to a novice or

moreover lay provider, but it is a very, very bold statement that intubation

has no place in remote site health care, when being carried out by an

experienced qualified high end provider,

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