Ambulance Numbers???
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AS per 2007 St John Clinical Practice Guildlines:ZO100_marto wrote:Say for example you live in Cannington and are a diabetic, you could have a van that shows up and gives you some glucose gel in your gums and oxygen on the way to hospital or you could van that shows up, administers glucagon maybe some gel and can often leave you in the comfort of your own home after watching you eat some carbs, drink some juice etc saving you the hassle of being "baby sitted" at an ED for several hours.
Glucagon:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
Glucose oral gel:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
From what i read there isn't must difference apart from Route of Administration
ZO100_marto thanks for the update just curious how long you been in the job for !!!!
Serpy always seem to turn a wheel compared to a while ago would go days without a job. It would be interesting to see if the w.a government would ever take over running the service like in every other state (well apart from NT) every state was St Johns then as years went by the government took over and run it.
But to put a paramedic in every sub centre would be a costly nightmare, is there a min requirement for calls before they look at placing a paramedic in a sub centre ?
Serpy always seem to turn a wheel compared to a while ago would go days without a job. It would be interesting to see if the w.a government would ever take over running the service like in every other state (well apart from NT) every state was St Johns then as years went by the government took over and run it.
But to put a paramedic in every sub centre would be a costly nightmare, is there a min requirement for calls before they look at placing a paramedic in a sub centre ?
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Arr the good old trusty Guildlines yep gone are the days of them being Protocolswizzard wrote:AS per 2007 St John Clinical Practice Guildlines:
Lets just say I'm looking forward to my long serviceMarkmywords wrote:ZO100_marto thanks for the update just curious how long you been in the job for !!!!
Serpy always seem to turn a wheel compared to a while ago would go days without a job. It would be interesting to see if the w.a government would ever take over running the service like in every other state (well apart from NT) every state was St Johns then as years went by the government took over and run it.
But to put a paramedic in every sub centre would be a costly nightmare, is there a min requirement for calls before they look at placing a paramedic in a sub centre ?
It would take a lot for WA to go over to being run by the government and realisticly ain't gonna happen anytime soon. At the end of the day WA is a cheap service to run compared to every other state and so unless something goes really really really wrong the government will be happy to fork out chicken feed.
A few years back QLD went over to having a paramedic in every town in the state and like you mentioned was an absolute headache for them costing hundreds of millions
Just another reason why St John and the Health Dept over here are trying to get this Rural Support Paramdeic off the ground. I'm personally against it but perhaps Schism_ could give you his take on them (as SJA are trialling 1 in his town).
Formally ZO100, now KG100
ubc 72xlt...ubc 60xlt...uh015sx
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slight difference:wizzard wrote:AS per 2007 St John Clinical Practice Guildlines:ZO100_marto wrote:Say for example you live in Cannington and are a diabetic, you could have a van that shows up and gives you some glucose gel in your gums and oxygen on the way to hospital or you could van that shows up, administers glucagon maybe some gel and can often leave you in the comfort of your own home after watching you eat some carbs, drink some juice etc saving you the hassle of being "baby sitted" at an ED for several hours.
Glucagon:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
Glucose oral gel:
Prepare Patient For Transport
- Patient must be prepared and transported without delay
- Do not wait for Medication to take effect
From what i read there isn't must difference apart from Route of Administration
glucoise oral gel is purely glucose. ?it may have some artificial carb content, but if so not much
glucagon is a hormone that releases stores of "sugars" from the liver (in laymans terms)
they work different ways. as the take out for time for the Intramuscular Route (Gluagon) is rougly 1-5 mins, Patient depending, u will get a result quicker, feed the Pat some carbs and go on your way. Correct statement is that it is an "in transit med" so if there is no response to the med or some other underlying cause for the altered conscious state, say for instance something like unresolved hypoxia in an unnoticed HI, then transport would be undertaken by AP's ASAP. Otherwise, its stay and play for this one.
Glucose Gel on the other hand is a pain in the ass (ok for an ambo who needs a 3am sugar fix!!! least it was till we went lemon flavored). problem is the intra oral route (or buccal mucosa for those med bods that will correct me, cause we all know the gel is absorbed by the buccal mucosa and not ingested) is at its best unreliable. most diabetics, apart from those who are unconscious, present agitated, or drunk like if u must, and when we squeeze 32g of gel into their mouths, they love to spit it, so how much do they get and how can it possibly be effective. Likewise I'm kinda not willing to airway compromise my unconscious pt with 32g of gel
so in the management of hypoglycemia with altered conscious state, a quick tackle, hold, inject and standf back works for me.
Vollies do a great job, and they now have access to some good meds: ie aspirin and vaso dilators for cardiac chest pain (same as para's), adrenaline for acute allergy (same as paras, although in an epipen), and salbutamol for asthma and also allergies (paras also use adrenaline for asthma that vollies cant).
They do a great job and u can spot the good vollies, they are the ones who recognise their limitiations and call for ALS backup if avail and in the metro area, or country towns where paramedics are.
Ambul8
Back home we use 50% Dextrose works a treat especially when the patient doesnt respond to glucagon due to the lack of stored glycogen.
Cant use gel because of airway compromise so a quick IV and bang 50% in and your on your way home. Will SJA bring this in in later years just another handy tool for the lunch box.
Back home we use 50% Dextrose works a treat especially when the patient doesnt respond to glucagon due to the lack of stored glycogen.
Cant use gel because of airway compromise so a quick IV and bang 50% in and your on your way home. Will SJA bring this in in later years just another handy tool for the lunch box.
The Critical Care Paramedics use this im pretty sure as a slow IV push rather than an infusion ( i dont have guidelines on me to check ).ST_DOC wrote:Ambul8
Back home we use 50% Dextrose works a treat especially when the patient doesnt respond to glucagon due to the lack of stored glycogen.
Cant use gel because of airway compromise so a quick IV and bang 50% in and your on your way home. Will SJA bring this in in later years just another handy tool for the lunch box.
Insofar as AP's running it, I am not sure because the official position of the Saint is that glucagon is an "in transit med" so whether they want us to play with dextrose im not sure.
that being said, take in a hypo and thats the first thing that hits those veins in ED.... so yeah