Wednesday, June 17, 2009

Upgraded skills of a Tasmanian Intensive Care Paramedic

Again, I previously posted (before rashly deleting the entire blog) most of the following information.

Tasmanian IC Paramedics previously did an in-house course lasting about 6 months but I recently completed an Advanced Diploma of Paramedical Science (Ambulance) over 9 1/2 months to obtain my Intensive Care qualification. I understand T.A.S. are still (maybe) planning on moving to a Graduate Diploma of Emergency Health (MICA Paramedic) through Monash University in the near future.

These are the upgraded skills of an Intensive Care Paramedic over those previously posted as Paramedic level in Tasmania (again this list is not complete but you get the idea):

12 lead ECG interpretation
Endotracheal intubation and cricothyroidotomy
-> Sedation to maintain the ET tube
Gastric intubation
Chest decompression (12g cannula)
External jugular cannulation
Intra-osseous cannulation
Synchronised cardioversion
-> Sedation for cardioversion
Enhanced pain relief (Morphine and Midazolam)
Extra cardiac drugs: Adenosine, Amiodarone, Atropine, Lignocaine, Sodium Bicarbonate
Extra IV drugs for: TCA & Psychostimulant OD's, APO, Asthma, COPD, Anaphylaxis, Vomiting, Meningococcal Septicaemia, Crush Syndrome, Organophosphate poisoning,
Full Paediatric Guidelines & Pharmacology

And just for some extra information, here is what I've heard around the station, should be coming to Tasmanian ICP's at some stage in the future, as other states already have them.
It may be years before we get some:

Rapid sequence induction (RSI)
Transcutaneous cardiac pacing
Dextrose 50% - changing to 10% for hypoglycaemia
Syringe drivers for accurate drug infusions
Amiodarone infusion for conscious VT, before Lignocaine
Magnesium for severe asthma
Intranasal Fentanyl as another option for pain relief

Til then, be safe.

Tuesday, June 16, 2009

Becoming a Tasmanian Paramedic and our current skill set

I previously posted (before rashly deleting the entire blog) most of the following information.

Becoming a Tasmanian Ambulance Service Paramedic can be done in 1 of 3 ways:
Try this link for some info from the DHHS website
or e-mail: wolfgang DOT rechberger AT dhhs DOT tas DOT gov DOT au

1) being hired as a "student" and completing 3 years on road whilst completing an Associate Degree in Paramedic Studies from the University of Tasmania (previously this was a Diploma in Clinical Practice (Paramedic) or similar, done by distance education via Charles Sturt university (I did this)). See this Newer Post from Tuesday 23rd Feb 2010 for more up to date info.

Some Australian ambulance services are moving away from this style of recruitment. New recruits are now having to complete their tertiary education prior to being employed, which makes changing careers (like I did) much harder for mature aged people, who might have a family and a non flexible financial situation.

2) completing a Degree, Associate Degree or Diploma in the pre-hospital care field (available from a number of universities) and being hired as a "graduate student" and completing between 12 & 18 months on road.

3) being hired on as a qualified officer because you were a qualified officer in another state or country (and have the appropriate education qualifications and experience).

In Tasmanian we moved from Protocols to Clinical Practice Guidelines about 18 months ago. Thus the skill set of a Tassie Paramedic is:
(This is not a complete list, but you get the idea)

Basic life support skills and the further enhancement of:
Interpretation of basic ECG's, SpO2, BSL, Temperature
Manual defibrillation
IV canulation
Limited narcotic pain relief (max 10mg IV of Morphine for non cardiac pain (max of 20mg IMI if no IV access))
Drug therapy (sublingual, oral, IMI and limited IV) for:
Cardiac arrest - Adrenaline IV & fluid
Chest pain - GTN, Aspirin, O2
Musculoskeletal Pain - Entonox, Penthrane, Morphine
Asthma - Salbutamol, Atrovent, O2, Adrenaline IMI
COPD - Salbutamol, Atrovent, O2
Narcotic OD - Narcan IMI
Hypoglycaemia - Glucatol, Glucagon, Dextrose 50% IV
Anaphylaxis - Adrenaline IMI & fluid, Salbutamol
Seizures & Agitated Pt's - Midazolam IMI
SVT - Valsalva Manoeuvre
Fluid resuscitation for Trauma, Anaphylaxis, Hyperglycaemia,
Airway adjuncts - OPA, NPA, LMA, Laryngoscopy and Magill's forceps
Limited Paediatric Guidelines / Pharmacology

My next post will have the upgraded skills of an Intensive Care Paramedic.

Til then, be safe.

Saturday, June 13, 2009

Advertising For New Staff

There were advertisements in today's local newspaper (Sat 13th June 09) and I suggest they were in the other 2 regional newspapers, for multiple statewide positions starting January and February 2010:

Student Ambulance Officers and
Student Ambulance Officers (Graduate)

Applications close Friday the 26th of June 2009

The Government Gazette will have them advertised this Wednesday.
Tasmanian Government Gazette

Til then, be safe.

Tuesday, June 9, 2009

My new Apple MacBook Pro...

I'm an Apple Computer user (since 1992) and the latest WWDC keynote address released details on the new laptops...

I'm going to upgrade my 5 year old Powerbook to a new 15" Macbook Pro, woo hoo.

I won't be getting it for a month or two, but I'm really excited (been planning the finance for months now).

In 5 years (for the same money) the specs have changed to:

Screen: 15.2" (1280 x 854) --> 15.4" (1440 x 900)
Processor: 1.5 GHz PPC G4 --> 2.8 GHz Intel Core 2 Duo
Video Card: (64 MB) --> (512 MB)
Bus Speed: 167 MHz --> 1066 Mhz
L2 Cache: 512 KB --> 3 MB
Std Ram: 512 Mb --> 4Gb
Max Ram: 2 GB --> 8 GB
Std HD: 80 GB --> 500 GB
Superdrive: 4x Single Layer --> 8 x Dual Layer
Airport: 802.11b/g --> 802.11n
Bluetooth: 1.1 --> 2.1 + EDR
FireWire: 800 & 400 --> 800 Only
USB: 2 x 2.0 --> Unchanged
Networking: Gigabit Ethernet --> Unchanged
Modem: Internal V92 --> None
No Camera --> Built in Camera
Battery: 50 Wh --> 73 Wh

And the 2nd revision of the iPhone is out in a couple of weeks.
I've held out long enough, (I was waiting for the new model), so I'm finally going to get one.

I need to work some more Overtime.

Til then, be safe.

Wednesday, June 3, 2009

Branch Station Officers

Well, I'm due to be back at the branch station this afternoon but something has come up with my family and I'm off work on carers leave, so I won't be going back to the branch station this block. My family comes first, as I'm sure it does for everyone else. (a wise Japanese sensei once said "family, work, sport, in that order")

Here is little more information about being a BSO (Branch Station Officer).
I have a more detailed overview post about the Tasmanian Ambulance Service, which I'll add a little later.

Tasmania currently has 13 stations where the salaried officers (BSO's) are supported by volunteer ambulance officers (VAO's). These stations are usually about 40 to 60+ kms from the larger city centres and thus service the smaller communities (populations of about 2000 - 5000) and then there are volunteer only stations that service the much smaller areas.
See this link for an idea...

Working at a branch station can be very financially rewarding for those that enjoy it and volunteer to become permanent BSO's or to those that put their hands up to relieve.

The extra cash comes from:
* the slightly higher pay rate you receive at a branch station
for working solo / with volunteers / training the VAO's
* on-call allowance
* the overtime earnt, by being called out
* living away from home allowance (for relieving officers)
* traveling allowance (for relieving officers)

The last 2 don't apply to officers who have chosen to become permanent BSO's, only to those that relieve in those positions.

Taking into account the extra money, it's not for everyone but some love it:
* You are away from home / your family for 96 hours straight.
* You are alone at the station unless you get a job
(permanent officers can pop home during the day and get to sleep at home, if they live in town).
* Your pager could go off at any time, (when you are in the shower).
* You don't have another qualified officer/student to bounce ideas off.
* But you are it, you make all the decisions.
* Quality back up is at least 20 minutes away.
* The work load is usually very light.

Til then, be safe.