Guest guest Posted May 13, 2002 Report Share Posted May 13, 2002 >Boys Boys Boys! I enjoy this list very much...do not contibute much as many things are attacked. It seems things get vicous and territotial. I cna put in 14's and 16's when required. 18's are certainly easier...I have to choose my challenges. Some cases do not need 14's or 16's and sometimes say in riser cranes at night you r visiblity is compromised and and 18 will do till in sickbay... Traumma....blood and guts--essesntial fluids...you go the limit.. 15 yrs emerge lets you know the difference.. Yous are a good bunch. we are a;ll here together...learning from each other...as well as our experience... Kudos to the list.. jude:) _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2002 Report Share Posted May 14, 2002 Ian, We have already done so and chose the group meeting mentioned to produce the momentum for further discussion. As I'm sure you are aware there are numerous forums and committees within industry specifically developed to discuss issues associated with the training standards. We are currently pursuing one of those avenues in which to open up discussions and debate. To perhaps clarify the status of AMA's a little further - as it is understood that the procedure is invasive, the AMA must seek guidance from a qualified practicioner via radio link before proceeding. Therefore the decision to cannulate is taken by someone else albeit the AMA might have to insert it. Their formal training is refreshed every two years but they also are obliged to participate within an Ongoing Onboard Development and Training Programme during the interim period. The refresher course lasts 2 days. For anyone that is interested all of the OPITO Emergency Response Standards can be viewed at their web-site - www.opito.com Details of the comprehensive audit and approval procedures which we as Training Providers must fully comply, is also on the site. They don't dish these things out to all and sundry and it's an expensive process to gain approval! I will be meeting with the Chairman of ERRVA and the OPITO Project Leader for the ERRV industry standards tomorrow (15th) and will obviously be raising this issue for discussion at some point although the agenda concerns other aspects of the training regime. As much as it may have been portrayed otherwise, our organisation are professional in our outlook and will continue to raise concerns through the appropriate forums where opportunity presents itself. Unfortunately it can be a long and drawn out process and you don't always get access to the right people. Personally, (and this is merely an opinion, not a half baked theory unsubstantiated or contrary to all clinical evidence delivered by a wussy fat bum in Stonehaven! - see ....I have been doing some reading!) I don't think that removal of the cannulae is the answer. I think that they should conduct a review of the whole situation, look at the equipment levels provided (which are extensive) consider and ascertain what are accepted levels of training required in each respective field and define the remit of the AMA accordingly. AMA's could then develop their skills from a core level to an accepted national standard through a modular training programme which would take into account the equipment and skill level required. Doesn't sound too barbaric a remedy does it? Oh and before anyone says that I'm only saying that for the monetary return to training providers initiated by such a programme - we don't train Medics! More to come eventually! Alan Hurry RE work offshore Firstly thanks to Ian sharpe for forwarding my intro to Remote Support Medics which I mistakenly sent to him off-line. Secondly, can anyone help with a query ? I have been registered with a company called Northern Marine for around six months now. They did employ two of my close colleagues with similar experience and qualifications and put them through their medics ticket (including survival course) with the proviso that they serve a minimum contract of two years or pay the money back. I have been phoning them on a monthly basis with the only response being that no further recruitment is on the horizon yet but to keep phoning. Another colleague who has been doing the same has now got fed up and decided to pay for their own course (around £ 2000 not to mention loss of earnings I believe). As an impoverished NHS nurse I could not contemplate this step at the moment and wondered if any of you knew of other companies that might sponsor well-qualified and experienced medics through their offshore ticket. Any advice gratefully received, Thanks in advance, Simon Furmage, B.Sc. RGN. Diploma in Health Science, ALS provider and FAW Instructor. RTO. Loch Lomond Rescue Boat. Member Information: List owner: Ian Sharpe Owner@... Editor: Ross Boardman Editor@... Post message: egroups Subscribe: -subscribeegroups Unsubscribe: -unsubscribeegroups Thank you for supporting Remote Medics Online. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2002 Report Share Posted May 14, 2002 Judy, Never intended to come across as nasty or territorial - I'm too mild mannered for that! Just defending our organisation and my staff who have been misrepresented unfairly in my view. Wholly agree we are hear to learn from each other, unforunately it seems that an awful lot of people were making judgements without having the facts in front of them. Please contribute to the site if you have something to say. Those who shout loudest often make up for a lack of quantity by increasing the volume! Regards Alan RE: RE work offshore >Boys Boys Boys! I enjoy this list very much...do not contibute much as many things are attacked. It seems things get vicous and territotial. I cna put in 14's and 16's when required. 18's are certainly easier...I have to choose my challenges. Some cases do not need 14's or 16's and sometimes say in riser cranes at night you r visiblity is compromised and and 18 will do till in sickbay... Traumma....blood and guts--essesntial fluids...you go the limit.. 15 yrs emerge lets you know the difference.. Yous are a good bunch. we are a;ll here together...learning from each other...as well as our experience... Kudos to the list.. jude:) _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2002 Report Share Posted May 14, 2002 I can remember a recent study that suggests that the majority of trauma victims, siffered from massive fluid overload and that this was a contributing factor in mortality rates, " the bigger the better " may be the case for massive blood loss, but it depends what u do with it, as the saying goes. I have in the past used 18g venflons on kids as a large line, I find that a range of IV cannulas is best. Denis Steve Benbow u out there Hello frew >From: " Brash, \\ Lines, Gavin (amed2) " <amed2@...> >Reply- > " ' ' " >< > >Subject: RE: RE work offshore >Date: Mon, 13 May 2002 07:26:08 -0700 > >Alan, > >I was one of the chaps who lambasted the thought of scrapping 18G needles, >However as it was reported on this site I was under the impression that it >was qualified medics that where taught this, I did however if you see my >posting mention that 18g is better than NOWT. I do however stand by my >statement that in trauma the bigger the better. Like most things an >absolute contraindication of any procedure is lack of operator \ Medic >skill >experience and knowledge. > >. > >PS what does MRI stand for, I know South Africa has an MRI ( Medical Rescue >International). > > Brash >Senior Nurse Supervisor >International SOS \ Cabinda Gulf Oil Company >e-mail: Amed2@... >Telephone: CTN. 8 345 2696 >Via Aberdeen 01224 334000 Cabinda Ext. 2696 > > > Re: RE work offshore > > > > Ian, > > > > Please be as bold as you wish and thank you for the information about >the > > discussions held back in March. > > > > We are that company - Maritime Rescue International in Stonehaven that >it > > appears most everyone has little or no respect for given those > > communications I have managed to read so far! Once I have had the > > opportunity to read them all through I will no doubt have more to say in > > our defence! > > > > To be going on with however, has neglected to mention a few >things > > about the situation which I would hope might shed new light on the > > argument and perhaps put our viewpoint into perspective. > > > > No member of MRI advocated or called for the removal of 14g & 16g >Canulae > > from SBV's. We raised an ethical concern over the suggested usage of > > these items by relatively untrained personnel onboard vessels in > > potentially less than favourable conditions. The fact remains that SBV > > Advanced " First Aiders " are no more than that. Their total training > > amounts to 5 days basic training followed by 5 days of Advanced skills >of > > which we can devote approximately 2 hrs to cannulation training on a > > prosthetic arm in a classroom environment. This is governed by the > > present training standards which we as a Training centre have called >into > > question with the Industry Association and are actively seeking a review > > of. > > > > What was put forward as an ethical concern was not plucked from the > > experiences of a " Geriatric nurse " but rather through consultation with > > discipline experts such as Dr Steggles, Chairman of the Faculty of > > Pre-Hospital Care, Edinburgh who wholly concurred with our viewpoint and > > also cited the latest Faculty consensus paper published in November of > > last year which I'm sure most of you are already aware of. > > > > We are fully appreciative of the benefits of large bore cannula provided > > those benefits can be administered by TRAINED personnel with practical > > hands on experience. We could not and will not condone the use of such > > large bore cannula (and have difficulty in advocating use of 18g) given > > the clearly comprehensive guidelines set by JRCALC etc. The fact >remains > > that AMA's onboard SBV's are not equipped with this level of skill under > > the current training regime and might exacerbate a situation rather than > > benefit it if required to do so. > > > > I would be interested to hear if any of the previous participants to the > > discussion would still recommend that the procedure is freely advocated > > for AMA's onboard SBV's? Hell, lets have them doing cut downs as well >! > > I reckon we can cover that aspect of training in about an hour! (NOT) > > What's a little pain when you are dying after all? Hold on though > > ...aren't the medical profession expected to ease unnecessary pain and > > suffering!? > > > > Might I finally add for the time being that all of my staff have >actually > > cannulated casualties at some point in their career and appreciate the > > difficulties associated. I know for a fact that a certain gentleman who > > contributes to this site has no practical experience whatsoever in this > > respect and relies heavily on his extensive reference material to >justify > > credence. > > > > I'm sure that once I have read all of the communications (I'll take the > > week off maybe!) I'll have more to say. Rest assured there is more to > > come! > > > > Very interesting to hear about the alleged demise of the BAEMT by the >way. > > We were actually instrumental in having the SBV standards amended to > > ensure that all EMT's associated with training & assessment were as a > > minimum registered with them as it was found to be the case that First > > Aiders calling themselves " EMT's " with little or no training in this > > respect were doing so. This was also looked at within the Merchant Navy > > Training Board standards also. If there is no BAEMT however, they will > > have to readdress the problem. I'm all for setting standards in >training > > but the one thing that is sadly lacking in our industry is definition. > > Everyting it seems is down to interpretation by the provider. I would > > agree that some are more conscientious than others in this respect. > > > > Look forward to the replies! (Honest) > > > > Regards > > Alan Hurry > > Managing Director MRI Ltd. > > (and Supervisor!) > > > > > > > > RE work offshore > > > > > > Firstly thanks to Ian sharpe for forwarding my intro to Remote >Support > > Medics which I mistakenly sent to him off-line. > > > > Secondly, can anyone help with a query ? I have been registered >with > > a > > company called Northern Marine for around six months now. They did > > employ > > two of my close colleagues with similar experience and >qualifications > > and > > put them through their medics ticket (including survival course) >with > > the > > proviso that they serve a minimum contract of two years or pay the > > money > > back. > > > > I have been phoning them on a monthly basis with the only response > > being > > that no further recruitment is on the horizon yet but to keep >phoning. > > > > Another colleague who has been doing the same has now got fed up and > > decided > > to pay for their own course (around £ 2000 not to mention loss of > > earnings > > I > > believe). As an impoverished NHS nurse I could not contemplate this > > step > > at > > the moment and wondered if any of you knew of other companies that > > might > > sponsor well-qualified and experienced medics through their offshore > > ticket. > > > > Any advice gratefully received, > > > > Thanks in advance, > > > > Simon Furmage, B.Sc. RGN. Diploma in Health Science, ALS provider >and > > FAW > > Instructor. > > RTO. Loch Lomond Rescue Boat. > > > > > > > > Member Information: > > > > List owner: Ian Sharpe Owner@... > > Editor: Ross Boardman Editor@... > > > > Post message: egroups > > Subscribe: -subscribeegroups > > Unsubscribe: -unsubscribeegroups > > > > Thank you for supporting Remote Medics Online. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 15, 2002 Report Share Posted May 15, 2002 Hi Denis, Trust you are well, Do I still owe you money??? :-) re my post, sorry I may not have been clear, to clarify I was not advocating massive fluid challenge in all situations just that as far as I am aware the general consensus is still to insert large bore cannulas in major trauma even if they are not used to full capacity. You are of course correct a range to choose from is the best option and a skilled practitioner will choose which to use in what situation. This thread follows on from a discussion that was held back in March that may or may not have misrepresented Alan's organisation, he at the moment is quite correctly putting the other side of the story so to speak. My question arises just because I want clarification of best " current " practice. Best Wishes Ian Re: RE work offshore > > > > Ian, > > > > Please be as bold as you wish and thank you for the information about >the > > discussions held back in March. > > > > We are that company - Maritime Rescue International in Stonehaven that >it > > appears most everyone has little or no respect for given those > > communications I have managed to read so far! Once I have had the > > opportunity to read them all through I will no doubt have more to say in > > our defence! > > > > To be going on with however, has neglected to mention a few >things > > about the situation which I would hope might shed new light on the > > argument and perhaps put our viewpoint into perspective. > > > > No member of MRI advocated or called for the removal of 14g & 16g >Canulae > > from SBV's. We raised an ethical concern over the suggested usage of > > these items by relatively untrained personnel onboard vessels in > > potentially less than favourable conditions. The fact remains that SBV > > Advanced " First Aiders " are no more than that. Their total training > > amounts to 5 days basic training followed by 5 days of Advanced skills >of > > which we can devote approximately 2 hrs to cannulation training on a > > prosthetic arm in a classroom environment. This is governed by the > > present training standards which we as a Training centre have called >into > > question with the Industry Association and are actively seeking a review > > of. > > > > What was put forward as an ethical concern was not plucked from the > > experiences of a " Geriatric nurse " but rather through consultation with > > discipline experts such as Dr Steggles, Chairman of the Faculty of > > Pre-Hospital Care, Edinburgh who wholly concurred with our viewpoint and > > also cited the latest Faculty consensus paper published in November of > > last year which I'm sure most of you are already aware of. > > > > We are fully appreciative of the benefits of large bore cannula provided > > those benefits can be administered by TRAINED personnel with practical > > hands on experience. We could not and will not condone the use of such > > large bore cannula (and have difficulty in advocating use of 18g) given > > the clearly comprehensive guidelines set by JRCALC etc. The fact >remains > > that AMA's onboard SBV's are not equipped with this level of skill under > > the current training regime and might exacerbate a situation rather than > > benefit it if required to do so. > > > > I would be interested to hear if any of the previous participants to the > > discussion would still recommend that the procedure is freely advocated > > for AMA's onboard SBV's? Hell, lets have them doing cut downs as well >! > > I reckon we can cover that aspect of training in about an hour! (NOT) > > What's a little pain when you are dying after all? Hold on though > > ...aren't the medical profession expected to ease unnecessary pain and > > suffering!? > > > > Might I finally add for the time being that all of my staff have >actually > > cannulated casualties at some point in their career and appreciate the > > difficulties associated. I know for a fact that a certain gentleman who > > contributes to this site has no practical experience whatsoever in this > > respect and relies heavily on his extensive reference material to >justify > > credence. > > > > I'm sure that once I have read all of the communications (I'll take the > > week off maybe!) I'll have more to say. Rest assured there is more to > > come! > > > > Very interesting to hear about the alleged demise of the BAEMT by the >way. > > We were actually instrumental in having the SBV standards amended to > > ensure that all EMT's associated with training & assessment were as a > > minimum registered with them as it was found to be the case that First > > Aiders calling themselves " EMT's " with little or no training in this > > respect were doing so. This was also looked at within the Merchant Navy > > Training Board standards also. If there is no BAEMT however, they will > > have to readdress the problem. I'm all for setting standards in >training > > but the one thing that is sadly lacking in our industry is definition. > > Everyting it seems is down to interpretation by the provider. I would > > agree that some are more conscientious than others in this respect. > > > > Look forward to the replies! (Honest) > > > > Regards > > Alan Hurry > > Managing Director MRI Ltd. > > (and Supervisor!) > > > > > > > > RE work offshore > > > > > > Firstly thanks to Ian sharpe for forwarding my intro to Remote >Support > > Medics which I mistakenly sent to him off-line. > > > > Secondly, can anyone help with a query ? I have been registered >with > > a > > company called Northern Marine for around six months now. They did > > employ > > two of my close colleagues with similar experience and >qualifications > > and > > put them through their medics ticket (including survival course) >with > > the > > proviso that they serve a minimum contract of two years or pay the > > money > > back. > > > > I have been phoning them on a monthly basis with the only response > > being > > that no further recruitment is on the horizon yet but to keep >phoning. > > > > Another colleague who has been doing the same has now got fed up and > > decided > > to pay for their own course (around £ 2000 not to mention loss of > > earnings > > I > > believe). As an impoverished NHS nurse I could not contemplate this > > step > > at > > the moment and wondered if any of you knew of other companies that > > might > > sponsor well-qualified and experienced medics through their offshore > > ticket. > > > > Any advice gratefully received, > > > > Thanks in advance, > > > > Simon Furmage, B.Sc. RGN. Diploma in Health Science, ALS provider >and > > FAW > > Instructor. > > RTO. Loch Lomond Rescue Boat. > > > > > > > > Member Information: > > > > List owner: Ian Sharpe Owner@... > > Editor: Ross Boardman Editor@... > > > > Post message: egroups > > Subscribe: -subscribeegroups > > Unsubscribe: -unsubscribeegroups > > > > Thank you for supporting Remote Medics Online. > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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