Perlukah Paramedik digabungkan sebagai satu unit???

nizamsha wrote:Keje fire station pun sama gak Zulk...ada auxilliary tasking.....

btul bro.. tp aku rasa kewajaran nya ada sbb... klu kita tgk wayang ttg paramedic kt oversea.. hampir semua attach ngn fire dept.. pendpt aku lar.. pre hosp kna d asingkn ngn hosp.. jd.. multi tasking mmg x dpt d elak.. cuma pendekatan mungkin berbeza.. kita ambik contoh ambulance call kt hosp.. ppp akn pergi ngn atendan & drebar.. mslhnya.. 2 kategori ni agak sukar nk perform... setakat angkat patient jer.. jd d sini ada mslh.. ok.. berbalik kpd paramedic d fire dept..(not the present situation coz i dont know ur protocol).. 2 paramedic (dedicated) akn keluar ngn ambulance follow fire engine/ berasingn.. jd.. response time lebih cepat & nk wat procedure pn senang.. coz sama level..

thats agreeable bro...i have been working with two dept...which major and primary tasking in Emergency Response....JPA3 try to applied the concept of having Paramedic attach to Rescu team..end result...failed...BOMBA also try to implement the same system but different approach...the result..failed..u know why???the policy make it hard for operational.....Protocol...procedure...it has to be inline....so much to think and study....Our big headed people wont accept mistake as an opportunity to learn....what they know is to implement the best system in the world...its not the same in Malaysia...How u want to implement EMS system???? The public is not aware and being properly educated....Sedangkan sebelum nak start EMS, step pertama ialah perkara tersebut....Kalau letak SN ke AMO ke...jadi Paramedic Kat Fire Station....sapa nak command dieorang ni sedangkan ....jawatan bagi Pegawai Penjaga Balai ialah Penolong Penguasa BOMBA Gred KB27..sama gred ngan SN dan AMO...so cemana nak command????Gred sama....kengkadang balai2 kecik..Pegawai Penjaga Balai tu gred KB17 je...pastu setiap working shift..Pegawai Operasi BOMBA adalah Pegawai BOMBA KB22 je...cemana nak command???....I been in oversea and being attach as Fire Fighter and even as Operation Chief.....jawatan paramedik harus diwujudkan bagi membezakan chain of command....sebab kat oversea ada EMT....kita ni mana ada EMT.....tup tap..AMO...tup tap..SRN....sedangkan EMT training just for six month..and concentration is only on pre-hospital care je....aku pun dok pening nak start up my own firestation.....pening bile cube menggabungkan kedua2 service ni.....FYI....i am conducting research and developing proposal for Megasteel in Banting...for Fire and Rescue services.....poning kepala......

nampak mcm senag jer kan.. tp bila melibatkn dasar2 kerajaan.. tu yg payah..sbb apa..yg bwt dasar adalah orang politik.. tak dak back ground dalam EMS/pre hosp.. jd implementation pun.. failed lah.. command is one thing.. but the other thing is.. mcm mne nk letak ppp/sn kt fire dept klu perjawatan d kkm juga belum mencapai tahap optimum...jd mcm mna nk letak kt other ministry.. tp aku mmg realy impress tgk bomba pnye peralatan.. tapi sayang byk yg mereka tak tahu nk pakai.. ada portable ventilator..tp tak tahu apa kebendanya.. mcm mne nk pakai..

satu soalan dr aku.. malaysia ada standard ambulance protocol ker..??

Tak ada.....jawapan yang paling tepat....bukan tu je...Fire Fighting SOP pun takde....BOMBA budget banyak...tu je..so apa supplier recommend...beli aje.....samalah JPA3......

beli tp tak tau nk pakai... hmmm... SMART plak mcm mne..??

SMART tu macam dah tak smart je...kah..kah...kah....Korang tau tak SMART....tu ditubuhkan sebagai skuad kamikaze.....ha..ha..ha...lawak tul SMART ni...keje ngan dieorang 3 thn..sengal je semacam....ha..ha..ha..

ye.. bunyi cam hebat.. jgn jd semak dah ler..

Semak je....dieorang ni concerntrate on Urban Search and Rescue....tapi sampai skang belum lagi dapat Heavy USAR Status...DART SCDF dah dapat dah...

xgabung pun xpe...kita jadikan semua2 unit n jbtn dlm paramedik ni besatu..bebincang sesama, duduk besama. kita jdkn paramedik ni di bawah satu union dh.
tgk mcm cikgu union dorg kuat..mintak je apa sj sekarang pasti dapat...diorg mn ada union cikgu2 bahasa inggeris ka, union cikgu2 matemetik ka.
diorg besatu...last2 apa sj diog mintak utk keuntungan profession diorg gk
seelok2 nya paramedik besatu mcm tu la
naikkn sama2 jbtn bkn naikkn satu unit atau nbtn sndiri je

nizamsha wrote:SMART tu macam dah tak smart je...kah..kah...kah....Korang tau tak SMART....tu ditubuhkan sebagai skuad kamikaze.....ha..ha..ha...lawak tul SMART ni...keje ngan dieorang 3 thn..sengal je semacam....ha..ha..ha..

compius la, nizamsha ni pengalaman keje byk tempat, tapi umur baru 24, stat keje umur 16 ke?

BlackBoner wrote:

keantt wrote:hmm... soalan untuk semua...
apakah tahap paramedik di Malaysia yang diperlukan untuk mengendalikan ambulans dan prehospital care di negara kita?
adakah tahap latihan yang ada pada MA/ SRN kini cukup untuk keadaan Malaysia dlm bidang perubatan kecemasan prehospital?

Perlukah orang dilatih seperti EMT-P di negara luar diperlukan di komuniti Malaysia?
adakah kita akan terima golongan ini?

untuk perbincangan semua...

golongan paramedik di malaysia masih terlalu awal untuk dikatakan terbaik..kebanyakkan staf di latih adalah utk memenuhi keperluan (kekosongan) di seluruh negara..tempoh latihan 3 tahun tidakla mencukupi utk ssorg staf itu dikatakan berkualiti..sbb itu KKM buat agenda Post Basic..di negara asing bila staf dia suma ada degree dan pengalaman yg cukup barula mereka diletakkan di lapangan kecemasan..bukan mcm kita..staf baru kluar skola da disumbat msk..bila ada kes berat keadaan jd kelam kabut..nak gabungkan suma paramedik di bwh satu bumbung akan mengambil masa yg lama..lg pula ia memerlukan satu protokol yg bersesuaian dgn suma paramedik yg terlibat utk melicinkan kerja dan ini mmg susah dilakukan sebab setiap golongan paramedik mempunyai protokol memasing dan kebykannya bercanggahan..stakat ini cara yg tebaik adalah meletakkan semua staf yg benar2 berkelayakan untuk diletakkan d A&E sementara staf lain carila inisiatif lain utk meningkatkan kualiti diri memasing..jdkan staf kita Gred A bukan Gred C seperti yg slalu di katakan org asing..KKM tak dpt memajukan kualiti kerja melainkan diri kita sendiri....sama2 la kita renungkan..

En. keantt....setahu kawe latihan atau program MA oleh KKM adalah ketahap primary care (hospitalise)/(rural area :Health centre some provided with ambulance care)...jadi pre hospital tu jus a part of it!!!...now a day since good development and efficient among us we are required up to tertiary care (referral centre @ specilised centre).....so apa sangat yg nak dibandingkan dgn lain2 latihan EMT....jiko ko mahu specilaised joint A & E pos basic......sudah dari cukup......tinggal lagi komitment ko terhadap apa yg diajar....biasalah Dr pakar pun ada yg honest ada yg cukup2 makan...jadi fikirkanlah diri kita sendiri yg KKM kelas kan paramedic itu hanya latihan separa perubatan...yg penuhnya MD @ MBBS!!!!

Di luar negara spt USA....kawe tidak berapa mendalami pasal EMT.....tetapi apa yg kawe faham, Physician Assistant sama seperti PPP malaysia....disana EMT,paramedic, SRN banyak yang convert jadi PA because of the ranking!!!!........selain dari itu freshie2 PA disana adalah gradute2 1st degree yg belambak2 dalam pasaran...mereka ditawarkan PA program...mungkin 6 bulan utk low ranking....dan ditauliahkan APC macam kita juga 3tahun.....ranking kita yg tinggi Pos basic....dan degree baru nak buka..tetapi tiada saluran!!!!

and we don need to care much about safety like nizamsha...because he will play his role.....basic teaching to us start with D...which need to removed danger.......i don think anybody will knockdown theirself because of small exgratia......let nizamsha do it and we take over outsite safety area!!!!!

Kawe tidak tahu jika kefahaman kawe ini sebenarnya keliru atau tidak harap maklum!!!

To be qualified as Paramedic u shud undergo EMT-P program..for sure course di ambil masa 3 tahun....As a Fire and Rescue Officer..I am the On Scene Commander...I'll coordinate physical and medical rescue on the incident....I decide strategy and tactic to be taken...I tak wat triage...i request a triage to be done....I ensure safety measure during the operation....So Paramedic has to listen to me...the problem now is...nobody is commanding everybody....Tak ada satu pun arahan atau protocol atau prosedur yang diakui bersama sebagai Multi Agency Response Procedure...sape nak lead sape...

Wan, Umur i 21..i da apply SMART.... i served a year with them...skang ni i jadi dealer jual barang kat dieorang..ha..ha...

klu ikut zoning dlm pre hosp care.mmg medical base akn berada dlm zon kuning.. hal ini bermakna.. pasukan penyelamat akn membawa keluar mangsa n d medical base barulah bermula peranan PPP.. jd klu betul nk wat pre hosp..kna ada EMT... khusus utk pre hosp... orang x cukup tp wat mcm2 program..jd adalah lebih baik sekiranya satu latihan khusus utk pre hosp adakan.. ** ni pandgn aku lar..

Bor...tu kalau Ikut ARAHAN MKN No.20-Pengurusan Bencana....tu ok skitlah.....

Tapi nak dihighlite kan ni.....Pengurusan Kecemasan...yang hari2 dok buat2.....takkan casualty ada 4 org pun nak set up PKTK....nak setup CCP....

Ada term dipanggil scene management...sizing up of Incident Area....maybe tu patut di ajarkan....

Bukan semua AMO atau SRN keje kat trauma dept tu ada Pos Basik A&E....yang ada pos basik pun ternganga kalau kena ambik responsibilities.....sebab tu kena wat program EMT...At least EMT-Basic dlu...baru ada inline......Mmg AMO ble wat pasal Medical tapi scene management....Pnah dgr Scene Preservation????

Tau macamana nak baca HAZCHEM Code???

kah kah kah... ppp kt mesia ni main purpose dia..perawatan perubatan & pencegahan penyakit.... pre hosp adalah ckit2..tp mse training x byk yg d ajar ttg pre hosp.. klu wat pos basic a&e.. role of pre hosp members.. triage, primary survey, resuscitation n stabilization, secondary survey, re evaluation, definitive care & rehabilitation.. n klu x silap aku on scene commander adlh polis kan..

size up.. yes..but for how big n how bad da incidents.. the teams (at this present AMO/ SN..may consist of MO as well) should survey incident scene for:
- type/ cause of the incident
- approximate number of patients
- severity level of injury
- area involve including problem with scene access..
thats all....

i'm not in this field but i learn all this during my post basic 6 years ago.. may be not relevant with present situation..

definately nizamsha..........in one small scene kancil turn over tepi jalan... driver still alive tapi...kena potong baru boleh keluar...because EMS eficient sangat semua sampai JPA3, BOMba, Nizamsha, PPP/MA.....agak2 apa berlaku.......biasa sangat kalo kita jumpa di mana semua nak tunjuk pandai menyelamat nyawa kan...spinal la...safety la...unstable..triage...tul dak...pakat serbu...

Kalo kawe terngaga pun kerana kagum dan suka nak balik banyak lagi kejo dok tunggu tul dak!!!.....bukan tak bertanggjawab/ pasal x da rule dan kerja kita bukan nak manage scene tu..!! jika JPA3 tiada...terpaksa la kita hampir setakat max. 3 meter (if not mistaken) atau setakat yg jauh dari bahaya,tunggu bomba bawa mangsa keluar...jika mereka menjerit perlu kita stabilised mangsa...pastikan nizamsha dah remove battery dan minyak tumpah di neutral dan mereka tidak memotong!!...kita kembali keambulance...biarkan mereka memotong..mengangkat..kita tengok saja dari jauh samua basic tu.....pastu boleh scope and run..kawe pun dah lupa dah creta ni....adakah EMT akan buat lebih dari ini....i like to hear that but we are not trained to face with danger @ hazard but we know how to recognized.....we not born to be hero but we ready to serve....jus shout it laud!!!!....

Zulk..OSC for minor emergency is not PDRM but...Nobody stated i the act...sape2 pun ble..coz tak ada arahan rasmi....PPP pun ble gak....Recognizing Hazard is a storry...how to overcome or eliminate teh hazards is another story...Biasalah..kalau ada scene...mcm2 org nk wat...nak tunjuk yg dielah segalanya..he..he..he..but when turn bad..or worst...would he or she be responsible????ke die nak cakap...i just do what ever i think it shud be done????

I have experience as being junior and also On Scene Commander...different level of approach by semua agensi......Kengkadang terlebih pandai...Kengkadang terlebih tahu lak....nak ketawa pun ada.....Byk yang kena blaja dalam field ni....it is not the same but the similarity ada....Sizing Up....Response Priority....Incident Level....Triage....Technic.....all has to be in the On Scene Commander head.....trust me...without knowledge..u'll be blank....dont learn by making mistake but learn by reading it by somebody who already making the mistake..then u know....but that also can't guarantee the efficient of ur command....

Lagi satu lah....kite letak satu scenario untuk di bincangkan....

Pada Jam 3 pagi...terima satu MVA Call kat Lebuhraya....Satu team paramedik dikejarkan ke lokasi....Ok...Masa dah dekat ngan lokasi tu...nampak kete VS lori tanker........


Kalau korang Paramedic yang ada dalam ambulans tu...korang nak wat ape dlu......n pada masa tu.....Balai BOMBA terdekat jauh giler........dan masa yang diambil untuk sampai ke lokasi lebih kurang 1 jam .......Ada empat Casualty yang diberitahu.....kesemua tersepit............

Kita bincangkan.....

tak payah sebut lorry thanker la nizasha.........kereta kecik pun kalo paramedic KKM @ PPP setakat dibekal dengan jaket pemantul apa yg boleh buat....safety boot pun dah out of order!!!.......any way it nice to discuss ......i also got another scenario, latest and thought to save our cos of living ..let see tis 1st!

not well response so far......

i m not specialised to specify in detail or according to protocol instated...definately not on my training day!!!, but i do keep in genaral knowledge to prejudge for correct dicision.

any body to approach in this casualty need to removed risk of hazard!!!...... That thanker must be a label with "Dengerous good safety Mark" together with no to call in emergency case!!!...phone guide maybe usefulll!!

KKM not waste a money to provide a such eq. to handle that, cause responsible to other parties/ body.

if u give me a full suit fire proof even more blast proof, safety boot to prevent heavy impact, sharp and chemical a proof , helmet and mask with air supply for breathing ( O2 supply risk of fire)...i passed that to any paramedic who willing to, because i m not working with that.....one hour time to released from "terkepit" is a crucial time if victim turn to hypovolume shock.....how to set i/v line with a thick safety glove unless provided with intraosseous infusion/ anterotibia injector...mmm..such a battlefield casualty!!! ... i will stay away within safety area for thanker appocalypse....nevermind i will help to close the trafic if no police around!!!!!..and maybe phone guide from the authority.

For me if i am paramedic which only being equipped with reflective vest...I choose to stay inside the ambulance...and just wait for BOMBA Arrival.....

Coz.....if tanker VS car....the tanker must bring a load of liquidified item which we don't know the hazard....Probability of liquidified spill is 90%...so what the hacks i want ot exposed my self to danger....Being a Smart Paramedic....stay out of danger.....

Dont try to be a Hero coz u r not Zorro...unless u want to end up as ZERO...

strongly agree with nizamsha.. jgn jd hero beb.. karang x pepsl ko jd abu.. klu x pun nk menjawab berkajang2 surat.. "OSC for minor emergency is not PDRM but...Nobody stated i the act...sape2 pun ble..coz tak ada arahan rasmi....".. ni plak apa yg d ajar dlm pos basic a&e..polis is a OSC.. klu kita wat disaster training pn..polis akn jd OSC.. tp tu la aku kte..ni apa yg aku belajo dulu.. skrg x tau ler..