Apologies, Catch-up and Fantastic News!

Sorry for the lack of posts, it seems I’m not really into this “blogging” thing yet!  I’m sure as I fiddle become comfortable with WordPress, and start my journey to becoming a paramedic and a doctor in not-so-near future, I will blog more and more. So bear with me.

On a “WOW!” note:

Although its been almost 2 months since my last post, my blog has had 600 visitors in June alone! That’s beyond amazing to me, considering that before June it had 300 hits – all-time.
Strange, but exciting.

Getting to the catch-up/news part:

In one of my previous posts, I mentioned that I would be going to Portugal and maybe the UK.

I haven’t and won’t be going until at least the end of the year

The reason: Something more important has come up.

I also mentioned that I might be doing my BAA in July, and after numerous discussions with regard to me doing the course, with family; friends and teachers (all of whom thought it was a good idea to do it), I submitted my application form to the academy, who – because of me being 16 and not the newly required 18 years old – had to send it to the HPCSA for review, and a final decision on whether I would be accepted into the course or not.

Anyway, after almost a month of anxiously waiting. On the Friday the 1st of July 2011 at 2.30pm, I received this email:

“Dear Student,

We herewith want to confirm that you have been accepted onto the Part Time BAA course starting on the 5th of July 2011.  Classes will be every Tuesday, Wednesday and Thursday evening, for the duration of four months!

We hope that you will enjoy the course here with us!

Kind regards,
H.E.L.P. Emergency Medical Training”

Yes. I GOT ACCEPTED!!

*insert major excitement here*

This has been what I’ve wanted to do for soooooo long, and in 4 nerve-wracking months, of balancing: school, squash, the course, and the stress that comes with it all. I WILL be a newly qualified Basic Life Support (BLS) Paramedic.

Hear that?
I – will be – a paramedic.

I’ve been dreaming of becoming a medic for so long, and now the dream is almost a reality! It’s almost surreal, of course, not forgetting the: hard work, responsibility, and devotion that will be needed for the next 4 months,if I want to cope, and achieve the first, of many LIFE goals.

Tomorrow I start the BAA/BLS course. I’m super excited, and slightly nervous.

WISH ME LUCK!

EMS system in South Africa

Here it finally is: My post on EMS in South Africa.

It is partly taken from http://en.wikipedia.org…

In South Africa there are  3 different levels of short course training for paramedics:

• BAA (Basic Ambulance Assistant) - This is a Basic Life Support (BLS) certification, and is approximately the equivalent of the U.S. EMT-B. This is the minimum qualification to be a crew member of an ambulance in South Africa. Training includes a 160 hour course consisting of lectures and practical simulations. The lectures cover basic anatomy and physiology, basic life support (including both CPR and first aid), emergency care, the use of ambulance equipment, including Automated External Defibrillator’s (AED) and Oxygen, and various medico-legal issues.

• AEA or Ambulance Emergency Assistant - This is an Intermediate Life Support (ILS) certification, and is the equivalent of the U.S. EMT-I, but with some added skills. To apply for AEA/ILS training, candidates must have at least 1,000 hours of practical experience as a BAA/BLS and they must pass an entrance exam to be eligible for the course. As an alternative route to certification, those completing the more advanced tertiary qualifications may challenge the examination and be certified as an AEA after successfully completing their first or second year of training. Training at this level consists of a 470 hour course, consisting of 240 hours of lectures and practical simulations, and 230 hours of experiential learning. AEA’s are qualified to practice various invasive techniques such as IV therapy, needle Cricothyroidotomy, needle Thoracocentesis, ECG interpretation, manual external defibrillation, and are allowed to administer various drugs.

• CCA or Critical Care Assistant - This is an Advanced Life Support (ALS) certification. It may be compared to the U.S.AEMT-CC. To apply for ALS/CCA training, candidates must have at least 1,000 hours of practical experience as a ILS?AEA and they must pass an entrance exam to be eligible for the course. Candidates must complete a 1,200 hour course to qualify as a CCA/ALS. They are qualified to practice a large array of invasive techniques, can perform cardio-version and are allowed to administer narcotics, sedatives and various other drugs.

Then there are also 2 different University / Technikon qualifications:

• ECT or Emergency Care Technician -This mid-level course is of two years duration, and exits on a level just above what many know as Intermediate Life Support (ILS), but below Advanced Life Support (ALS). This course is covered at 5 different training colleges in South Africa. Students who pass this course are eligible to apply to the HPCSA to be registered in the category of Emergency Care Technician (ECT).

• BTech/BEMC or The Bachelor Degree Technology or Bachelor Degree in Emergency Medical Care, is a four-year professional degree and students who achieve this degree are eligible to be registered with the HPCSA in the register for Emergency Care Practitioner (ECP) which has an additional scope of practice. The most notable addition in stand-alone capabilities include Thrombolysis and Rapid sequence induction (RSI). ECP’s are also trained in the rescue disciplines offered by their University, normally up to the level of Advanced Rescue Practitioner. (Example: High Angle, Motor Vehicle, Fire Search and Rescue, Aviation, Confined Space, Structural Collapse, Industrial and Agricultural, Trench, Aquatic Rescue, etc.) The advantage of the BEMC qualification, is that they can offer their patients a higher level of care as their protocol is higher than that of a CCA.

Further opportunities for educational advancement exist for the ECP, as they are able to articulate into various Masters (M.EMC)(Mphil.EM)(MSc.EM) and Doctorate (DEMC)(PhD) programmes.

All EMS personnel in South Africa are required to meet the standards of the governing body, the Health Professions Council of South Africa (HPCSA). All health practitioners in The Republic of South Africa are regulated by the HPCSA in terms of legislation set out in the Health Professions ACT.

South African Paramedics – in action!

The national objective is to have one staffed emergency ambulance for every 10,000 population, however, in some parts of the country this ratio is approximately 1 ambulance for every 30,000.

 There are currently no official “response time” standards in the South African system. However, response times of fifteen-to-twenty minutes for P1 (Red/Critical) calls in urban areas are considered acceptable, and in rural areas, response times of up to forty minutes to an hour, for similar calls are not uncommon.

Emergency Medical Services in South Africa fall under two categories, private sector and government sector. The government ambulance services are generally referred to as ‘Metro’ – or an acronym name depending on the area (ie. JEMS – for Johannesburg Emergency Management Services, EMRS for Eastern Cape Emergency Medical Services, etc). In addition to paid paramedics, the government sector has many unpaid volunteers.  The co-location of ambulances with fire apparatus is common in South Africa, although they are two independent services. The national emergency number for the Emergency Services (EMS and Fire) is 10 177.

Government (JEMS) Ambulance!

A Government (JEMS) RRV (Rapid Response Vehicle).

Eastern Cape Government Ambulance.

These government operated services are ‘helped’ by two main private-for-profit ambulance companies, namely:

• Netcare 911 - Who was the first nationwide private EMS company, and are now one of the largest EMS companies in SA. They operate from +-60 base’s around the country, with an emergency vehicle fleet of:   a number of Medical Helicopters (HEMS) staffing doctors – trained in Emergency medicine, and an ALS/CCA paramedic; 

A Netcare 911 Helicopter.

+-100 ambulances crewed as either: A Dedicated Intensive Care Units (equipped with specialized equipment) capable of facilitating Inter-hospital Transfers – ranging from adults through to neonatal ICU patients staffed by any health care professional required, a Basic unit staffing 2 BAA’s/BLS’s, a Intermediate unit staffing a AEA/ILS and a BAA/BLS, or advanced staffing a ALS/CCA and ILS/AEA or just 2 ILS/AEA’s;

Netcare 911 Ambulance

+- 60 RRV’s (Rapid Response Vehicles – vehicles used to get to a “call” as fast as possible) staffed by a ILS/AEA or ALS/CCA paramedic and +-5 Doctor RRV’s which are staffed by doctors specializing in Emergency medicine and only respond to the most critical of calls.

Netcare 911 RRV

and

• ER24, who operate out of (x) bases that are strategically placed in all major metropolitan areas and towns around the country as well as contracts with well-established ambulance service providers in the outlying areas. The National ER24 Emergency Call Centre based in Johannesburg handles in excess of 40 000 emergency calls per day.

ER24 Paramedics doing medical stand-by for an event.

In August 2000 a second major private emergency medical care company was registered in South Africa, ER24. ER24 is 100 percent privately owned by Medi-Clinic (A group of private hospitals in South Africa). Soon to become one of the largest privately owned Emergency Medical Care providers, ER24′s name was changed to ER24 EMS (Pty) Ltd. and now known in the industry as ER24.

The ER24 fleet consists of a 225 ground vehicles:

• Ambulances which are staffed similarly to the Netcare Ambulances, but don’t have Dedicated Intensive Care Units.

•  To cater for a much lacking need in South Africa, ER24 and Discovery  Health partnered in June 2009 to launch the Medicopter. The first Medicopter was launched in June 2009 in Johannesburg. A few months later the Medicopter was launched in Cape Town. Today, ER24 operates three Medicopters across South Africa with the third in KwaZulu Natal.

The ER24 Discovery Medicopter receiving a patient!

ER24 Medicopter Interior...

• RRV’s staffed the same as Netcare’s RRV’s, but they also have Medicopter Ground Support Units (MGSU) which are fully medically equipped BMW X5′s. After the partnership between ER24 and (a medical aid company), and the subsequent launch of the ER24  Medicopters, three ground units were set in operation in Johannesburg, Cape Town and Durban. The unit comprises of three crew members who are qualified as Intermediate Life Support practitioners. The MGSU acts as a normal RRV, but is also called out to calls that require the Medicopter. The crew staffing the MGSU have been trained in the ways of HEMS, and have the knowledge to allow for the Medicopter to land, take-off, and be 100% safe throughout this process.

A ER24 MGSU – isn’t she beautiful?

A ER24 RRV!

• Rescue Vehicles which carry paramedics trained in the various rescue disciplines, and carry specialized rescue equipment.

ER24 Rescue Vehicle

• Fire & Rescue vehicles, of which there is only 1 at this time, and is based at a mine.

ER24 Fire & Rescue Vehicle

• And Trauma Support vehicles, staffing trauma counselors, which are called in to traumatic scenes to help grieving relatives, traumatized victims, etc.

both of which operate nationally, and by a variety of smaller private services, such as Emer-g-med.

Emer-G-Med Ambulance

Or Hatzolah, which provide EMS exclusively to the Jewish communities.

Hatzolah Ambulance!

The  government sector and the private companies are further supplemented by voluntary ambulance services, including the South African Red Cross, and St. John Ambulance.

All private, and volunteer organisations are required to meet the same standards as the government services with respect to staff qualifications. These private and volunteer services are self-dispatching, and do not participate in the national emergency number scheme.

Public air ambulancee service is provided by the Red Cross Air Mercy Service from bases throughout the country. They also operate fixed wing aircrafts.

Red Cross Air Mercy Services (AMS) Helicopter

Emergency air ambulance service is also provided by Specialized Trauma Air Rescue (STAR), a not-for-profit group, operating nationally, and formerly known as ‘Flight for Life’. Private air ambulance charters are also available from a number of aircraft charter companies throughout the country.

And there is Helivac who run also operate a HEMS service.

Helivac Helicopter.

And there you have it! The EMS system in South Africa!

P.S. I don’t work in the industry (YET!), so some things may be wrong, if they are feel free to leave a comment and correct me!

With many thanks to Marcel From http://marcelnlsn.wordpress.com/ and Vanessa Jackson from ER24!

A quick catch up…

So its been almost  2 months  since I first posted, I suppose I’m not used to this whole blogging thing yet…

What’s gone in these last 2 months?

I had my 16th birthday on the 30th of March – and to “celebrate” I went to donate blood, that is the Wanna Be Medic thing to do right? Two of my best Twitter peeps, friends, and amazing bloggers Gnat_J  and Cybelle came with to provide moral support – partly due to the fact that they couldn’t donate. It was my first time donating blood, I was super excited! And apparently I’m a fast bleeder.

I was slightly irritated when I got home, read through the pamphlet they gave me, phoned the helpline on the pamphlet, that I am on one of the medications that prohibit you from donating blood for a month after the last dose (Roaccutane),  and that my blood was “contaminated” and would have to be destroyed. I had to PHONE them to tell them I was on Roaccutane, even though that in the interview (yes, they interview you when you donate blood) I told the nurse, or whatever she was, that I was on Roaccutane, and asked her if it would be okay to donate while on it – to which she replied “Yes, its fine”.

Even with all the bullshit the slight incompetence, I can’t wait to be able to donate again

My "contaminated" blood!

It was my dads 48th on the 31st of March – his birthday is a day after mine, isn’t that cute? And I figured out that I will turn 18 a day before he turns 50 – can you say: “HUUUUUUUGGGGEEE party”? I didn’t see him on his birthday for the first time ever – but he did take me for a birthday dinner on MY birthday – I think that counts.

During my April school holidays I did my First Aid Level 3 course at ER24 (a private ambulance company here in South Africa – but more on that in my next post), a birthday present from my mom –  which I passed with flying colours, 96% for theory  and 80-something% for the practical.

Yes folks I am now a qualified first aider, which sounds so lame but excites me hugely. I can’t wait to actually put some of it into use – although most of it  I already knew.

My instructor dude (a long-serving and well-respected paramedic) made it fun, and gave me extra information on becoming a medic. At all the lunch breaks I would end up talking to the paramedics about their jobs and what they think I should do to get into the career. Those 5 days were some of the most informative and inspiring days of my life – thus far…
Then, my first 2 weeks back at school was a DISASTER, mainly because I couldn’t go. I had a bad ”virus”, which my mom was later admitted to hospital for, although we thought it was a flare-up of her diverticulitis at the time.

I’ve been playing lots of squash, some soccer, and I’ve started eating healthier – because I’ve decided that I would like to lose some weight… so wish me luck with that!

So yeah that’s been my 2 months… Hopefully the next 2 are better (health wise)!

In some more recent news though: as you all know I have been trying to get onto an ambulance for a while now, and I recently had some “interesting” developments, so hopefully in the next week or two I’ll be able to experience the adrenaline, thrill, heart-ache, pride, compassion and the ups and downs of “being” a paramedic!

I’ll hopefully start doing my BAA in July, with the H.E.L.P Academy, I’m very excited about doing that.

June and July are going to be GREAT!! In the beginning-to-middle of June I will be writing exams at school… and if there is one thing I truly love at school it’s exams. Then during the school holidays (June-July) I hope to be going to Portugal, Spain and maybe even the U.K, and when I get back i’ll be starting my BAA (hopefully) and community service.

So that’s all for now, and I promise my next post will be more focused on the EMS system in SA for those of you asking about its workings.

Why I want to become what I want to become…

 

My future job – unless I become a doctor!

 

So in my first blog post I thought I’d share an essay on “Why I want to become what I want to become” that I wrote for school – a topic that I actually enjoyed writing about, so without further a due:

 

“Many people ask me why I want to be a paramedic, and I always tell them: “I think I would enjoy it, it’s always been what I’ve wanted to do, even though the income won’t be high. I think it’s worth it. After all it is a job you do to enjoy and be fulfilled by, not for the money”. Being a paramedic has always been my dream – and I still to this day intend to follow that dream. Just seeing an ambulance or Response vehicle driving lights and sirens on its way to a call makes me all the more eager to follow this dream.

I would think that the greatest challenge facing a, newly qualified, paramedic is the emotional turmoil I expect would come with the job. Seeing people in extremely disturbing and stressful situations, people who are severely injured and are in a huge amount of pain, people who are crying and sobbing because you’ve had to tell them that their loved one has had an acute heart attack and so has passed away – this stuff has to affect you as a person mentally and emotionally (Because yes, paramedics ARE people too) But at the end of the day I know I will find pre-hospital emergency medicine a very fulfilling career choice  - helping people who would die without my care – it must be one of the best feelings you could possibly feel (well at least I think so). I suppose to not let the bad experiences put you down, you would have to build your inner-strength (emotional and mental) and I think this inner-strength is found and gained with experience.

Another challenge is the poor salary a paramedic receives, for instance an ALS (Advanced Life Support – the highest level of qualification for a paramedic we get here in South Africa – equivalent to the U.S Paramedic (EMT-P)) paramedic generally earns about R20000.00 – R25000.00 monthly without deductions. Considering rent of a one bed-roomed apartment is +-R4000 per month. This would make living comfortably more difficult to do. But like any other obstacle, it can be overcome. To add extra income I could go and work in a country that has a large need for paramedics and will therefore pay more (at the moment an ALS paramedic could go work in Saudi Arabia and take home about +-$45000.00 after a month-long contract – at least that’s what I’m told). Or I could get a job on the side – become a part-time medical equipment salesman.

I know I will enjoy being a paramedic, I’ll enjoy helping people who are really sick, I’ll enjoy helping people who have been in a car accident and now need immediate medical intervention, I’ll enjoy the continuous learning because I will be learning something I enjoy learning about. I might not enjoy telling people that their child, wife or mother has died, but I will enjoy helping them cope with their loss. The feelings of pride, the feelings of self-worth, a paramedic must feel after helping somebody who would’ve died, without their care – surely that would make the job worthwhile, would it not?

To start the lengthy journey (I’m only 16, and a high school student) of becoming a paramedic, a good thing to do, as  suggested by many of my mentors, would be a “ride-along” where I could go out with an ambulance or response car for a shift, and experience the thrill, the adrenaline – of responding to a call,  lights and sirens, through peak-hour traffic -  getting to a not-so-thrilling accident scene where a patient is seriously injured, and is bleeding profusely – someone who will die if a paramedic doesn’t rapidly intervene. And see if it after all it is the career I REALLY want to pursue.

I will also be trying to do a BAA (Basic Ambulance Assistant – the first entry-level of paramedic here in South Africa – equivalent to U.S EMT Basic (EMT-B)) course, many places won’t allow a 16-year-old to do one anymore, so trying to find somewhere that does hasn’t been the easiest thing. But, if I can’t do the BAA I’ll be sure to at least do a First Aid course, so that the next time I’m witness to a car accident, where people are strewn over the road I’ll know what to do – and won’t feel so utterly helpless. Yes, I felt helpless seeing a truck accident not even 30 meters from our own car where 12 people were thrown off the back (Why do people put others on the back of a truck, without any covering – let alone a seat belt? Slightly idiotic if you ask me!), some landing in a river,  10 people seriously injured lying all over the road, and 2 who were carried away by the rivers’ current,  and all I could do was phone for help and assure the injured people that help was on its way. That was the day when I knew that I wanted to be one of those people, people who save lives for a living.”

 

Yes, I know what all you EMS folk say; as UKMedic999, a very well-known UK EMS Blogger (who has now stopped blogging), summed up: “I can understand the ‘thrill and the adrenaline’ side that you are looking for, but in reality that is rare in everyday responding. The time where you will really make a difference come around so infrequently that they really need to be cherished when they do. I am sure that a South African Paramedic will see a much higher percentage of trauma than I do, but I would put money on the fact that it is still a small percentage of their workload. That is what becomes the biggest challenge!”

And InsomniacMedic another UK EMS blogger, one of the best might I add, who said “A word of warning – not everything is life saving in this job!”

Yes I get what they are saying, you get your fair share of fools frequent fliers, dumb-asses drunks, and other abusers of the EMS system. But in the end, even if it is only 1 call in your entire career – where you saved someones life it makes the job ENTIRELY worth it!

 

Anyway, that’s my first post done and dusted! In my next post I’ll try and explain the EMS system in South Africa for you foreigners!