Completely agree about conservative nature of pre-hospital care in the UK. Our paramedisc still do not perform Rapid Sequence Induction, put in chest drains, naso-gastric tubes, urinary catheters, cardiovert (small shocks for treatment of a rapid pulse), etc., etc.
Some is due to the short distances, but mostly due to the forces of conservatism to which you refer!!
Some of the best jobs I have done have taken the best part of a day worth of travelling, etc., in Africa.
Our long-distance stuff is over half an hour here!!
Cheers
Anton
