My Nan.

Wasn't allowed to call her Gran.

That was the name of the other one (Dad's Mum).

The farmers wife who taught my mum to be my mother.

Who cooked my meals and cleaned my clothes when I came to visit on the farm every holiday.

Who always wrapped and dated and froze every rabbit I shot at the farm.

Who loved my Pop and me not matter what mess we came home in.

Has left this place.

She feels no pain.

She again has no limits,

And she will be missed by us all.

Kathleen Joan Thomson, my Nan.

Be careful out there and I'll see you at the Big One.

Taz

Well those last two post were interesting!

Look here's the thing.

I'm not showing the early signs of PTSD. I have had a run of cardiac jobs and I was enjoying a drink in the safety of our home with my wife and I found it hard to type in that condition that's all.

But

It makes me wonder! (Local protocol & pharmacology discussion, transmission will return to normal after a while. I apologies to any who are bored by the following and suggest that you go and find the blog of Paris Hilton and then you'll know real boring content.)

P1 officers are getting a different analgesia that is cheaper and easier to order in bulk. That's good pain management is very important and needs to be done.

We are reportedly also getting laryngoscopes and magill forceps to remove that side of beef that gets lodged in the throat of some poor punter.
But how often do we attend a real choking?
So up until now, back blows/chest thrusts, IPPV and get to hospital quick if that all fails on the 'once in a blue moon' choking that we don't attend.

I'm told that we will also get a form of IV dextrose for the common hypoglycaemic jobs we do. That will be a really clever decision by the powers that be.

Now what about arrests? (Some of this might get a bit bloody silly.)
Now we arrive on scene, we could be a level 2,3,3C or P1 officer, because there are thousands more of us than Intensive Care level 5's

We are entrusted to be able to correctly diagnose a cardiac arrest and advise comms of such and activate the extra manpower required.

Now ponder, with the extra skills and pharmacology that P1's get why don't we have Adrenaline for the arrest job.
Now before some of you start taking me to task about the ABC's, they are a must and nothing will interrupt them other than defibrillation but if another P1 car is nearby cardiac drugs could be started sooner.

I mean what are we looking at (and feel free to make a comment)?

Keep it simple Cardiac Arrest is three things

1) Too Fast
2) Too Slow
3) Nothing

3 - is easy, work for the heart and check every now and then to see if there is a shockable rhythm.

1 - slow it down, first try a good dose of electricity per protocol and then Amiodarone if that fails.

2 - speed it up, Adrenaline and some Atropine and any voltage as required.

Yeah, yeah, I know there is a little more to it than that, but not much and I ask you to remember that we can all diagnose an arrest and that basically means the person is warm and dieing at a cellular level from the lack of heart activity.

It's a one way trip from here, what I'm asking is can we not get more options to give this patient who does not have a very good prognosis without waiting for a level 5 when there are all these highly skilled P1's around now and the P1 numbers are only going to grow.

Food for thought, discuss amongst yourselves or leave a comment on the blog

Be careful out there and I'll see you at the Big One.

Taz

I've had too much to drink.

Sorry

Be careful out there and I'll see you at the Big One.

Taz

Cardiac Arrest

Have you ever had a run of them.

In the last six days I had three. VF and Pulse less Electrical Activity or Electrical Mechanical Disassociation.

These are jobs that the Intensive Care Paramedics are called for. I've been lucky with my two VT arrests as I got both of them back.

Is it inappropriate to sleep well at night knowing that you did your best, they were dead when you arrived and stayed that way even after you did your best????

Be careful out there and I'll see you at the Big One.

Taz

The overtime shift went ok.

Ended up working with another overtime officer and being sent away to a beach side station.
Knocked over about seven jobs, got no sleep, couldn't seem to pick up any of the work load from in the city which was busy and have had to knock back an overtime shift at my station tonight because I was asleep when they called today!!!

I have just updated my profile on Friends Reunited to include the footage from the episode of Bondi Recue and some wedding photo's.

I don't like Facebook it's way to intrusive and overpowering.

I have been also working on these days off on re-doing the list of common medications that I had in the original TAO question books that I sold.
With developments in the booklet this list got too difficult to add and was dropped.

It does provide a handy tool for the beginner to use when checking the patients medications and prescriptions.

So I have been checking the whole list against MIMS for currency and spelling and may do a further audit of old case sheets to see what meds are recorded over say a twelve month period in my sector anyway.

Be careful out there and I'll see you at the Big One.

Taz

The student ride-a-longs at our station have been getting an eyeful and we have all enjoyed their company. When I have talked to them they have been getting lots of good work and a clear view of what the job really is.

On the local politics side.
If it is a contravention of SOPPs for an officer not call off at the end of our lunch break, if you read the Operational SOPPs, at the commencement of shift each officer is to secure a portable radio, that the service does not provide enough of.

To me, the scale of importance of either reminding coms that we have now finished lunch (that they can and do interrupt if a job is called in) or each officer having a portable radio for personal security and safety is really a no-contest.

That management should be threatening officers with an official reprimand on our files for not reporting off lunch is another very poor decision made I hope by someone in the ivory tower who does not have any on-road experience and thinks this is a big issue.

Larger than individual officers safety even.

Maybe the investigations into Harassment, Bullying and increased Suicide Rates may be able to improve the lot of the on-road staff who often get the feeling of expendability from upper management when dollars need to be spent.

Well that's my political spray for the week.

Apart from that nothing much more happened, the rest of the shifts were slowish with no terribly interesting cases to let you know about and I already have an overtime shift for my days off.


Be careful out there and I'll see you at the Big One.

Taz

Greetings Readers.

Wow, look at all the visits from the European countries.
I am pleased that you stopped by and hope that you found my blog entertaining.

The cold weather here has seemed to have a negative effect on the work load for ambulance with punters not going out in their usual numbers or maybe its just too cold to stay out late and have a mis-adventure????

As is the practise of our service, trainee officers in their second last week or so of training at the education centre have been appearing at various stations for their one week of day shift only ride-a-longs.

This is very useful to provide them with a brief window to view what the actual life of an on-road ambulance officer is like in case they are not sure if this has been the correct employment path for them.

As we in the job know, it is an unusual occupation with extreme stress levels and extreme outcomes and emotions and not all are suited to it. My own ride-a-long had not been with me for more than an hour and a half before she had to participate in her very first cardiac arrest.

It is a credit to the officer and the education unit that she was not embarrassed or a burden to the incident and provided fast and helpful assistance to all the qualified officers in attendance appropriate to her skill level, well done.

I wish all the other trainees out there during this period the best of luck and encourage them to glean as much from this exposure as possible.

Apart from that, Tracy is off up the coast tomorrow to visit a friend who has recently moved up there so I'll be roughing it between the night shifts, I'm sure I'll survive and Tracy knows I will also otherwise she wouldn't be going.

I notice that no-one has responded to the Blood Donation challenge yet so I'll have to keep offering my arm every four weeks to do my part and see if some of you can summon up the courage.

Be careful out there and I'll see you at the Big One.

Taz

Even in Tasmania.

I still consider myself to be a musician even though I haven't really played in five years.

That's not to say I haven't had the occasional rehearsal but I have not performed in a performance other that the re-union of the Concervatorium Huge Band in a very boozy weekend July last year.

The Hobart City Band is my pride and joy. I started in that band when I was 15. I held every position except that of Bandmaster and was made a Life Member when I departed to join the ASNSW.

I had a Custom trailer made to transport large instruments, percussion instruments, chairs, music stands, Amps & all the other stuff that a 40 -50 piece Concert Band could need on a gig.


This a shot of me addressing the band on our wedding day. The entire band was also invited guests at the receiption. I knew everyone's secrets and they were my family.

Anyway some fricking toe rag has nicked my bloody trailer.
It's sign written, very large and custom built and Tasmania it to small for this kind of shit to happen
The bastards, I hope body parts get infected and fall off.

Sorry gentle reader for my crude and thoughtless spray above, please forgive me!

Be careful out there and I'll see you at the Big One.

Taz

Greetings Friend!

As I expect you to be.
Because your here on my blog, you have made a conscious decision to be here and therefore I greet you.

Yea, it's been slow. No mammoth bursts of adrenaline, no big jobs.
Station duties get done, rooms tidied and some get sleep, I must admit I think on our last night shift I may have even checked the back of my eyelids for cracks!

I've got a bit of a limp from pain in my left lower back at the moment and I have just knocked back some overtime as I would like to rest it some more before returning to rostered duties.

Another crew needed a hand to extricate a patient on the third level of an apartment building the other night. My partner and I were on the foot end at first and I think that I used my body to slow down the decent when it got a bit away from us.

It just grabs every now and then so I'd be a fool to put it under pressure just for O/t rates.

But I have gone and given blood today. No blowouts like last time and I was wondering how many of you also give?

The rough Australian average in only 1 in 30 donate. I didn't before this job. It really wasn't even the job that got me off my arse to do it, it was my flatmate dragging me along.

The following are grabs off the Australian Red Cross Blood Service web site to firstly show you what your donation may be used for,

Platelets have a self life of around 5 days.
Red blood however has a self life of 42 days.
Plasma tops it off with a self life of up to one year.

I give whole blood every twelve weeks and every four weeks between I do Apheresis, which is platelets and plasma.

But what blood type are you?



Yea! these are the typical spread of blood types in Australia

I'm an O negative blood group, which is the third most common but it does make me a very interesting donor because I'm what's known as a universal donor.

My blood can be used to save everyone of you!



See.

So if you don't already or haven't for a while, why don't you drop into you nearest blood bank.

Click Here to find out more,,,, I challenge you!!!

Go on.

Be careful out there and I'll see you at the Big One.

Taz

Funny kind of weather.

Some sun, a lot of rain and wind.

I've still been riding in but the return trip home tonight was a hurried event in between heavy showers. The work load for me has been light but that's not to say it's been boring.

Our job isn't all about lights and sirens jobs. They have a certain appeal but the plain sick person also helps develop your diagnostic technique along with investigative questions that should help you stop from becoming complacent with patients.

So these cold wet days produce quite a lot of these patients. There has also been a high percentage of skin tears that have required treatment.
Does anyone else attempt to get the skin back into place before it dries out to much?
One of my early training officers, also a nurse did and would get me to do likewise rather than just a moist dressing and my partner made comment that she had never seen anyone else do that???

On a personal note Tracy and I have decided to have another crack at the IVF so I might have some side effects from the hormones,, you never know.


Be careful out there and I'll see you at the Big One.

Taz

Vomit.

So what's the biggest, measurable one you've ever witnessed?

None of those various sized containers that they seem to keep to show you (sometimes it is useful to have a look at the contents, but most times it's not).

I'm asking about witnessed by you, into something that can quantify how much.

Further to that, I also limit it to, non-intoxicated persons irrespective of whether or not they have consumed garlic prawns.

Just an ordinary Joe or Jill having a barf!

1200mls plus, that we caught.

One whole vomit bag plus nearly a quarter of the next, delivered by what appeared to be the same technology used to refill a V8 Supercar (F1 or Indy car if your outside of Australia) in less than six seconds.

The nearest thing I've seen to this is Mr Creosote from Monty Python's The meaning of Life. This was also performed while pushing the patient into the department with staff nervously watching on in case we stopped at a room or cubicle that they were nursing at.

The look of satisfaction on the patients face after that was got rid of was also a delight. Most likely food poisoning but I insisted that they stay and have a complete check up after they had told me one minute out from hospital about the proximal nocturnal dysponea and heavy chest pain that had awoken them that morning.

The 'cheese and kisses' is in bed already so I better go.

Be careful out there and I'll see you at the Big One.

Taz

The 2am thought that wakes you up!

We've all experienced them at some time.

It's usually the name of that song you were trying to recall.
The name of that fellow officer you saw today and could only call cobber.
Or the silent review of a recent job and the blinding thought of that small thing that could have made it even better.

Whatever it is, we've all had it.

Now it could also have been the 2am bladder call but I'm not that old and well, I don't have that problem so it must have been this thought and explanation of when I post about how busy or not I've been.

There are two officers on the vehicle, I'm not a single responder but I only talk normally about me. There is just about always someone else there with me.

I/we, are not the only vehicle responding to incidents but as a sensible rule I don't comment on other jobs because I'm not there. You may recall an earlier post in which I did comment on a large job that occurred without me. It was about the professional manner of those on the job dealing with the resources, location, time and size of the incident that I heard via our radio and the comment was positive to all the voices heard, operational, comms staff and operational management.

But at any other time when I'm bleating about how slow or busy it was for me there are another dozen or so crews out there doing their best to serve this community in my sector.

We also know, those of us in the job that your work load can also just be a matter of being in the right place when the call comes in.

I am a very small part of a very big machine, I know that and my peers are more than able to make a comment on this blog about anything if they wish and some have.

I not really blowing my own trumpet, although I'm more qualified than most of you to do that (humorous commentary stemming from me being a tuba player for over thirty years!!!).

The views expressed here are mine, they are not those of my employer, they have their own web site to spruk themselves but I thank you for coming over for a visit and,

Be careful out there and I'll see you at the Big One.

Taz

God that was a loong weekend.

There were lots of parties to celebrate the Queens birthday and I'm sure there were people who over partied but I never got called to them.
In fact I'm sure that there were also people who were really sick but I never got called to them either.
Washed a couple of vehicles, even got the little brush out on those front rims, brake dust can be so hard to get off. A car check along with downloading the new protocols and pharmacology's off the intranet.
Basically not much going on in this little black ducks pond right now!


Be careful out there and I'll see you at the Big One.

Taz

A nice reminder.

Greetings all,
as I have posted previously, I ride my bike to and from work. At this time of year that is, for day shifts, in the dark. I wear if you work in my sector unusual eye wear at night to protect me from bodily fluids and these broke on my way to work on my first day so I have been looking for something similar to replace them.

Today while between jobs I had just checked out a local eye wear shop in a local mall and was making my way back to the vehicle when a woman chased after me and hailed me down.

Immediately I think that someone has fallen or needs my assistance as an ambulance officer, however she reminds me of an incident I responded to over four months ago in which she was the patient.

She had chased after me for several shops having spotted me and recognised me from her accident to thank me and my fellow officers for all that we had done at that time.

The result of a heavy fall, she had suffered a cerebral contusion but luckily no skull fracture. We had delivered her to our local hospital safely packaged with all precautions and during the rest of the night as we often found ourselves back there I, as is my habit would stop by her bedside to check on her.

This is what she remembered the most, even though she was aware that we were busy and returning often, that I had continued my concern towards her long after my involvement has been passed onto the much more qualified ministrations of the hospital staff.

I am aware that,
I am by design,
someone who would stand out in a crowd of my peers.
I am aware that some think it funny and others may not be so amused, again that is their opinion.
I still get comments about that snippet of the local reality show that was broadcast nationally on which I appeared.

This sometimes embarrasses me.

But if by being recognisable and professional and caring I enhance the public opinion of our health services and it's much taxed staff I don't give a stuff.

Bring it on!

Be careful out there and I'll see you at the Big One.

Taz

What ya' doing?

Nutin' much,

Got the bikes serviced as I said, new chain, brakes, gear alignment and a frame detail for mine and a first service for the wife's. Every time I walk out of Renegade Cycles in Lane Cove I leave with a sense of extreme satisfaction even though I've just dished out some serious money.

I'm just a suburban cyclist, I ride my 14-16ks to and from work but they take the time to talk about our mundane riding and seek our satisfaction, great store, fantastic customer service.

Did a nice hypo (hypoglycaemic or low blood sugar level) a while back. This guy was a GCS of 3 (breathing and has a pulse but not responsive). He and the friends had been out drinking and when they left one establishment he lay down on a bench and they just left him there thinking he was simply drunk.

As we know intoxicated like behaviour is a sign of a possible hypo. After an hour in the lovely rain we've been having for the last week they remembered that he was a diabetic and rang us. I commended them for that decision, not once did any of them say 'oh we were just going to take him home to sober up' or anything like that which could have been fatal. Really took me by surprise.

Anywho, the patient got the glucagon injection and responded as per protocol, all very nice, my partner hadn't seen a hypo that far down before and it was a good reminder about the reason and importance of taking a BGL on a patient. There is one facility here in Sydney that ALWAYS asks for the BGL on EVERY PATIENT and when their most typical presentation is considered, it's no wonder that they do!

Well that should do, I think I might go and hit the fartsack (bed).

Be careful out there and I'll see you at the Big One.

Taz

I'm up early!

Don't have a reason but I am.

I've had breakfast, watched some news and have continued the downloading to the laptop of service pak 3.

Got an overtime shift for my days off, and lucked it at my own station.

Have started on assembling another ten or twenty of the booklets and even considered a possible new question that was posed at me a few days ago,,,,,, there in fact I have just added it now.

That's why on the cover it says compiled by Taz,it started with the original questions that my first station gave to all of us probationers when I was there, and then there have been additional one's I have thought of and those that have been suggested.

The whole meningococcal page was at first just an idle conversation that grew to it's inclusion in the questions.

And while I'm on it the role of the training officer in explaining to the trainee why these questions are asked is very important. Good officers are not created out of books alone, direction and explanation are all important to our continuing education.

Shit, it's just after 5am, bugger this I'm back off to bed


Be careful out there and I'll see you at the Big One.

Taz

Blogging just helped me save money!

How good is that.

Ambowife (that's her digital scrapping name. http://tazmanianshe-devil.blogspot.com/) and I were having a very annoying problem with our broadband last month, there are references to it through the posts.

Well the phone bill has arrived and it has a rather large sum on the dial-up connection, I reset the old dial-up as an emergency internet connection thinking about if I worked at another station I could still access my internet without using the work system just using my laptop.

So we were using the dial-up when the broadband was down. Now I had posted when it was down as well as the day the technician arrived and replace their supplied modem that was the root of all the problems.

I had sent an inquiry off to the billing dept suggesting that it would be morally right if this charge was refunded over the weekend and got a reply last night telling me to ring up another section and discuss it with them.

So I called this morning after I arose from my slumber while the missus was away slaying more Numbers off the weight watchers scale dragon. Spoke to an ex nurse, we had a nice worky type talk, you know the stuff;

HER;- You must see some terrible things?
ME;- No not really.
HER;- I could never do your job.
ME;- I could never do yours, I only have a patient for a short time, not the whole shift.

And so on, and I was able to use the posts as a reference for her to look up and confirm my claim and thus refund the entire dial-up charge.

Pretty good?????

I know that the national carrier is a more expensive option for our telecommunications but I also enjoy the ability to ring a geek anytime I want too, demand service and refunds with a real person, after I have waded through the options that never really match what your calling about so you choose the least wrong one and hope for the best.

Well that should do for now. I have to get off to work and collect my bike. Jumped on to ride home after my last night and had a flat rear. Luckily one of the guys was going my direction and gave me a lift home.

It's due for a service so I'll nick it and the wife's over to Renegade Cycles this arvo. The cloud cover and rain mean we wont be going for a ride so that will be a good time to have them done.

Be careful out there and I'll see you at the Big One.

Taz

Social Commentary

So when are the rest of the licensed establishments going to ban glass containers?

Does every eatery have garlic prawn?

And why do intoxicated people always seem to have eaten them?

And what is it with this rise in the carrying of weapons and using them?

Did you know that on average you are captured on camera 250 times a day!

That's enough to ponder, I'm off to bed.


Be careful out there and I'll see you at the Big One.

Taz