The Crazy Bus!

Yep!

That was us over our night shifts.

Five in total and two were just general transport transfer from Emergency to the Mental Health Ward at our local hospital.
These two were drugged to the eyeballs and we had security escort still one each night not together.

The was no full moon
The was no wind (makes little kids crazy as well, ask any teacher)
And there was no evidence of red cordigal (sic) at any of the private residences we collected some from.


Shameless self promotion now.
Tuesday 31st March
Channel Ten or which ever shows Bondi Rescue,
I think I make another appearance????

Not sure but at the end of last week the promo looked like a job I did up there.

So if you can't say anything nice about me then DON'T WATCH IT!

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

Taz

Ob Noo! I'b cork a coold!

And thank modern medicine for the drugs to treat the symptoms.

Occupational hazard to catch a cold every now and then. I take supplements to help prevent such, but with our high level of exposure and seemingly most of our patients don't know that their hand can be placed over their mouth when they cough!!!!!!

You have to cop one.

Well the next shifts really didn't get that much better. Surprisingly my current Padawan who really is going back to school in five weeks or so did have her first Deceased Patient while she was treating.

Initially called to a palliative patient in a supportive role.
On arrival we found ourselves present at the exact time of death.
While death is all part of our job, we seldom arrive at the exact moment.

It's about 8:00am, on a beautiful sunny day.
We are in the bedroom with all the blinds open, a Panoramic view of Sydney Harbour behind us.
Not only are we welcomed by the carer as the Ambos but we are a crew who has been here recently and are recognised giving us that much more of a connection with the patient.

As we are already prepared for the patients condition we calmly check for signs of life and I confirm the findings before acknowledging to the carer what I believe she already knew.

I do what I have to do, advise Comms that the patient is now deceased and request Police to attend as it is an out of hospital death. I then try to contact the patients own Doctor who if able will come to the scene and sign a death certificate that will speed and simplify the next steps.

He is able (saves on a trip to the public mortuary and possible autopsy). But can you answer me this and I think Dragonfly will but then she is a Doctor.

Why can't I complete some form of Death Certification?
I am able to recognise the absence of Respiration, Circulation, Fixed and Dilated Pupils, Cold Waxen pallor, Rigor Mortis, Dependent Lividity, I have a monitor to show the absence of cardiac electrical activity?

Even if it was only for experienced Paramedics.
I've completed my Probation,
I've completed the rest of the training and gained qualification.
I've completed a period as a qualified officer.
I've completed a re qualification course with peers and superior officers and educators.

I believe that I could with precision identify deceased persons in circumstances such as this?

So why does it require a 'Doctor' to come and look, listen and feel to determine that their dead?
They don't even do an ECG!

I wonder how much response I get from this question?

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

Taz

And how was your day?

Mine was boring.

Discharge to Rehab closer to home post CABG,

Abdo pain but I think he just wanted a lift and I'm not able to refuse a transport request,

Four weeks of vomiting and diarrhoea with constant attempts to self medicate and care for themselves, lots of TCL for this pt,

RSI playing up on a young performer allowed me to read off my history of performance to establish my credentials to instruct with authority her to rest the joint for several weeks and the institution to not allow her back without a clearance letter.

And that's it!!!! next shift better be busy.



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

Taz

Oops got slipped an O/t shift.

I reckon Tracy was out of bed quicker than I was.

Ironing board out, uniform pressed.

I wonder if it had anything to do with me agreeing to buy the Photoshop program if I got O/t???

Anyway had an easy day at my old station with a good friend as my partner.



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

Taz

Nothing much on the Eastern Suburbs Ambulance Front.

Our first night was quiet this nothing from midnight to 0600hrs.

The second was constant but not busy by any means,

It was Dubbo's birthday
I finished a reply to a complaint about my junior partners driving,

So I was really hoping to get some good overtime work?
But that hasn't happened yet!

I have on an upside purchased a new Outlook 2007 as my old 2002 version wouldn't shut and was no longer supported by MS. So I have been playing with the newer features of that when ever I can get to my computer.

Tracy's laptop has lost the ability to use the Photoshop she used for Digi Scrap Design so it is loaded onto mine as a trial until her new genuine copy arrives Monday?

And thats more or less what's been happening for me.

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

Taz

The much lauded Association is live.

Now I am the first to admit that I haven't been around long enough to feel comfortable with the industrial history of paramedics here in NSW.

So I will not put in my two bobs worth and make a fool of myself in the process.

Yes I am fence sitting then but I'm well balanced to observe and analyze the options.

While remaining a member of the official union I will also join the new association so that I may be able to increase my knowledge and understanding of the situation.

If you are a NSW Ambo and for some reason have not received anything about the association then here is the link;

http://nsw.emspa.org.au/

Go and have a look for yourself and make your own decisions.

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

Taz

And then there was this other patient.

So next shift after the Heart Block pt we're tasked to a person fitting?!

Pt sitting on a kitchen chair,
Conscious, alert (if not a little 'space cadet' with us),
BP about ten mmHg lower than you would expect,
BGL normal,
Describes an almost out of body experience - vertigo, knowing the body was shake/twitching, was aware of heart beat and sweating.
No Incontinence or LOC,
Pulse irregularly irregular?????

Why don't we put the dots on and have a look and what's that we see with the ol' Zoll Defib that gets bounced around day after day in the back of the truck,

No P waves - AF, but hang on
That looks like Atrial Flutter on the long R-R Interval,
And is that a Bundle Branch Block as well?

Ching Ching, Congratulations you've won a trip to Hospital.

The pt had been sitting talking to their partner enjoying a beer or two and a spiff, a roach, a bit of Mary Jane,,,, Cannabis.

No current meds,
Only past med history that of IVDU like thirty years ago, been clean for twenty.
Father died early (two - three years younger than pt is now!) of IHD or similar.

So Hypoxic Seizure from the combination of the three cardiac issues,
Transport,
Oxygen,
Monitor,
Acetylsalicylic Acid (or Aspirin if I have to say it),
Re-assure pt and partner

After all,

We're Professionals in Control


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

Taz

Cardiac Bus, that's what we were!

Not bashing the Intensive Care Paramedics system but, the old way of keeping them for 'The Big One' means that general duties crews get to be first on scene and treat some very sick people and such has been our shifts.

One night it seemed that every patient either;
Has a pacemaker without a problem,
Has a pacemaker that has a problem,
Needs a pacemaker.

Best capture was of a patient under investigation for ???Syncope.
Suspects are prolonged QT interval, 1st degree heart block.

Healthy person, no other history.

Zoll Defib - three lead, no diagnostic capacity does show what would be a long interval by being more that half of the R-R interval but only just.

Everything else looks good,real good but you can stay on the monitor and we'll wheel you out anyway.
Totally uneventful journey, triage and that bed over there will be free in???? 20 minutes or so.

Patient states 'Oh,oh not feeling well' then like some slow m o t i o n action from the Matrix or something,

Observe a changing ECG,
Press the record button,
Lower the patient to supine on the stretcher,
Watch the rhythm drop to 18, (still recording)
In a controlled voice that penetrates three feet of concrete and all other consuming thoughts of the staff I ask for assistance (learnt that as a Drum Major when I needed to tell you how uncoordinated you were and your parentage),

Four Doctors decide my patient is much more interesting than theirs and we go straight to a Resus Bed and I'm still recording the whole event. The patients been wearing a twenty four hour halter with diddly squat showing up.

Sinus Arrest or SA exit block which ever, but patient had a return of sinus rhythm after two asystole periods of five and seven odd seconds.

Went to Cath Lab for a temp pacer and my job ends there.

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

Taz

The parties over!

And what a party it was, well done Sydney.

The costumes, the floats, the music, the joy and happiness.


The Pimp Hat was a going away present from the old station (near the horse race track) for when I moved to my current station (up near Kings Cross), they said I would fit in then. Note the one sequin and one rainbow epaulette.

And I even had a different hair piece.

And then the young ones lost control.
Pissed, armed and bloody dangerous.
Thousands of them in Hyde Park.

We did the best we could with the usual heaps of help our mates the Cops.

But that's the norm for a Saturday night just not so concentrated.


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

Taz

Strange work patterns.

As of last Saturday we lost the penalty for missing our meal break if there was too much work to be done. If there were enough staff and vehicles we would get our break and so not get the penalty, that was fair.

Seems someone convinced the ol' codgers on the IRC that we somehow made this extra work and were routing the system so it stopped.

We now get a single penalty of one hour if our break is missed or interrupted so we can still work the rest of the shift without a meal break and it's tough luck. Thank you IRC and your fat cat salaries and business lunches.

A whole lot of officers are opting to have our unpaid lunch off air or unavailable as is the norm for any other worker but the managers have to bring vehicles in from other areas to cover ours while we're off road, so it appears that we are not being allowed, (by the virtue of doing non urgent transports and taxi work in other areas,) to get back to station to dine.

It costs them one hour penalty only and we still don't get a meal break so the day shifts have been very mundain.

That is until some bright spark (pardon the pun) in the NSW Fire Brigade pushed to start having NSWFB officers trained as first responders with the inclusion of drug therapy???? or lets screw the Ambos a bit more. Last time I looked we still drove on the left so why are they trying to slip the thin edge of the wedge to turn us into the American version!
I was so upset but this news from our union that I sent an email off to the fire fighters union and do you know they didn't know anything about it??? I have passed on the details as I knew and look forward to seeing what they do.

Maybe the Government is trying to save money by joining the two?????

Now I do have a lot of readers from the US and I do not intend to criticise the system of Paramedics being part of the FB but it's not the way we do it here. As I understand FB Paramedics are also trained in fire fighting, sorry I'm not interested in that.. I'll stay outside the burning building.

But enough gloom, it's Mardi Gras

I have my bit to decorate the uniform and am looking forward to a fun night with all the partys and joy that should be flowing tomorrow.

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

Taz

Dear Mincer,

Back on the 25th of April 2008 I wrote a post about how I had received an Army medal and a brief description of why I got it for my time in the Army Band and also listed my attendances at ANZAC day marches etc.

I don't do that anymore.
I'm not in a band,
I don't march.
I never picked up a weapon.
I never left the shores of Australia.
It was peace time.
I played a tuba.
I may attend ANZAC day marches now either as a Paramedic or as a watcher.
I would not feel at ease marching with just that medal, I would feel a fraud.

I currently put my life on the line every day at work, it's not an immediate risk like getting shot or blown up but as any ambo knows we are exposed to potential life threatening diseases, infection, trauma in uncontrolled environments all the time.

It is part of our job.
We try to minimise the risks.
We are not looking for any special recognition, it's our job.

I welcome your comments as a clear indicator of the values our military forces went to war to protect (freedom of speech, liberty).
I ask that you respect my posting and position as part of those values.

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

Taz

Sorry I'm late posting.

We have had my best mate and best man from our wedding up for a visit this weekend.

Not that well planned because I was on duty Thursday and Friday nights but darling Ambowife took care of him with a drive to the Don Bradman museum while I had a quick sleep on Friday and then I just had a few hours sleep Saturday morning before the two of us went out.

We took in one of the free shows at local venues as part of the Mardi Gras. I love my home in Tassie but it is very sheltered compared to Sydney on any other given day and we're in the Mardi Gras groove and it's even more party time now.

The humour, taking the piss out of themselves and big bright outfits make a Mardi Gras time show special and you just don't see that stuff in Tassie.

Both nights had good work,
Cardiac - rapid AF
Cardiac - dead
MVA - Car v Bus
MVA - Car v Motor Bike
Drunk
Assault - probably deserved it by attitude shown to those trying to help them! (what's new about that?)
Assault - wrong place, wrong time
Psych - just a carpet bag of problems there
The usual falls or klutz moments
Another heroin OD, some really strong stuff on the streets still
Headache - that was just a bit wrong, IC bleed on scans, thank you to the diagnostic bump itch!

Looking forward to the march Saturday and all the fun and work that it brings and that's the important thing about our job.

In the city we get flogged stupid a lot of the time and while it appears that we have received a sly sided pay reduction (it will take a few pay periods to really tell), our station had something like twelve hundred emergency response jobs, between six crew on three cars per shift several months ago. That makes us the busiest in the Sydney South and East sectors but we always have our bit of fun. Never come to work grumpy or always whinging.

If you don't enjoy your job, leave.

Ok, I'll get off the soapbox now.

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

Taz