The night before work sleepless again.

In fact I got up at 0330 an hour before the alarm.
Watched a video, had a longer slower breakfast and left on time.

So what did I do on the fourth last shift before the holidays?

UTL.
28F - ?? Psych, personality disorders, Dr shopping.
75F - Increasing falls, poor health unlikely to improve, assessment needed for hospice.
58M - Chest Pain, had the history, rapid AF to NSR.
94F - Got wrong footed in the kitchen and took a fall, fracture wrist, don't know where she got the wrong feet from??????
18F - IP, a big dance party on today and she peaked way too early!
Called off job.
59M - knee pain,,,,, big girls blouse.
25M - IP, we got him a cab.
23F - Can't talk about it because the Police are involved.
37F - Hyperventilation/Migraine, she refused transport.

All this with a very annoying stitch in my right upper gum where my wisdom tooth was yesterday!

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

Taz

Days Off.

I brought all my kit home but just never got around to putting in for O/t.

Had some catch up drinks with an officer who went bush and I've been to see my LMO about some blood tests results, nothing wrong LFT is reducing and comfirmed my status of clear on Heps and immunity to B.

Done a ride or two,
Donated some plasma,
Ordered some more ear pieces from ebay for the work portable radios,
Got my stethoscope/utility pouch repaired - needed a press stud.

Looks like I'm the only one posting too at the moment, at least on the blogs I follow.

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

Taz

Saturday Night as it should be!

Busy I mean.

69M - SOB, Asthma. I've picked him up before and it's real.
45M - Chest pain, reserve my diagnosis but I treated as stated.
22F - Sad story as they usually are. I got her to the best help.
Assist another car.
30M - PFO, someone else called and told him he should stay on the footpath until the ambulance arrives. If their not going to come with me why did they stay there on the say so of a bystander?
Assist another car.
50-60F - found on footpath grazed and blooding after developing a very sudden case of intoxis-legwobblis. People said she had been to a Christmas party in the street and lived by herself also in the same street. She's so pissed out of her gourd that she believes I've broken into her apartment while I'm talking to her on the street.
Duty of care says I have to take her but do I really have to have this vile, poison mouth for the entire trip. Hospital copped some also but then they just knocked her out.
85F - Hopspital to hospital transfer.
26M - Drug effected.
29F - either an inner ear problem or gastro. My promethazine reduced all symptoms but still not sure were the little bit of diarrhoea came into it.
25m - Pissed and sleeping. Caller thought he was dead, good grief!!!
45M - driver in an MVA declined transport.

The next night was dead boring so I'll not bore you with it, besides I forgot to write them down.


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

Taz

A hot day in Sydney.

The mercury was touching 36C or 96F today and our first three patients were elderly.

81F - Dizzy and anxious. A talk, a cup of tea and some air conditioning had her feeling much better.

82M - Uninjured fall answering the door for his home care community nurse. Transport was for further aged care assessment and possible n/h or self care hostel placement because he can't continue to live alone safely.

??M - Sulking in his apartment. His sister rang because he wouldn't answer her calls. When he ran the building concierge to tell us to go away, it was enough for me, we left.

94M - Discharge to N/h after three weeks in hospital.

35M - Deceased. No obvious cause, treated it as suspicious.

45M - Metho drinker who hadn't had a drink in eighteen hours, post ictal.

25M - Fall on some stairs, lower flank pain. There were signs of injury to be totally fair.

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

Taz

Not much to start,

But it got better.

83M - Regular dialysis.
50M - Heroin OD, was talking so he just came with us to hospital to enjoy the trip safely.
13F - Epistaxis, reportedly has them quite regularly but has never had it looked at.
81M - Had a stumble at a dermatologists clinic and the Dr wanted the pt to be observed?
75F - Takeaways, hospital to hospital transfer.
91M - GI haemorrhage, a whole day of melaena and haematemisis. Last I saw of him he had had my fluids, a bag of gel and two units of blood. You have to go sometime.
51F - Frequent flyer spent the day at the cricket before wanting to go to hospital with her gross cellulitis.
78M - fell over in town dropped by a medical centre and they put a stitch or two in his head and then rang us to transport him to a hospital for we don't really know.
57M - Slipped on a shop floor hurting wrist and then has a syncopal episode. Pale, diaphoretic, shit BP 60/40, Pulse 45-50 just, ST depression by two little boxes on average, managed to get the BP up with posture and some fluids and gave half a 600mcg GTN along with the Aspirin and O2. Infarcting, triage liked what we had and we went to resus.

Another life saved.


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

Taz

So what did I do on the O/t shift.

21F - Passenger in a small MVA, got a small knock on the head from the window and wanted to be checked at the hospital.

30M - Knee pain. Does anyone know were you can get those really big suppositories of 'Toughen the Fuck Up' or even the generic 'Stop being a girl' 'cause this guy needed them too!

77M - A happy Demented pt discharged after an IDC was replaced. If the shadow of dementia was to sneak up on me this is the type I'd want.

22F - Normal people, six hours of lethargy and palpitations. No drugs or even coffee. Monitored rate 120-130 and had that scoop from the end of the QRS to the T wave that would usually indicate something like a Digitalis toxicity.

UTL the first call to the gent below.

18M - with a good sized lac to the back of the ear from a bottle?????

27M - has been out on the tiles (drinking) but is not feeling normal. He looked like crap and was happy to accept a large qty of liquor drunk but no drugs. Got him in the back and put the dots on,,, Rapid AF of about 150bpm. Lucky catch.

35M - in the police cells after having assaulted a train carriage. Well the whole story was there had been a domestic incident and he then turned around and hit the train. There was good movement but it needed an x-ray, that could wait till after the police were done. I gave some simple analgesia and an Icepak.



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

Taz

Lookout Overtime

That will be three nights straight,

Lovin' it.

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

Taz

Second night of the new roster.

And what a busy interesting night it was.
Much more to my liking.

Highlight for the night was our first job.

61F - Medical Centre, chest pain. It's one of our local centres and the Drs do commence treatment before we arrive (I'm sad to say that a few don't), ECG, Aspirin, GTN, Oxygen.
A block and a half transport, MI confirmed, thrombolised, off to the Cath Lab and she crashes at the end of it.
Peritoneal haemorrhage! Rushed to surgery.
How awful. Just popped over to visit her son, felt sick, goes to Dr, bang bang bang in surgery with life threatening condition she knew nothing about. Tread softly and enjoy each day!

68M - Odd behaviour per hostel staff. Had been discharges back to this aged care hostel today after an alteration to his schizophrenia meds but of course it will take a day or two for them to take hold. This was explained and they (staff) were happy.

?30M - Pissed Backpacker, sleeping in someone's enclosed front yard. Nearly made it to his dorm just around the corner. We walked him there.

25F - Drink spiking, well something had been ingested 'cause she was pinging off the walls. Unusual location though, restaurant with a large party of friends, pt occasionally has social drinks so pill popping is not her thing???? They took her home to stay with her for the night.

54F - Psychiatric case, the story kept changing but enough to say pt had run out of meds for the last week, was hearing dead relatives call her to them and was so sick of it that she wanted to throw herself in front of a train. As we were at Central Rail Station we took her away.

18F - Another one who almost made it home. Woke her up and walked with her the extra 100 metres/yards to the front door.

23M - What was needed here was a very large suppository of 'Toughen the Fuck Up' maybe with a repeat dose for the few scratches on his face. What a big girls blouse.

54F - Psych transfer. Yes that's her, the same one. While she has been Dr shopping over the last week with presentations at various hospitals with a similar story, nobody but our guys stopped to look further and actually treat. She was a little ticked off about the fact that I had put a Mental Health Section on her and not told her, she didn't think Ambos could do that. Little did she know.

23F -Your pissed and stoned what do you want?
For your friends to take you home and care for you!
So we let them.

?22M - Want a be, gangster, Wog Boy. Fell over after an argument with G/f and his mum called us because his arm hurt. On arrival he seems to have toughened up and puts a show on for us. Shoulders rolled forward like they do when they trying to look tough, rapper talk, grabbing his crutch (these types must have really small penises to have to check that it's still there so often),
posturing. It would have been funny if he hadn't believed his own hype.
We left him there, not even our worst hospital deserved him. Last seen still feeling for that small willy.

22F - French student, went for an after midnight skinny dip in a pool in a local park with a boy she had met that night. Yes the pool is fenced off and after security arriving and them trying to climb the fence to avoid them she received a large soft tissue laceration on the underside of her upper arm. The pair got away with a warning from the Police and she got a dozen stitches.

To close the night down a 71M with urinary retention.

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

Taz

First night of new roster.

There is a theme here,

First job a scooter rider down!
As with me on the treadly a bloody motorist had just pulled straight out in front of her.
30F - Very very lucky, abrasions on the ankle only, primary survey, obs, sign here and off she went.

70M - Left deficit from a progressive condition, a simple mechanical fall. His spectacles frames gave a nice lac to the forehead that needed stitching.

66M - Neighbour saw him entering the units with blood on his face and called us. Primary survey, obs, sign here, off we went.

47F - 'PFO' She admitted it, and kept admitting it like twenty times. Two nose lacs and a chipped incisor.

24F - Sacrum pain post MVA.

21M - King hit and again this guy was an innocent victim. Resolved epistaxis and a few lip lacs. One however went all the way through, weird it was up under the nostril penetrating where the gum meets the inner lip inside the mouth. The 'perp' may have had a ring on?

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

Taz

Second day of the new roster.

I work with two different partners this roster one on first day and night and another on second day and night.
They are both level two officers, meaning I don't have to watch them all the time.
They can care for a pt by themselves.

This will be different.

80F - Chest infection, no doubt about that.

24F - Vertigo, ? inner ear infection.

22F - ? Hypo, a family history. Refused transport but going to see own Dr.

61M - Courthouse job, Chest Pain, real chest pain. Large ST depression, BBB, QRS complex 0.16sec. Jumped about Five other crews as we had bat called this pt.

30F - in the local Psych ward, ? unconscious.
Don't pull this shit with city ambos, this is an area we excel in, the unconscious pt, so you better be unconscious or I will ridicule you for bunging it on.
One minute after our arrival the pt had stood up unassisted, walked to the stretcher unassisted and we transported for medical clearance.

41M - Chest pain. Had a motorbike accident a week ago and the ribs hit the handle bars???

33M - Lost control of his scooter and got his right leg caught under it. Fracture Tib/Fib. Interestingly he got 25mg of IV Morph and it didn't touch the sides. He told me a similar experience with Morphine with a past injury. This is the second person I have met that has this response or rather lack of response to Morphine.

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

Taz

First Day, New Roster.

Our regular dialysis pt.

79F - Lower leg pain. Sight unseen their Dr told them to ring for an emergency ambulance. So having us travel with excess speed to someone with arthritis endangering members of the public and ourselves. Lucky our Pro QA questions didn't make it a hot response.

31M - Courthouse job, gent going to court today checked his BP early this morning and decided that 140 SYS was high and he should double dose his BP meds. Need I say more.

67M - Hypo, friend also recognised the signs and took action, we arrived and really just did some obs, got a signature and left them alone.

70F - Chronic nausea, haematuria.

41F - Weak and dizzy. On perscription opiate analgesia and psych meds and is bunging it on.

52M - C/o chest pain.

8M - Face planted of the handle bars of the bike. No obvious major injury but skin missing of nearly every pointy bit of his anterior body. Ouch++++


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

Taz

How embarrrassment!

So I got to and from work the other night without a problem.

I've slacked off the pedals so maybe I can tighten up half a turn.

Went for a ride to the shops this morning,,,, no problem with either cleat.
Maybe I can tighten them another half turn.

'I'm just popping out to test the cleats', Ambowife rolls her eyes.

Half an hour later I return with sand up one side of me, a bit of skin missing off the left leg,, you get the drift.

'What happened?' as I'm called to explain my presentation.

I had one foot unclipped to pull up at some lights but the footpath ran short and I bogged it in some sand,,,, and fell to the wrong side!

I don't think this really counts as my first cleat fall, it pulled up real quick I was going to go over no matter if I did have the leg out.

Got myself up, pushed the button, remounted and clipped in and waited for the light to change not looking at any of the twenty odd cars also at the lights. If I don't acknowledge it it didn't really happen.


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

Taz

Ok, so I got some overtime.

So I had fitted the pedals to the bike, adjusted the cleats as lose as possible and been for a ride to practise unclipping with out crashing. All seemed ok.

Get the call, do I want to work in the city that night. Do I? and I can ride in!!!!!!

So got to work without mishap and this is what we did.

50F - Non-specific unwell and looks it. Nausea, vomiting and does appear ??? jaundice.

42F - Syncope, same thing at work two days ago, describes it as still being able to hear but not communicate????

75M - Angio Oedema (huge lips). Appears to be from chocolate in the AM had some and felt some throat tightening. Had some more in the PM and the lips blow up without threatening the throat. Has Left Ventricular failure so I drew up the adrenaline but didn't use it.

20F - Young lass locked out of her backpacker accommodation. I used ambo door knock and got someone to open the front door!?!?!?!?

23M - Drag Queen who might have forgotten when the theatrics should stop and got his friends all concerned. Patted his hand, told him to pick his moments better and left him there.

28M - Who in trying to break up a fight between mates got struck suffering a head laceration.

83F - Abdo Pain.

79F Pulmonary Oedema.

31M - Acute appendicitis. Transfer to bigger hospital.

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

Taz

I'm on a really long break.

Between the end of the last roster and when I start back again on the new roster I have about seven days off, that's why I haven't posted.

So I went for a ride today, to get out of the house maybe, to definitely stretch the legs and to check out a few shops for their prices on upgrading to cleats on the bike (clip-less pedals and shoes).

At the local outdoors shop I found shoes and pedals for less than shoes at most of the bike shops so I bought them there and then.

A bit of a impulse purchase but I was going to do it with the next service in December. Their Shimano Mountain Bike shoes and pedals with a cage around them so you can still ride with just normal shoes on.

I'll have to zip up to the local Auto shop to get an open ended spanner to take the old pedals off and fit the new tomorrow and then start to practise uncleating myself before I have to ride for real with them.

I'm told that's the most embarrassing thing, not being able to get your foot out as you pull up at the traffic lights!

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

Taz

Our last night together.

He moves to a more suburban station out western Sydney near the largest Ikea store in the southern hemisphere.

Have you ever seen an electric stove cooking element explode?

Well that was our first job. It came down as a Burns/Explosion but there really hadn't been any heat involved.
As she turned on the electricity the coil element arched or exploded under the pan sitting on top of it and in doing so tripped all the circuit breakers. Pt was completely uninjured but shaken.

Some prick of a neighbour thought it would be funny to prank call this dear 74F with a suicide armed with weapon call. Nine Police in the apartment! then two Ambos for nothing. I hope they contact the caller and give them a serve.

37F - current problem a bad case of the beginnings of the 'DTs' on day one of alcohol detox. Respectable, well off family but the story was not right, way too many prescription opiate analgesia meds in the bedroom (chronic pain), too many of the right phrases with dosage amounts. The hospital quietly told us about the alerts they had for drug seeking presentations and it confirmed what we had already figured out for ourselves.

22F - I smoke cannabis four to five times a day. I've only had one shot of Heroin today and this is my second packet of cigarettes -can you take me to hospital to check that my baby's ok (unborn second child).
I'm not a bigot, nor a racist but I hang my head in shame.

49M - very low speed car crash, uninjured but the Heroin that made him fall asleep and let the car roll off the road was a problem but easy to fix. Much easier than his car and the troubles he will be in with the Courts.

How funny would it be if he is required to attend Traffic Offender programs like the one I do for the PCYC???

80M - Chest pain, transport for investigation.

Had a beer with the Padawan wished him well, which he doesn't need because he is going to be a good officer and came home to sleep or try to in the 35C (95F) temperature today.




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

Taz

First nights work.

Posting again from the phone at the hospital near the horse race track waiting to unload.

79F - deep wound on the shin.

31M - intoxicated and abusive, we escorted him from the hospital on arrival.

58F - Who has a Hx of cellulitis with hospital admission usually required for aggressive treatment.

43M - intoxicated at home. Fell asleep with the TV up loud and the neighbours called the Cops, who called us because he was unconscious. He eventually heard out ???? knocking, answered some questions and we left him there.

25M - Psych transfer.

30M - Altered LOC. Denied drugs but symptoms and the alley behind the well known night club SHOUTED different.

Well we're unloaded now, I hope we get some better work for the Padawans last shift in the City.

From the PC at Home.

That was interesting posting from the Phone yesterday.
It's an HTC Diamond Touch phone and you use a stylus to type, combined with sitting on the wall out the front of said Sydney hospital 'that has its own television show' with the notepad open in a slight breeze. Enough that I'm seated at the desk in the study right now.

First job yesterday was an obstetrics in nature. Lets say a few weeks short of the 20/40 gestation period before they are really viable and our patient is spontaneously aborting in the middle of the city. Not nice and the first spontaneous abortion I've ever done. I believe it is much more common at earlier say like during the first trimester. Anyway I wasn't overly chipper after the job.

88F - Abdo pain. As I search around the apartment I find more and more discharge letters and GI clinic appointment to provide a mosaic of this chronic idiopathic complaint. I would have given some analgesia if the spot of pain didn't keep moving. But the Padawans hand seemed to make the patient feel much better.

54F - Hosp to Hosp transfer via Air Ambulance pt discovered to have a brain tumour.

28M - Had a dustup (fight) with his mate and suffered a very minor scalp wound. Refused all assistance, GCS was 15, Not pissed or drug affected just didn't want a bar or us.

8F - Unresponsive, found sitting on a couch with a pile of vomit beside her with an absent stare. HR too fast - 120, BP too high - 150/90, BGL ok, Pupils =, Resp ok, Afebrile, no response to BGL lancet or cannulation.
Midazolam if it is a seizure but there is no Hx, no meds at home to have been taken and was until found a happy, healthy little girl.

I asked for Intensive Care Paramedic backup on this job and was told I had done everything right and just continue supportive measures and they would block traffic at the intersections for us.

I'm following this one up with the ED staff.

64M - Has suffered a brain injury from early treatment for HIV post a needle stick injury in the 1970's pt was a health professional. Anyway coordination gets to be a problem some times and today was one of them. Just an assist up.

61M - From local Psych ward with chest pain, manipulative, attempting to dominate both of use, NO ECG changes and it looks a beautiful normal sinus rhythm.
Problem is there is a cardiac Hx and he's a IDDM. Transport and treat per protocol and don't let him in your head.

Right I'm off to bed for some more sleep before night shift.

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

Taz