The punters are trying to behave.

In the lead up to NYE and all the celebrations that it will bring and with the school holidays there are a lot of people out of the city and there has really only been mundane work.

28M - Pedal cyclist, face planted over the handlebars. Not wearing a helmet, got a lecture from me and informed that it was a $120.00 fine if he'd been caught by Police. Looks like he has busted his nose but elected to go and see his LMO.

38M - Very localised right sided abdo pain. Family history of kidney stone and still has his appendix. Imaging and more tests needed to complete a diagnosis.

82M - A rigid, swollen and contused right calf. His is on wafarin and the pedal pulse on both feet was damn near impossible to find but they were both 2-3 second cap refill. I thought he had heamorrhaged ino the muscle. The triage and Drs liked that idea and kept he there.

73F - Near syncope inside a church. It wasn't stuffy, well ventilated and if anything cool but she took a very long time to appear anything like normal so we convinced her to come to hospital to get checked out and I have a suspicion that it was mostly behavioural she was just sounding a nervous Nellie.

39M - Bad sciatica. He's had it before. He had the usual medications at home to manage but it wasn't to be. I get sciatic pain when I over do it and I understand skeletal pain well from my many hip surgeries, he was struggling with the pain so we started him on some fentanyl (synthetic Morphine X80 stronger). Chronic pain sufferers wear fentanyl trans dermal patches that may deliver a 25mcg/hr dose. We deliver it intranasally like one of those decongestant sprays. 240mcg didn't make must difference, checking obs and observing the pt he took 540mcg to properly control the pain and he wasn't hypotensive or with a decreased resp rate he was bright and sharp and pain free. I don't like pain.

?30M - Addiction is hard to kick and many services are available but few succeed first time. This pt had managed to complete rehab and make it to the share house that assists to integrate the pts back into the real world where so many addicts fall back into the same ol' routine. Our pt had failed to resist and paid the ultimate price.

48M - Very minor injuries post a MVA, he just wanted them documented. Left with Police after treatment.

84M - Lives in a hostel/nursing home, is ambulant without any walking frames or sticks, had a fall four months ago was assessed in the ED and treated, had a fall last week but suffered no injuries. His LMO has put him on a diuretic (increases urine o/p and decreases blood volume and BP), increased his opiate patches (that may dialate blood vessels and decrease BP) has a 2 day old blood test showing his Hb to be 100 which is high for him with a known Hx of anaemia.
LMO thinks he needs to be assessed but for what, why can't his own qualified LMO do it rather than bumming him off to an over taxed ED? Where is the emergency with this pt?


As of yesterday we have managed to reduce our road death toll from last year by a significant number of 451 to 419, well done NSW motorists.

See you at the big One.

Taz

What should you not do on a glass top coffee table?

29F - first pt, the answer is sit on it! It shattered, she got a few cuts that needed some stitches.

49M - First cardiac arrest we're called to for the day, ??? seizure in a methadone clinic.

77M - At rehab post mitral valve repair and has sudden onset of tachycardia not resolving.

52F - Pillion passenger on a motor scooter. Wearing Bondi Safety Shoes (thongs or flip flops). Driver gets too close to a curb and her toe nearly gets ripped off. Stupid.

91F - Abdo pain, has confirmed gall stones, transport for management.

51F - Second cardiac arrest we're called to, opiate OD. Claims that she thought it was cocaine. Narcan, refuse transport left in care of a friend.

That was my day.


See you at the big One.

Taz

What does EMU stand for?

Well in most of the hospitals I attend it's Emergency Medical Unit.
Having said that there rarely seems to be anything of an emergency nature going on in there.

By in large they are waiting areas.

Waiting to go up stairs to a ward from the ED.
Waiting to be collected by family or us for transport home or further care.
Waiting for discharge from the unit back into society.

All the big hospitals have them.

I found this at the little inner city hospital that we usually take the abdo pains and drunks to the other day.

Officially none of the staff knew of it's existence!


Look at it, I know there have been cuts in the budget for hospitals but no mattress!
Just one blanket!


I'm not sure that OH&S would be happy with a glass bottle and the neck is terribly narrow to take a whizz in anyway!


And that dear reader is my silly post for the silly season.

See you at the big One.

Taz

Twas my last shift before Christmas!

2M - Has hurt his arm at day care. Mum has arrived and can't console him, his guarding the limb but of course with a young one there is seldom a fully visible deformity. A quick whiff of the Fentanyl and away we go for an x-ray.

29M - Suicidal thoughts. Not uncommon this time of year. Not known to us and was judged as a significant risk so almost straight into the psych ward.

23F - Lower abdo pain. The Methoxy whistle and transport.

61M - From the Air Ambulance base to hospital with triple vessel disease.

18F - Claiming haematemisis after Goon (cheap cask wine where they remove the bladder and drink out of it!) and a few puffs on a joint!

And that's it.
Christmas day with my beautiful wife and just relax with our 2011 protocol and pharmacology updates and some other clinical improvements that will bring all of the health services to the same point.

Have a good Christmas if it's your thing.
I feel it's just another day and do get a little pissed of with the seasonal festive goodwill to people when it should be all year.

Don't even get me started on the commercialisation!!!!!!!!!


See you at the big One.

Taz

Reader Comment.

I got this on the post about total numer seen and the number of patients per shift.

Anonymous has left a new comment on your post "And the total has been reached!":

Hi. I'm enjoying the read. Of those 1104 patients in 144 shifts, how many were transports to hospital, how many were non-urgent transports somewhere else (drop patient off at nursing home, etc.) and how many did you turn up and not need to transport the patient?

I don't know.

The post usually indicates if it was say a discharge to N/H or hospital to hospital transfer.

As one of the pioneer officers in the Clinical Assessment & Referral (CARe) program that was introduced in ASNSW several years ago and is of 2011 to be included into standard clinical training, on many jobs I was looking for possible other options than presentation at an ED.

Thanks for the comment and reading my little world.


See you at the big One.

Taz

Twas the first night before Christmas.

Well it was my first night shift before anyway.

31F - Relationship issues and maybe while washing a glass it slipped and cut her wrist, up the arm not across. Transport for stitches or gluing and maybe a chat.

46F - Been seen today for same at hospital, there is some diarrhoea but after I relieve pain they decide to hold off until tomorrow rather than wait in the waiting room. I had given her a whiff of Fentanyl, it was twenty five minutes before I left and it's only effect on her was to take the edge of her pain.

18F - IP, seven schooners of cider and beer mixed that are called snake bites! They're worried that her drinks been spiked,
Ya THINK!!!!
Which bit the excessive cider or the excessive beer!!!!
Transport her her safety.

40F - Anxiety, not doing well out in the world after rehab,
We talked and I seemed to calm down her anxiety and she decided to wait and go see the councillors in the day time.

71M - Unresolved vertigo this AM. Significant recent cardiac Hx AVR (aortic valve replacement) and one CABg (bypass). BP's good, no postural drops, no inner ear issues, strong pulse but it's funny irregular. Put the lifpak on and there we have sinus tach with 'P' waves and now we have Bi-Geminy for ,,,eight seconds and this was all at rest supine on the bed.
Got ya', the plumbings good it's the electrics on the motor.
Transport of course.

See you at the big One.

Taz

What a difference a day makes.

With our sparkling clean ambulance we attended the following,

81F - Regular dialysis pt who was royaly pissed because we were really late picking her up.

30M - Chest wall pain. Has had it for six hours, no cause like trauma, over exersice. Equal air entry no deformity, we were told by hospital later that there was nothing found and he woke up pain free from the analgesia and was discharged.

Pain is a very subjective thing and many times we are made to shake our heads at the reaction some pts have to their perceived 10/10 pain.

24F - Asthma not relieved by her own meds. We were the second car to arrive so I didn't get a peak expiratory flow rate before our bronchodilators but after two nebs with 100% O2 it was at best 305 l/min with her known max of 550. She was fair pinging from the amount of salbutamol (ventolin) that she had taken.

97F - Still lives at home alone with meals on wheels and home services coming every second day. Today she had finally rung her Dr about a cough she had and he had rung us. She was hot enough to cook on and just to hear her breath in the same room as you was like listening to a gravel truck go by. Transported.

49F - Abdo pain. Have any of you noticed that the are some wealth people are just dumb about their own health and what is it like to be really ill. There was by her statement a stomach twinge and she thought she was going to die. She eventually left in her own car to do some shopping before going to see her LMO.

70M - Mechanical stumble, a bit of skin missing but just requested assistance to his front door.

MVA - three cars one with a pt trapped by confinement (the door wouldn't open), the Water Fairies got it opened as we arrived and we got cancelled.

55F - Well known to most city ambo's and ED's, developmentally delayed/ brain injury, lives in a group home and when she has a fight with someone she gets on a train and comes into the city and gets people to call for an ambulance. Most usual presentation is claiming to have had a seizure or to feel that she's about to have one.
Today we picked her up from a railway station. Took her to the little hospital in the city. She left after the Dr sat down with her and explained again that we all know her real Hx and that there is nothing wrong with her.

55F - Sitting in a hair dressing salon, yep! same pt and because of our system if she asks for transport I have to take her. To a different hospital where the social workers aren't the nurses and can spend time to sort her out.

13F - who is developing multiple food allergies and felt some of the symptoms, maybe. Was with mum who told us that there was a likelyhood that some anxiety had developed and multiplied the sensations. No airway involvement and when she had calmed and thing resolved mum and dad took her home.


See you at the big One.

Taz

How many ambulances can you wash on a slow day?

After going out early for night shift to a,

??M - was walking, is now lying, he maybe dead! How the hell did the call taker allow the caller to make that leap? Unable to locate.

All the day shift crews went to the waters edge for coffee and some idle chat.
Then we went back to station and waited. No jobs came.
So we got the washing gear and tubbed all five of our vehicles.
And then it started,

7M - Had a tummy ache and got mum to ring the ambulance. Mum was given directions to manage him and he stayed at home.

33M - With Police who were concerned for his altered state. He was under the effect of drugs. His friends were reasonably straight (un-effected) and took him home. Good result.

24M - Psych Hx from interstate, was seen yesterday twice. Personality disorder who loves the attention.

47M - Abdo pain but very asymptomatic.

54F - who fell and did a good job on her chin. Transport and she left within the hour sown up.

27F - Syncope, 8 weeks pregnant, there looked to be partial seizure activity Drs need to sort this one out.

55M - on a scooter and got clipped by a car. Transport for x-rays to cover any later insurance issues.

See you at the big One.

Taz

Social commentary. Maybe not interesting.

Kept my ambulance running.

It doesn't mean that we were any better at our jobs than other crews.
We had some luck with the type of job, the circumstance/setting of the pt, location.

The old 'You call, We haul' is indeed the safest option in the view of many still in the current ambulance service.

Your taking every single patient to the hospital to see a doctor.

This is safest mainly for your benefit, it covers your arse.
You care,
Cover Arse, Retain Employment!

It is best for the pt?
Is it best for the health service (hospital)?
Is it best for ambulance services?

No.

We have to think outside the box, be proactive not reactive.

It wasn't hard to see that the asthma pt had a home nebuliser and think what if we left her a few ampoule's to use over night rather than unnecessary transport to hospital.

The all over ache's for over a year, to the low acuity little hospital to be put in the waiting room, and while there are not drunk tanks as such unfortunately that's what we use the waiting room for. If they can sit or have someone to keep them sitting they can also leave when they're sober or less drunk.

It's not transporting everything because it's easier for you.
It's not leaving them at home unsafe.

It's clinical decision making, it's taking your professionalism further and even educating the public not denigrating them.

I'll get off the soapbox now.

Besides, the fact that you're here reading this means that you do already have these qualities.
Your the right stuff in a sometimes bad place that we love/hate to work in.


See you at the big One.

Taz

We kept our ambulance running all night.

More by good luck than planning. A whole heap were stuck at a few hospitals with no unload times.

34M - IP near the big train station, taken to the little hospital in the city that deals with this type of pt so well.

55M - In the road behind the same little hospital, maybe drunk or maybe dead. Gee that's useful job details, UTL, a witness stated that somebody walked a drunk into the hospital???

24M - Known to me with Hx's of ETOH abuse and self harm. He had slashed his wrist upwards not across. No arterial blood but a good strong ooze.

86F - Febrile with a savage cough.

39F - SOB. Had run out of nebs for her own machine. Some quick obs and a peak expiratory flow test and leave her a couple of ours for later if needed. Left at home safe with meds.

49F - All over body aches > 1 year. To the little sity hospital again. They love this type of pt.

40M - IP and not responsive to any of my pain. Very diaphoretic, just a little hypotensive. He didn't flinch with a 14g in the cube, some antiemetics and fluids and low and behold who starts to come around at the hospital with it's own TV show. Still maggoted but with eyes open now.

37M - Near drowning, boat owners had thought the shouting was coming from another boat for about ten minutes before they went out to check in the marina. The dude's still in the water struggling. He was dragged out by the time we arrived. Hypothermic, confused, urgent transport.

See you at the big One.

Taz

OMG what a boring night.

10M - Fell off his skateboard onto his arse. Somebody with a mobile called for an ambulance, for a sore arse. Pt went off with his mum to watch the fireworks after we had diagnosed a sore arse.

37F - Epigastric pain. Really very distressed. Transport to investigate.

14F - IP, transport for safety and to wait to call Mum. Manditory reporting to Social Services.

38M - Now it could have been the booze or the thrashing he got from the bouncers that had him in an altered state. Fifteen minutes after unloading when he refused to use the bottle and bounced out of bed and walked to the toilet,,,,, I guess it was just the booze.

And that was it for the shift.

See you at the big One.

Taz

Opps, sucked into the suburbs!

A beautiful day, Oprah is in town and it's getting busy.
We are stuck in the same area south of the city going back to the same already full hospital.

42M - In Police custody and has a headache, here are two panadol.

72F - We're really not sure what happened, a language barrier, but it appears she fell to her knee and the pain was that bad she got the family to call and ambulance. No laceration, contusion, mark or deformity.

78F - Vertigo and leg weakness. She thought it was a CVA but it was bilateral. Transport for more tests.

75F - # NOF. Just fell from standing.

85F - PR bleed.

89M - Febrile, lethargic, infection but where? Tests will located and treat.

See you at the big One.

Taz

You can have a day full of nice patients.

52F - stumbled on the bus and struck her nose on a hand rail. There was a small lac and the bleeding had stopped but asked to see her photo ID and that thing as way off to the side. When she asked what an ED would do I was honest and said just take the x-ray and refer her to a specialist, She said well my LMO can do that and we agreed. Left to see her own Dr.

77F - A pt known to me or rather the wife of a pt. He has recently had to be admitted to full time care and she really isn't coping with the guilt feelings. This has lead to depression, anxiety and are manifesting as physical symptoms with no pathology. We transported to seek some professional directed care and assistance.

44F - Just on a quick connection layover at the airport and BAM, the abdo pain that has been slowly growing since they departed jumps to a 9/10 and she nearly faints. Good country stock, not prone to over doing illness and with no Hx I'm stumped. All her innards are in fine working order and she's already had the gall bladder out? Transport for tests, and re-schedule the flight.

89F - Had a fall two weeks ago interstate. Nothing found on the ED discharge letter and sent home with analgesia to self manage. The pain is not responding to the meds and has not shown signs speedy enough for her liking for recovery. Wants to go to our hospital to get re-examined.

29M - Fell over last night a bit drunk with his arm under his ribs. This morning it feels like he may have broken a rib or two. X-RAY!

Assist another car with a difficult extraction of a suspected spinal pt.

30F - 33/40 gestation and having a small haemorrhage but can't located from where PR or PV. Not really something we go looking at and with the advanced pregnancy transport is the best.

89M - Helping his son to move a filing cabinet and it dropped on his lower leg. Nasty big laceration nearly 3/4 the length of his shin and down to the bone.

See you at the big One.

Taz

Hello RKR!

This is in response to his comment on the post Much more transport tonight.

Greetings to you too Dude.

VACIS or eMR as we are calling it, has I think now completed it's trial period at selected stations and will begin it's slow roll out here in 2011. I'm sure I have read a time scale for it's implementation but as any of us know these things usually take longer than expected.

I remember in my previous life when computers where going to give us a paperless office system that manual invoicing (which is really what part of the documentation is for) was decreased by 95% but the books were never thrown out.

There are really only four levels of officer in our service,

Trainee - your induction and basic training at school (8 weeks) and the remainder of a year (usually) on-road with Qualified Officer mentors.

Paramedic Intern - after another stint at school and then anything up to two years on-road for skills consolidation and development. There are many things in this job that can't be learnt from a book.

Qualified Paramedic - another stint at school for the largest jump in skills and knowledge.

Intensive Care Paramedic - not a natural progression for all who wish to gain the extra skills, knowledge and responsibility but a hotly contested, merit based selection system with limited positions. It does, and this is my opinion (like arseholes I'm allowed to have one before any ICPs try to rip me another), it deters really good officers who are not the cream of the crop at examinations, interviews or application writing.

Then there are the speciality positions, Rescue or Special Operations Team, Flight Nurse or Paramedic, Rapid Responders cycles and cars.

The eMR is going to have all the protocol and pharmacology on it but you'll always need a book on the job.

And as a note to any reader you can always drop me a line direct to taztheambo@gmail.com


See you at the big One.

Taz

Much more transport tonight.

73F - Fall, stumble, tripped through a fly screen. ? a fractured shoulder. Analgesia and transport.
21F - Pancreatitis, confirmed diagnosis recently. Analgesia and transport.
90F - Discharge to a rehab with fractured humerus.
26F - IP, with her husband who was fine. Some busy body passers-by had called in and waited to tell us that she needed to go to hospital because she was intoxicated. Husband just wanted to go home, friends had a car and a nominated sober driver but busy body had passively stopped them from leaving until we had arrived. We released them and smiled insincerely as busy body walked away thinking they were important.
50M - O/s tourist with a fever. Been in the country for over a week so I guess they've caught one of our bugs. It was 40 degrees so transport was indicated.
Major incident; on the harbour.
20M - C/o mid thoracic central back pain. Collar, spine board, transport.
36M - Shoulder blade pain from fall suffered in same incident.

Back to normal-ish patients.
I don't care what colour you are, sex, age, race or religion but there are some who draw attention to their group and reinforce stereo types, such as FAS or OMG.

32M - IP, interestingly they are of a religious background (they informed me) that I know doesn't drink. There are not only language barriers but cultural differences. Wailing and gnashing of teeth while head butting the inside of the car or bashing the arm that is supposed to be injured does not go down well with us or the hospital. I tried to explain that ambo's, nurses and Dr's should not have to defend themselves from pts who were physical. Security kicked them out because apart from him being a total wanker there was nothing medically wrong.
35M - Deep lac to the muscle at the base of the thumb. needs lots of stitches.
53M - Heavy chest pain. Protocol and transport.
37M - Abdo pain, sounds like renal colic ,,,,,, interesting that that was the last job on the previous shift also.



See you at the big One.

Taz

Who will come, in my beautiful ambulance.

88M - Not feeling strong but doesn't want to see a Dr. Left at Home.
20F - Drunk and assaulted another innocent female. Left with Police.
20F - Running about in traffic, It was a call about the girl we had just seen but took longer to filter through from the call taker. Still had to do paper work.
55M - SOB, how about a blocked nose, honest a blocked nose. 'No I don't think you need to go to hospital sir'!
45F - IP at the big train station, who had got on a train and left when we arrived.
43M - Minor facial wound post assault. Declined transport and left with Police.
??M - Unable to get up. The location was the other side of the shops we are at with the last job,,,,,,, Duplicate call I reckon, we couldn't find anything.
24F - IP, I'm not sure why we got called. Pt was standing by herself, talking and drunk. B/f was on his way to collect her, left with her friends to wait for him.
BRAWL - multiple pts. Yeah right. UTL.

At this stage of the shift we have not transported a single pt. I'm starting to get desperate for hospital coffee!!!!

39F - IP, Xmas party, has never felt like this before, this drunk that is. A lovely lady who was in need of our help. Her friends had been trying to get her into a car but the evil wobbly leg syndrome kept stopping her.
21M - Xmas party IP, had fallen on his wrist but against a gutter and given himself this huge skin tear come laceration. Definitely needs hospital.
80M - Decreased mobility. Which is a known issue and there is an underlying dementia but he doesn't want to go. We've all seen the battle between that aged couple who really needs to have one in care because the other can't physically care for them any more. Left at home to see if the family can help to resolve.
34M - Abdo Pain. Renal colic.

See you at the big One.

Taz

Can you give cement to a Pt?

Only just enough so they could toughen the Fu*k up, like this guy.

30M - Had got off the bus outside work, was talking to another employee, finished, turned to walk into work and walked into a street sign pole. Not ran, not tripped and fell but walked and hit his head.
Rang for an ambulance because his head hurt, there was no visible injury, there was no swelling, there was bleeding, there was no mark at all. There was no motor/sensory deficit apart from the moment he had hit the pole and it 'went dark and I could see stars and my legs were like jelly'. He had taken no analgesia and had only called his mummy who was a Dr who thought he should go to hospital.
I'm aware of the worst case scenario and complications but he hadn't even tried an icepak and some simple analgesia, no called for an ambulance and talked it up so hit was a hot response more lives at risk because he's a soft co*k.

40M - Poly-pharmacy OD. Anti-hypertensive and herbal sleeping tablets.

21F - Period pain, nearly bad enough to make her nearly faint, or so she told us after we arrived to find her sitting in reception waiting for us. (MORE CEMENT NEEDED). It was given a hot response for a pt who decided that 'Oh no I don't want to go to hospital'.

52M - Know street dweller seen to have what sounded like a good description of a seizure on a park bench.

39F - Chest pain from a Dr's clinic. I think it was more to rule out cardiac issues or ischaemia really.

32F - Hypoglycaemia, it took a good while to bring her back and she was at work so I was keen to transport.

9/12mth M - had a chomp on a brittle plastic Christmas tree ornament and freaked the shit out of mum. The was a minute amount of blood in a little drop of saliva from where he had spat it out. We transported and explored the back of the vehicle.

See you at the big One.

Taz

4th Anniversary of my first Cardiac Arrest save.

Yep, four years ago I can claim my first witnessed and saved cardiac arrest.
So with that in mind and with a student from our education as a ride-a-long we set out on adventure today.

It didn't seem to be happening though!

32F - Near faint in the underground train station or maybe it was just Floppy As*&^ Syndrome that I have blogged about before.

63M - Who was vigorously scratching his male member and made it bleed. It bled quiet a lot despite bandaging. Honest readers you couldn't make some of this sh*t up.

93M - Nursing home staff say his GCS has declined this morning. While none were on his meds chart I think he was doped out of it.

50F - A simple mechanical fall going to her birthday celebration. A face plant but during examination her central mid-neck was very tender. No motor/sensory deficit but all precautions taken.

64M - Post ictal. Was by himself so I had to encourage transport and he did eventually agree.

49M - Chest pain, yea sure, we eventually locate him because he doesn't really know his exact location. Doesn't look the best, short history AMI two months ago with two stents and today was his second day back at work and he was just driving when the pain came on.
Three leads show elevation in 3 & AVF so while I'm technically not supposed to be able to understand a twelve lead I do one and confirm a STEMI and treat with O2, Aspirin and nitrates we were too close for me to get any morphine for pain just an 18G in the forearm.
Pass a code 3 to the hospital, walk in with all my prints and up to the cath lab we go.
Funny it happened today.

Thanks to PP Author for the comment about anonymous comments, that's how I handled it in the end.

See you at the big One.

Taz

Social Media and the Medical Profession!

This sounds interesting doesn't it?

Most of us long term bloggers have spent plenty of time considering the possible ramifications of our posts on others and our careers early on in our blogging history.

I used the standards I observed in other's blogs when I first started.
I also reviewed these with my own personal beliefs of integrity and confidentiality.
I got criticism, some from peers, none of whom had the guts to put their name to the comments.
I reviewed my standards with the nine recognised patient identifiers used by the my health dept.

Several of my on-line blogger friends have stopped or greatly reduced their posting because of pressure either direct or veiled from peers and employers.
I was ordered to a meeting scheduled with management about my blog.
Two days later it was cancelled without reason and not rescheduled, I have always assumed that maybe they had actually read it after the secret squirrel gang had complained.

So it was with great interest that I read this document forwarded by an associate from the Australian College of Ambulance Professionals (ACAP)
Social Media and the Medical Profession and watch the YouTube film and open the pdf lower on the page.


Yes it's a long read but thought provoking and insightful so I recommend it to you even if your from overseas.

I conducted the Google test suggested to see how much information is out there on me (because ego is not a dirty word{Shyhooks circa 1975})

With my real name in full, nothing in the top 50 of 45,000 hits.
Christian and Surname only, 46th listing in top 50 of 308,000 hits.
With Taz, 45 of the top 50 of 37,700 hits.
Taz the ambo only got 40 of the top 50 in 131,000 hits.

Only one of any of these was about Facebook, the rest were blog related or news articles

Enjoy.



See you at the big One.

Taz

Some Amphetamines and some Hammer to end the night.

34M- From small to large hospital with a non-stemi.

42M - Men's hostel resident may have intimated that he had abdo pain but denied it when we arrived. We gave him the quick once over and left him there 'cause there was nothing wrong with him.

69M - He was describing sciatic nerve pain but had an active Hx of CA with boney mets so we couldn't discount skeletal cause. Transport.

42M - Amphetamine OD, sweaty as a pig, pants anywhere from groin to knees, pinging off the walls, totally inappropriate speech, running around in circles. It took three cars of our finest constabulary and one extra ambo crew to assist with restraint while I wacked our mechanical restraint device on him.
Five hours later he wanted to talk to the crew who brought him in. We recanted all the piss funny bits, told him that CCTV had recorded the whole episode and cautioned moderation.
I mean it's not like he's going to stop.

39M - ULQ abdo pain.

32M - Heroin OD, crew called us to hot response assist with an overdose. Extra hands in a difficult location. As we entered without any gear because it was to provide muscle they got told about the 'other guy' who was just sleeping in the other room!
Cyanosed, resp rate = 6, diaphoretic, GCS = 3.
They're easy enough jobs, oxygen and Narcan if needed. Our treatment protocol has changed in the last two years, it was 5ml/2mg mini-jets repeat twice if needed.
Now it's 400mcg or maybe 800 (max of 2mg) to bring them back but not enough to let them get up and leave. The plan is to be getting them to come to hospital for observation in case of renarcotisation.
Our dude to the 2mg and was still not fully alert so he got transported.



See you at the big One.

Taz

First night with the new partner and another famous person.

Not that I can tell you who.

31M - Shakes and weakness, that'd be the cocaine bender you've been on then. Elected to stay at home and ride it out.

36F - Directing the hubby into the car spot in a garage and got trapped by the bumped, like compressed. Released before we arrived. No obvious injury and had born weight but transport anyway.

21M - Waiting to catch a train home but was noticed by rail cops to be covered in blood. Got in a bit of a fight and had these two minor head lacs that had just bled a lot. cleaned him up and dressed the lacs and he went home because he was already very late!

32M - Tired and fell asleep in the Adult Sauna. I'm not saying anything more.

23M - IP that had traumatised member of the public just by being there. They called me up to come and wake him up from his doorway to move on so they wouldn't be so traumatised by him.

25M - IP, twat that thankfully the Police took home.

Six jobs and transported just one of them.

See you at the big One.

Taz

And the total has been reached!

To recap,

Taking the number of days in a year and deducting 42 days for holidays.
Divide the 323 by 9 which is the roster cycle, four on & five off giving you 35.88.
Multiply roster cycles by four comes to 143.55 or say 144 shifts per year.

The following is the 144th shift.

89M - Discharge to nursing home.
91F - Transport to hospital for a fracture review.
18M - Recently diagnosed with an inflamed appendix, given oral ABs and told to come back if pain didn't decrease or increased. It got worse.
29F - Gastro, for three days now.
39M - Same gastro.
62M - From Medical Centre after presenting three days after being dumped in the surf. Dr thought he may have a carotid aneurysm?
17F - At school, near faint. Mum was coming to collect her. That sounds good.
3M - Fall in playground onto the the tightly regulated absorbent material under the play equipment. Over protective parent maybe because the kid just wanted to get back to the playground. They went home for ice cream.
20M - Has a mental health Hx and wigged out on the public transport. we transported him to a controlled environment to calm down.
66F - Mechanical fall and resulting face lac that was going to need stitches.
91F - N/h staff called for SOB. Pt was chucking an anxiety attack and playing it to the max. We did transport but when I talked to the family they told me she's been doing it more and more frequently.

And so that was it for my theoretical year of work,

1104 pt's seen in 144 shift for an average of 7.67 pt's per shift.


See you at the big One.

Taz

And final number of patients seen is?

To be revelled after one more shift

86M - Fall two days ago discharged and well for the last two days. Today decreased mobility.

75M - Confusion and dysphasia, the symptoms would resolve and then return. Still there when we did eventually knock off.

27M - With Police who will schedule the pt if we transport rather than the back of a cage truck.

78F - Near faint while shopping.

24F - Abdo pain but thankfully not period pain.

81F - Had a fall three days ago and only now goes and see's her Dr who wants her to have an x-ray now!!!!!!

70M - Heat Exhaustion a bunch of Americans running all round the place after some grand prize being followed by heaps of cameras and audio techs. I had to sign a release.

64F - 120mm lac to the lower right leg. Definitely needed stitches.

1093 jobs /143 shifts = an average of 7.64

See you at the big One.

Taz

This is worth a read.

From the Flobach Republic the question was asked what do we wear to work, what tools do we carry?

From the Insomniacmedic came this and strangely at our end of roster dinner the other night it was a topic of conversation before I had read the post.

Have a look, it is worth it, you'll understand.

Well done to both of you.

See you at the big One.

Taz

Shift Swap something different for me.

Shift swaps, someone needs a particular shift off and you work it for them.
You don't get paid for it except for any penalties and they repay you when you need a shift off.
Now I love my work and arrange my life around it generally so I don't normally do shift swaps because I rarely need time off and therefore don't need my shifts covered.

I have swaps owed from five years ago! But one of our guys was going overseas and really needed this one covered, he'd tried everyone else so I did it.

40M - Had used IV methamphetamine and landed at a relatives house screaming about someone chasing him with a gun. Then the other hallucinations started. He was much to wired for the back of our ambulance so the Police transported him for us to hospital and we followed.

20M - IP. Why is it that they can't scratch themselves but can vomit and spit? Credit to his sister, she did arrive to try and drive him home but not in a little two door coupe!!!!

23M - IP, punched once to the face, cut lip, refused transport.

20M - A decent lac on his finger but he was in custody so the Police came too.

32M - Very IP, horse play at a party saw him fall backwards with another IP falling on top of him. That drunk and unable to tell us his address, day, month or year even though he was talking well enough meant a collar and transport to clear the neck and head for maybe a closed head injury. I made sure his friend remembered what a twat he had been to my partner, the nurses and Dr's at hospital.

34M - Occipital abrasion. Refused transport and cried on his G/f shoulder.

23M - Contusions to scalp also refused transport.

29M - Epistaxis post alleged assault, refused transport or Police. Absconded the scene to hunt down the people who beat him up!

21M - In custody, claims concussion, he was trying to pull the Police and our chains, when explained that ok fine we accept what you say so it'a up to hospital in cuffs for four hours of neuro ob's he changed his tune and recanted his story.
The Ambulance are not a get out of gaol/jail card.

1085/142 = 7.64 average jobs per shift.

See you at the big One.

Taz

Accepted one more o/t and knocked one back.

So I did another night shift at the station near home.

What a difference,

77M - IP (well maybe that's not so different) fallen over in the bottle shop!!! A straight cut on the scalp that will need glue or stitches. Problems are he's NESB (Non English Speaking Background) complicated with the intoxication, severe hearing deficiency and there's something about the uniform that gets him agitated. We over come these and unload at hospital an hour and a half later.

74F - One of the best Manic pt's I've had in a long time. She was at the airport trying to get on a plane to fly off to see some Dr overseas. Non medicated and with no physical health concerns we were able to transport directly to the psych ward and she had the staff there shaking their heads. She was harmless but way , way out there.

62F - Central Chest pain with an inverted T wave, sinus rhythm, angina history, radiating to the arm. Came on at rest was there for over an hour. Oxygen, aspirin, nitrates, pop a line in just in case. Cat 3 triage and wait. No movement in the department or upstairs on the wards. Treatment done on the stretcher, ECG, first bloods drawn and chest X-ray. Three hours to unload and the pt was pain free.

And that was it.
Three jobs.

1076/141 = 7.63


See you at the big One.

Taz

O/t at the home station.

40F - Abdo pain, toilet felt dizzy and knelt on the floor. Pain much resolved on our arrival, everything checked out good, pt stayed at home.

29M - In Police custody but behaving very odd so they called us, I'm happy that he's not using me a ticket out of gaol (as such). The hospital thought so too and kept him.

31F - Called to a collapse, pt said they thought their BSL was low so had ingested a couple of those sugar packets you get at a cafe. I think someone was too quick on the triple O call.

54M - Haemorrhoid haemorrhage. Significant enough that I wanted to transport.

35M - Chest pain. UTL.

29M - In the cells of a different Police station. They have to call but they were so apologetic when we arrived for this sook with what looked like a paper cut in the cells. I put a bandaid on it and didn't draw a smiley face.

19M - ?? fractured nose, it was straight but is bruised up really quick so maybe even zygoma or orbit fracture as well.

64F - From one hospital to another.

1073 jobs/140 shifts = an average of 7.66 jobs per shift.
See you at the big One.

Taz

The following night was also above average.

18F - Had threatened self harm in front of a witness. Look it was most likely just a simple argument about nothing but you can't pick up a pair of scissors and say something dumb because that's where I become involved and believing that you don't have to cooperate only makes it worse.
I really think that she just has some issues that can be resolved with simple conversation rather than medication or in patients services.

75M - Call was for a public assistance off floor but as a diabetic with high sugars post normal insulin and with reduced mobility we thought it better to transport.

20M - Was being transported by police and had a reduced GCS. By the time we arrived this very intoxicated young fella had perked up and the police were happy to continue with returning him to home.

54M - In another Police stations cells, c/o chest pain, key word that Police act on. Again very intoxicated and not very cooperative but we eventually got it out of him that five weeks ago he had suffered some rib fractures and it was those playing up. He didn't want to go to hospital but just some simple analgesia.

21M - After a domestic argument he got depressed and picked up a knife and started some bad thoughts. In a flash of rational thought he knew this was wrong and unable to think of anyone else to call he called the Cops. The knife was secured, he had had a talk to his mum on the phone but still would have liked to talk to someone about this episode. No previous Hx of mental health we did transport and found out later that he had flown of the handle at hospital staff with verbal threats and had to be restrained????

51F - With what I can only call a 'Man Cold'. Demanding hospital. Yes she was sick but no she didn't need a hospital or a bed, after being put in the waiting room she jumped in a cab while the case sheet was still being written.

23F - Found by Police drunk and asleep in a doorway. A tourist from interstate she was so lucky the Cops found her. We gave her a lift back to her motel and to the room and her worried friends who had lost her in the Cross.

63M - At a Police station with blood around his mouth not making any sense. The blood was dried red wine and he was just speaking a complicated dialect of 'Pistonese'. Pistonese is a common dialect of the Derro allys of most large cities which while similar to slurred speech is much harder to translate due to varying speed, syllable structure, dribbling and interspersed laughter. The old fella had called in on his way home to thank the Police for being heroes and reducing crime in his suburb. After I explained this to the station front counter staff they shook his hand, accepted his thanks and we took him home.

1065 jobs/139 shifts = 7.68 jobs per shift average.

See you at the big One..

Taz

But the city was busier the next night!

94F - Hospice to ED with decreased GCS.

21F - IP, was at home and friends didn't seem to understand drunk and vomiting. Left at home once this common phenominum was explained.

37F - Inflamed PEG tube site.

78M - Discharge to n/h following negative tests after chest pain.

18M - transfer from one hospital to another.

18M - Two small lacs on nose from a rolling brawl (one that moves). Move on order by police.

17F - How many times do we have to tell you she's not having an ASTHMA attack. Sit down and put this mask connected to nothing on her and stop patting her hand. Went off to find her BF who was in the brawl.

15M - Head lac, he was in the brawl too and left with his friends to go to hospital to find his other friends whom I may have said had gone there, I'm hoping that the triage would see the bandage and investigate as that was all he'd let me do.

21M - Who can't blow air out of his ears! We think he must have gone swimming today (tourist) and had water in the ear. Someone must have smacked him in the head because we got cancelled as we pulled up.

Assist another car with a 'King Hit' male pt who really was just a pissed knock, he ended up having no cerebral bleed to blame his behaviour on.

36M - Domestic argument and he lost his front left tooth, bleeding had stopped so he was going to see a dentist on Monday.

24M - Another 'King Hit' but he was in the middle of the road under the Coke Sign in the Cross. Again no bleeds or fractures found at hospital.

??M - IP, walked into a wall???? Police to him to provide a lift home.

72F - Febrile and nausea. An infection some where! Hospital can find it.

1057/138 = 7.66 jobs average per shift.

See you at the big One.

Taz

The Shire goes crazy.

The Shire is 20 odd klm south of Sydney, a suburban area that is often joked about in an extreme rural bumpkin or Froddo Baggins style.

They were sucking cars in from everywhere. We got a cold backup of a single responder from the middle of Kings Cross and at nearly an hours drive time in traffic.

But the day started out in the city as normal.

65F - From hospital to Air Ambulance and home.

??M - With a cut over his eye and running around disorientated?? Call came from a third party and the police and us found nobody.

59F - Mechanical fall on uneven surface and face planted. Resolved epistaxis and a very minor lac but she requested hospital over seeing her GP.

26F - Well known syncope when exposed to emotional stressors. This time has done it at work during a safety presentation. I was happy with her story, work hadn't seen it before they freaked she was happy to take the rest of the day off and go home.

28M - Headache and vomiting, had mainlined some methadone. These are adverse effects from this. Transport for management and to clear other doubtful causes.

46M - Narcotic OD in public toilets. GCS = 3, Resp Rate = 6, Sweaty, Tachycardic a simple job that we handle every day. Oxygenate well before the narcan and up he pops with no vomiting or aggression. Shame that he was released from prison today and here he is shooting up and his shooting buddy has buggered off with the rest of the hammer and the money from his wallet. No honour amongst thieves or junkies.

34M - A pt with a rather obvious mental health history from the first ten words out of his mouth. Starts telling me about this back pain from a footy match 17 yrs ago!!!!!!!!!!!!!!!!!!

Porno Videos on the floor, a bong on the table, IV drug paraphernalia lying in open view and a pt who sounds like he just dropped out of Wayne's World. At hospital, where they didn't even come and get his details off my paperwork they know him that well, I take his BP and he states that magically I have fixed him and can he go. I weep on the inside and say a thank you to the Gods for saving the ED staff from him at least.

85F - Acopia we took Hubby as well because he wasn't much better. There comes a time when it is no longer safe to live at home.

85M - SOB, chest infection most likely.

1043/137 = 7.61 job average per shift.

See you at the big One.

Taz

What are we? The psych and pissed bus?

Just one of those days really, while others got some good work,

20M - At a drop in center with blood on his pants. Yeah like old washed blood, there was no injury Services not Required.

66F - Has been battling a chest infection for three days but had three syncopal episodes this morning while talking to her daughter.

35F - Has also been fighting respiratory symptoms and today coughed the wrong way and hurt her back?

64F - Depressed, feels like she can't keep going but doesn't want to harm herself just wants a talk to the mental health team.

??M - Self harmed with scissors and then buggered off. Police were still looking when we left.

57F - IP in womens refuge, not allowed, has to be medically cleared by Dr before they will accept her back.

42M - Regular IP who just needs a bed. Missionbeat fixed him up when we called them.

31F - OD in another womens refuge, same deal.

51F - IP, abusive, depressed non compliant, call in the cops and put on our mechanical restraints and then load onto the stretcher.

These two both required use of our powers under the Mental Health Act.

Not long now, the total shifts done each year by an officer after six weeks holidays would be 144. Today was 136 and 1034 jobs done for the shift average of 7.60

See you at the big One.

Taz

Some O/t.

With a new person that I have not met before from the country.

2/12M - Sounds like a febrile convulsion and we're transferring from a small hospital to a big but have to drive to another station to collect our baby seat.

Get there and get called off to a car into a shop. Low speed it really only just mounted the footpath and broke the glass front window. It did totally munt the fully sic lowered suspension and body kit. Everyone refused assessment.

Got the seat and went and got the kid. Happiest little fella, totally stable and charmed all the nurses at the Kids hospital.

81F - From hospital to a nursing home thirty odd kilometres away.

30F - Swollen lip. Claimed she didn't know what was happening but doesn't realise that even if we take you to a new hospital they can check on other hospital presentations within the health system and see your treatment yesterday somewhere else for the same thing.

76M - From Hospital to Air Ambulance to go home.

1025/135 = 7.59 Average jobs per shift.

See you at the big One.

Taz

But it got better tonight.

77M - Rigors & Fever, has had an invasive procedure today with sedation only but also has a history of malaria. Doesn't matter he's sick and does need a doctor with resources now.

27F - IP, true to form obnoxious vile and much worse than any drunk guy. Absconded from hospital after mouthing all of us, fell down immediately outside and the hapless room mate helped eventually to the road and a taxi.

25M - Decreased LOC over a plate of Oysters Kilpatrick. Known young street dweller who had some new threads on and went into a restaurant and ordered food. Unfortunately he'd had too many pills and fell asleep before he could enjoy the meal that he didn't have money to buy. The job came down as a Cardiac Arrest.

38F - Respiratory Distress or hyperventilating. Took an hour but we got her down and left her at home rather than the ED.

50F - Gale stones. Admitted to McDonald's in the afternoon.

30M - Small face lac. On the door at a Pub, got a glancing blow to the face that just pulled the skin. He wasn't interested in us or transport.

38M - Swollen foot. Give him his due, had a bicycle stack three days ago and hurt his ankle and tried to self-manage at home. It wasn't getting better and he couldn't bear weight at all now.

25F - Totally Drunk. Able to give us the finger, tell us her name and open her eyes to voice. They don't realise just how dangerous this condition is for them medically and morally. This young lady still had her underwear on because everyone could see it, the 'Baby Doll' dress wasn't covering much. She couldn't even hold her head up, what if she had been in a back street rather the main street.

59M - Alleged rib pain from an alleged assault.

74F - From private hospital to the air ambulance to go home.

Returning to base there's a building fire that we had to drive past and even though they needed our car back on station for day shift we are still an available resource right there and then.

Standby at a building fire. One deceased on scene and one transported by another crew for probable smoke inhalation who cracked the shits and walked out of the hospital an hour later.

1020/134 = 7.61 average jobs per shift.




See you at the big One.

Taz

A quiet wet night.

44M - Homeless, sore feet, requesting hospital but not expecting a bed. During our conversation he mentioned his schizophrenia but that he currently had plans that he would like to follow to improve his situation. Positive attainable goals, well done. Fungal infections and they called Mission Beat to collect him and take him to a shelter for a bed and some social work.

37M - Near syncope. Bent down to the floor from the hips and was dizzy when he straightened. He decided that he was probably ok and to go home.

34M - Sick, no like really sick. Returned home from overseas a week ago, travelling to major cities only. Five days ago started to have fevers with joint aches. Seen his doctor three times for blood tests,,,, maybe Hep A they think but change it to e coli. Start him on oral antibiotics two days ago with paracetamol for the fevers. Tachycardic, Febrile at 40.4C, Hypotensive 90/50 and hours later in hospital while they had all his symptoms under control they still didn't know what the infection was.

19F - Surfing down the banister of the big staircase in the backpackers and fell off. Luckily bounced a few times and landed on her feet totally uninjured but scared the willies out of her.

30F - Another backpackers, got up to go to the toilet in the dark room and tripped over a siutcase and dislocated her shoulder.

And that was it.

1009/133 = 7.59


See you at the big One.

Taz

I've cracked 1000 jobs for the year.

80F - Community Alarm activation. Pts daughter had contacted mum as we pulled into the street and cancelled us outside.

89F - Took an unwitnessed tumble at the n/h and had a minor head lac and had complained to them of mid back pain. The lac I could see but depending on how and when you asked about the back pain?????

72F - Had a fall two days ago landing on the chest wall but didn't want to see a Dr until today when she struggled to breath because of the pain.

59P - Near syncope, total knee replacement six days ago, discharged five days ago even though she had a similar near syncope when leaving. Transport for further investigation.

31F - Well known developmentally delayed pt who doesn't like her group home and absconds to the city usually to end up in the hands of the police because she becomes a nuisance in a public place. They handball to me and I handball to the social workers at the hospital.

30M - Chest pain on descending on a flight to Sydney after a big Loong weekend in Melbourne for the Cup. First bloods looked ok when we had left after a delay unloading.

Two cyclists collided and both suffered right shoulder injuries so there were two case sheets.

So that made eight for the day and 1004 jobs over 132 shifts for an average of 7.61 per shift.
Remembering that I have calculated that I would do 144.3 shifts over a year and that I am just adding every shift I do till I reach 144 and then I'll have a figure for a year.

See you at the big One.

Taz

The Race that Stops a Nation!

They don't stop ambulance work.

38F - Sprained her ankle at the train station.

32M - Epigastric pain, burping and farting,,,, sounds like gas.

84M - Terminal CA pt with ascities.

??F - Chest pain but not bad enough to wait for our arrival lights and sirens.

10M - SVT! no really hospital to hospital transfer.

32M - Street dweller who was ?? post ictal. He didn't want anything to do with us.

20F - Regular normal bad period pain, lucky me I had my female partner today. Not so lucky for the pt.

88M - Much increased confusion and agitation. Development of his dementia.

48F - Slipped at the races and hurt her shoulder.

78F - ? arrest, I called it dead on scene.

996 jobs/ 131 shifts = 7.60 average.




See you at the big One.

Taz

Hello is there anyone out there?

Ha! I should talk.

I just haven't done any o/t and I completely forgot to write up my last shift so I missed a post there. I guess I'm a little flat after losing Shona, I still catch myself looking for her but that will ease with time.

Ambowife now has an urn above her workstation just like I have on my computer tower containing the ashes of our beloved pets.

I have been doing some stuff work related on the days off.
I have applied for relief station officer positions within our sector.
Attempted to finally complete some online education on 12 leads.

So that's what I've been up to

See you at the big One.

Taz

Oh it was a long shift.

We took over a day shift pt so they could knock off and we unloaded that pt nearly two hours into our shift.

82F - Fall, assist to feet a quick general assessment and she's fine to choose to stay at home.

Then we get tasked to go west for coverage, like 40-50klm away.
That's like the other side of the moon for us, get the GPS out!!!!!!

58F - Vomiting a Diarrhoea, we walk down the 'stay at home' path which is best, if there are no red flag exclusions, to manage this condition, she'd prefer this so easy job.

77F - Simple mechanical fall onto wrist and left hip. Osteoporosis Hx so transport is needed so off we go to try and find a hospital,,,,,,,,,,,,,,,,,,, we found it eventually and then we waited. All hospitals were the same, that's why we got sucked out here because they didn't have any vehicles. It's part of the job, you accept it and get on with the job or it eats you rotten.

Six hours later we're back in the city,

94M - Pulled out his SPC, round trip to the hospital where it's re-inserted and back we go to the N/h.

21F - Knee injury while in bed alone! She says she rolled over, heard a snap with instant pain? No deformity that I can see so analgesia and transport.

94F - We're called for a blocked nose - SOB. She's in heart failure, that's why she has a pacemaker but the pulse is irregular!!! ECG shows more spikes than beats. Transport and not unload until nearly two hours past knock off to a day shift crew. Thank you girls.

986 jobs/130 shifts = 7.59 average.

Not long to go now just another 14 shifts to give me an annual total of patients

See you at the big One.

Taz

Not a day of any great note.

That's not to say that it wasn't enjoyable and we did meet some very interesting people.

53M - Slipped on the wet floor of a bus (it's been raining for two day +) C/o knee pain. He is clearly in pain but I can't see any injury, everything is in place and no deformity. The very least of my job is to provide adequate analgesia and I do that well. No one is in pain in the back of my ambulance and our pt is later discovered to have ruptured a tendon.

89M - Feeling funny. From the details supplied by the wife and pt it seemed like a TIA episode. With a Hx of CVA 20yrs ago we're transporting. His pacemaker is also firing twice before there is a complex.

9M - At school, jumped up to go to the board and write his name and fainted on the way.
The school has a duty of care but mum was already there and he was ok so she just took him home with some common sense instructions.

23F - Known epileptic who is not really compliant with her meds so had a seizure. Interestingly her contractions are that strong she dislocates her shoulder. It's happened before she's good otherwise and Hospital pop it in no problem.

55F - Lac to top of head just needed some stitches.

23F - ? # ankle. As we pull into the loading dock of the department store we're called off as pt has been taken to the medical centre in the shopping centre. Never heard anything more so it can't have been broken.

23F - 4/7 Hx of fever and cough, has seen LMO and got some AB's for a throat infection, returns to work because they're very understaffed. Feels very hot and goes to toilet to spritz herself, feels dizzy and sits herself down on the floor (this pt has more common sense than most). Woke up kissing the floor tiles and the boss shaking her. She may have been there for ten minutes or more but as it was a true LOC even though it's likely cause is the underlying infection and the pt's work ethic we transported.

87F - Vomiting and dizzy. As we pulled into the street we were diverted to a nearby MVA to assist another crew with an extrication of a pt with spinal pain.

Many hands make light work, we assist with the application of the short spine extraction device, pt reassurance while rescue chop and lop the car and the actual removal of the pt.

86M - Abdo pain, RLQ but he's had his appendix removed so it GIT related.

62M - In a book store and he had a confirmed LOC. Otherwise healthy gent was very slow to accept postural changes without effect, transport again is required because of the full LOC.

980 jobs/129 shifts = a 7.60 average




See you at the big One.

Taz

We are a dogless family now.

Our second dog Shona, seen here with my Kelpie cross Hope a few years ago has lost her battle with age and kidney failure today.
A friend always happy and loving gone.

Work was a bit thin too,

33F - Popped some pills and tells her dumb B/f that she now feels funny seven hours later. Maybe it was the entire night out that's making you feel funny? They changed their minds.

33F - Severe period pain. Second episode this year. My bet endometriosis interna, she was in real bad pain.

Transfer from Air Ambulance that was taken off us as we arrived at the airport.

57M - Renal Colic.

3rd party call about a taxi driver slumped of the steering wheel of his cab in the middle of an intersection. We were there in a minute or so and found nothing.

Vita Call alarm activation after the phone plug got pulled out of the socket. The dear old pt was fine.

81M - Arm and chest pain. We followed the cardiac pathway.

969 jobs/128 shifts = 7.57 average


See you at the big One.

Taz

Their not there or their Stupid!

First job, female being assaulted with a DVD case. We attended with the Police, found nothing.

25M - Unconscious on footpath with a pill bottle beside him. Can't have been unconscious because he was gone.

91F - SOB, Lovely pt , lovely family, everyone knows where this disease is going.

30M - 'I'm sick, everything hurts' Flown from Melbourne to see his daughter. Not important enough for him to have stayed off the gear and booze though. The mother of the child really didn't want him there. Again ham strung by the stupid people.

67F - Assist lift in a hostel after a fall.

25M - Found by Police absolutely shitfaced on drugs trying to walk on the road. For the public and his own safety we had to take him.

56M - Who knows he has gastric ulcers but still decided to eat a strong curry, STUPID.

81F - Lives alone and looked like she had gastro so while it's better to let it run it's course at home if you can tolerate the oral fluids an in a hospital she needed our help to transport her.

962 jobs/127 shifts = 7.63 average.
See you at the big One.

Taz

Shouldn't have expected too much for a Sunday.

34M - Partial obstruction from ??Food. Pt suffers autism so communication was poor. Air entry was good, pt was pink and walking but as we were about to go in the side door of the vehicle he had a large projectile vomit, turned to us and said I'm better now and walked back into the house.
Problem solved???

Took over a pt from a day shift crew.

83F - SOB.

35F - Vomiting from a bit too much GHB. A regular social user of the drug and had never suffered this before. A quick shot of some antiemetic that stopped the vomits and everything else was good. Left at home with B/f.

25M - IP who actually asked the police (who were going to take him back to the cells for public intoxication) to call an ambulance for him. Claimed BiPolar but en route said it was all a rouse to get away from the police.

42F - RUQ abdo pain, recent diagnosis of gale stones, got the pain under control and transport for a better pain management plan.

81F - Regular dialysis pt, a nice easy way to wrap up the shift.

954 jobs / 126 shifts for a 7.57 average


See you at the big One.

Taz

Just interesting people.

That's the only highlight from today's jobs.

62F - Assist to feet after a hour on the floor from slipping off the edge of the bed. We are about to undertake one of the larges field studies into the aged and falls in Australia but unfortunately the questionnaire's have not arrived at station.

31F - On her way to work and got back pain with nausea and vomiting? Seemed a very normal person and was happy to help her with the pain.

26M - Neck pain. Yawned and stretched in bed and heard a crunching sound in his neck and then couldn't move it because of the pain. Everything pointed to purely muscular. No motor/sensory deficit at all. Don't know what to make of it.

Bus V Car just turning into the street and called off for,

17F with abdo pain. NO not the usual period pain but she has gale stones, like it's full of them. A genetic pre disposition to them from both sides of the family and multiple members. Cholecystectomy is her next treatment.

64M from Air Ambulance to a big hospital.

48F - In the big smoke for one of those shop till you drop tours of the factory outlets.
Ten minutes into the three hour coach trip back up the coast she has a witnessed syncope.
Lasts less than a minute, all obs good when we arrived but still pale, clammy and sluggish on responses but GSC = 15. Had partook of the same lunch as the rest of the shoppers and been keeping up the fluids so it really was unexplained and if it wasn't for the pending long bus trip I may have still let her think she could refuse my transport offer.

947 jobs/ 125 shifts = 7.57 average


See you at the big One.

Taz

A normal day.

20mth M - Febrile and vomiting, the job was transferred to our Health Advisor in the despatch room and the parents decided to just take their own car like they had the day before.

80F - Had a big bowel motion and fainted gashing her forehead. It needed more than a bandaid.

82M - Call from Home Visit Community Nurse who was rightly concerned about the pts ability to cope at home after discharge from a month in hospital. Non compliance with meds, very poor diet, raging BSL.

75F - Fractured humerus from a nursing home.

19mth M - On a outing with family when they thought he became unresponsive. We got called off for a closer car but they didn't transport.

55M - Regular IP who rings about once a week to go to hospital and we can't refuse him.

70M - Fell over drunk in a park and the public called an ambulance without asking him if he
needed one, which he didn't.

28M - Abdo pain. It took forty minutes for a car to successfully get to the payphone (us) but he hadn't stuck around for us. Maybe he had gone to the small inner city hospital four blocks away or the bulk billing medical centre across the road.

22F - Playing touch football and 'rolled' her ankle. One look at it and it failed the Ottawa exam, very deformed.

And that's 940 jobs/124 shifts or a 7.58 average.



See you at the big One.

Taz

A call from my telephone company.

We had changed our broadband limit last week and received a call today to discuss our telecommunication requirements.
We increased our download limit from 50Gb to 200.
We have a mobile phone each as well as the home land line.

Apparently whenever you change your plan the computer throws it up to be reviewed by a consultant to see if you are still eligible for any benefits you may have been getting or in our case extras we were eligible for.

The review of our bundle and phone use has shown a saving on my mobile plan, our home phone and looks to save us anything from $80 - $100.00 per month.

Hows that for a good news story about phone companies!

See you at the big One.

Taz

welcome to another follower!

G'day to Firefighter/Paramedic.

I hope you find my ramblings of some interest, I guess you do otherwise you wouldn't have signed up as a follower.
As with all readers if there is something you don't understand (most likely from the way I wrote about it) or if you would like me to go into more detail, drop me a line or make a comment.

See you at the big One.

Taz

Got to love the Friday/Saturday nights double.

Can the fun continue on the second night?

(I'm not short they just had Killer Heels on)
While enjoying a coffee on Oxford Street early into the shift I was recognised by one of these lad-ies. I had apparently provided assistance to one quite some time ago and they just wanted to say thanks and pose for a picture.

67M - Dementia pt at a nursing home who had recently been transferred there for higher restrictive care. He didn't understand this and had been doing his best to escape to return to his hostel. It's a booked transport so whilst I know that there is nothing the ED can do and really it's more a management problem for the nursing home, I can't refuse to take him.

F - ?? fainted with head lac, hoax call, two other units responded to the same address during the shift with less and less urgency. It's a Hungary Jacks restaurant so a note has been put on the system to ring if this address is ever used again.

75M - Public assistance to his feet and then bed.

80F - History of episodes of rapid AF that usually self resolve. Tonight it hasn't after three hours. Several hours later it still hadn't responded too well to meds either.

25M - Tragic job. Pt fell five meters or more to a concrete slab landing horizontal. GCS=3, visible injuries haemorrhage from nose and mouth nothing from ears, haematoma to occipital region, one pupil dilated, strong radial pulse but decreasing heart rate.
ICP arrived at same time along with ten or more Cops.
Stabilise spine, maintain airway, scope and run, active treatment en route was a 16G cannula and some metoclopramide from me, spinal care by one ICP, my partner did suction and bagging the other ICP drove, it was maybe a whole kilometre transport distance. Second pupil dilated by arrival in Resus. CT showed a huge midline shift and the family are flying out with small hope.
He'd been in the country a day, just one day and was sky larking around drunk at a backpackers.

35M - Social workers could see the pt but couldn't get into the premises due to a locked screen door. Pt may have been dead they thought. We carry crowbars in the side locker for just these jobs. Pt was dead, dead drunk. Rescue arrived as we were leaving.

20M - IP. Two inebriated older gents approached us and didn't ask if we needed help or offer to assist they just pushed into our treatment area and said 'we're Doctors'. I told them he was just drunk and again they swelled their chests and stated they were doctors. With restraint, I informed them, that was nice but as this wasn't a hospital and there were no nurses around to do their work and as we were Qualified Paramedics they could move on.
I have a very good relationship with my ED and local clinics doctors but if I was drunk outside a Goth/Emo club in Sydney identifying myself a a doctor is not something I would do, twits!

20M - Also IP.

Multiple pt at a brawl. Cops didn't find it and neither did we.

21F - IP.

76F - Vertigo, a little hypertensive. No one single whole symptom more like a collection of half symptoms. Transported.

That's 931 jobs in 123 shifts for an average of 7.57 jobs.



See you at the big One.


Taz

A day off for a course and Bam!

An introduction to Emergency Management.
No assessment, good presenter and I got paid to do it.

Come back to a night shift and what a shift, just like the ol' days.

9M - Up here for a soccer camp just with Dad. Coughed the wrong way and Dad panicked. The young fella was ok and Dad decided to self manage.

32M - Heroin OD. Easy job pt didn't want to come to hospital with us.

24M - Cut on the tip of the thumb. He asked us what we thought. Now I didn't say he should visit Bunnings (hardware store) and buy some cement and toughen the F$%k UP. But my partner might have. He stayed at home.

Called to an UNKNOWN job, got called off.

54M - SOB, speaking in full, complete, lengthy and rambling sentences. Maybe just a bit pissed and anxious. Stayed at home near his booze.

MVA - Two taxis nil injuries.

20M - IP, got called off.

30M - Assaulted cousin when they both got on the grog big time and then passed out. An ED won't do anything for a simple broken nose but GCS under 10 vomiting boy needed a trip for observation. When he woke up he didn't remember a thing!

36M - Abdo pain, got called off this one too.

38M - with Police, had been escorted out of a hotel and then appeared to start fitting. More like drug induced dystonic twitches. Cops found heaps of different gear on him and his presentation made us think that he may have been in the K hole (ketamine - a rapid-acting general anaesthetic).

26F - Had got bumped on the hear by a door. Hotel security called for an ambulance even if she didn't want us because it was nothing, which it was.

40M - Homeless dude in McDonalds with busted apart trousers, no shoes and a bad smell. Who are they gonna call. Small hospital in the middle of the city was the right place for him tonight.

50M - IP who can't walk,,,, Amazing how a good accidental wedgy can fix that. For public safety and even his own we transported to a waiting room.

24M - A member of our fine Constabulary who was sprayed by a co-worker while taking down a bad guy needed us to de-contaminate him. Don't know if the bad guy needed some too,,, don't really care from the abuse coming from the back of the cage truck.

85M - Asthmatic. You can really do some good by recognising a proper asthma attack. Three nebs and some adrenaline started to fix him up but a trip to hospital was needed too.

15 jobs in a 12 hrs shift!

920 jobs/122 shifts = 7.54 average.




See you at the big One.

Taz

14 in 12 hrs!

Of course not all were transported or even found.

72M - Currently being treated with chemotherapy for leukaemia. Febrile and weak.
80F - Fall at home assistance required - Called Off.
A person unconscious on a train, arrives in five minutes - Called Off when someone woke them up.
46M - Motor scooter rider racing a truck off the lights and cuts in front. Clips the truck and gets stuck under the front wheel until the truck stops. De-glove of the leg with no vascular injury, fractured pelvis and abdominal haemorrhage. Stabilise, package, scoop and run. He needs surgery.
40M - Anxiety and sore legs requesting transport to hospital.
81F - Transport for palliative care - Called Off.
45M - Chest pain at a sports ground - Called Off.
72M - Haematuria in his SPC.
55F - Ankle injury, positive Ottowa examination and x-rays later confirmed.
80M - Social work required, he walked into a clinic for tests he had months ago. We tracked down his LOM who said he had been showing signs of cognitive degeneration and confusion.
??M - Cancer Hx now with leg pain - Called off.
92F - Not feeling herself, not sure who she was feeling so we transported.
??M - Called from a payphone demanding transport to have a plaster cast removed from his leg. Didn't stick around for us, UTL.
85F - Long Lie, had been on the floor for nearly thirty six hours. Luckily for her it was a nice warm dry apartment with thick carpet and she had been pulling herself around to try and reach either the phone or the Vita Call pendent she wasn't wearing. Transported.

905 jobs/121 shift = 7.48 average

See you at the big One.

Taz

Now for a complete WANK!!!!!

I've just had a quick look in the ACAP Shop site for some thing else.

They have off to the side a Ten Most Popular list!

Guess who's book is number six!!!!!!!!!

Ambowife and I are pissing ourselves laughing.

On a more serious note there are no immediate plans for book signings.



See you at the big One.

Taz

A long weekend in the bigsmoke.

We have the Grand Final of two different codes of Football and numerous dance parties.
On previous occasions Ambulance services have been stretched to near breaking point.
Operational management appear to have taken note and are calling in overtime crews to be,,, floaters or area resources. Not assigned to any one station but an extra crew to help the regular rostered crews.

I got the call to be on one of these crews at my local station with a senior officer from a very far away sector who made for a very interesting and delightful shift.

19F - Going to the dance party but peaked way too early, probably a bottle of vodka consumed prior to getting to the venue and she never made it past the entry point. That's $145.00 in ticket price gone up in smoke or down the drain like vomit. Which ever you prefer.

48M - SOB, got called off halfway there for,

35M - Motor bike V Car, the details said high speed but on scene it was more like under ten km speed. The rider got clipped by a driver pulling away from the curb. Maybe a fracture in one of the small foot bones but nothing else. Transport for an X-ray.

22M - Facial injuries from the airbag deployment in another MVA. An abrasion on the inside of each forearm and he was wearing glasses so a very small lac lateral to the eyebrow. Everyone was cleared and not requesting hospital assessment.

72F - Pet cat had killed pet bird. Had been interviewing tenants for a rental property and thought she had taken her night time tablets too early. After spending some time on scene the pt decided that she was going to go to bed and have a nice sleep rather than go to the hospital. We were happy with this also.

68M - SOB with exertion. Hx of CCF, obese, actually asked for the injection that would make him strong again. What can you do? We transported for a review of his meds and re-evaluation of accommodation from hostel to maybe higher care.

74M - SOB and then chest pain. Rapid AF. Symptomatic for around three weeks and hadn't seen LMO yet. Knew his history quite well and had never been told of AF so it may have been a new symptom. Doesn't matter really he was always going to be transported.

33M - IP after celebrating the Dragons win and fell over backwards. A good lac on the occipital but the booze sealed the collar and spinal precautions.

84F - Anxiety, decreased mobility, incorrect analgesia for ?? arthritic issues, not coping at home. Hospital on a long weekend is not the place for her to be but like so many other health care service we don't have the resources to deal with her otherwise.

Knocked back another shift because I have an order for some more of my Trainee Question books for the Aust College of Ambulance Professionals bookshop.

891 jobs/120 shifts = 7.43 average

See you at the big One.

Taz

Working with someone half my age.

Who finally likes to stay out all night too!
Shame there wasn't the work to go with it.

91M - Has been a semi regular caller with catheter blockage problems but he tells us he goes out each day to the cinema, shops, malls, places of interest because he doesn't like sitting in the retirement village (not a nursing home) waiting for the Grim Reaper so for my money he can call whenever he wants.

39M - Abdo cramps and pain. Initially regular vomiting but the gun's empty now and no diarrhoea yet. Is very embarrassed about ringing us but the pain was really bad. Shame that while with us the pain had stopped so we gave no analgesia which is included in the cost of our attendance, just transport. The diarrhoea started soon after we were triaged.

27M - Outside a strip club with a shoulder injury. The gentlemen on the door didn't know anything, we couldn't find anybody so we left, UTL.

60 males brawling at Australia's most well known beach. Yeah right!
The cops cancelled us five hundred meters from scene.

70F - Did one of those 'foot on the accelerator instead of the brake' type accidents in a multi level carpark. The barriers had stopped the car which is lucky seeing as it was five levels above ground and the airbags had deployed but neither had sustained any serious injury. We were called as a second crew the passenger was complaining of chest wall pain and the driver knee pain.

37M - Sleeping outside a pub in an old hospital gown and track pants. Social services at the little hospital in the city would be just right for him and could also fix his scabies infestation.

18F - IP, friends had left her. Lovely polite young lady who appreciated our efforts and concerns. Must have been from the country!

46F - Head lac. Was in a convenience store being emotional/drunk, store owner called us and the cops. This is the story we got from her, doormen and independent witnesses.
46 mother of three went into a strip club for a QUIET drink??????
Starts chatting up some bloke and ends up throwing punches at him which brings the show girls into the story as they jump her and attempt to break up the fight (throw some jelly in there too and I'd watch,,,, naaa just joking, I'm in uniform I can't)! And that's how she got the injury.
Does she want us, no.

57M - Central Heavy Chest Pain. Too simple, even had a significant family history.

And I'm stuffed. The two extra day shifts straight back from holidays that's what did it.
I slept well into the evening and missed a farewell drink with a colleague.
But that's the way it can go.

882 jobs/119 shifts = 7.41 average

See you at the big One.

Taz

Oops, slipped back into boring.

60M - Pedestrian hit by car, there was another crew on scene, ours was a duplicate call for their job.

87F - COPD, Sp02's of 88% after six of her NEBs. She needs a hospital but not for much longer.

22 mth M - Swollen sub-mandibular region, febrile. Transferred to a bigger paediatric hospital.

54M - Went to bed pissed, got up to go to the toilet still pissed and fell forward and scratched his nose. We discussed options and he stayed at home.

53F - Several vomits and three Losses of Consciousness after taking only two prescribed antibiotics. I wasn't worried about the vomits more the LoC.

And something like five hours on station, boring.

873 jobs/118 shifts = 7.40 average.

See you at the big One.

Taz

We had a ride-a-long today from our own administration.
A non clinical person who will be coordinating our 'Health and Wellness' program.
The day started slow but picked up later.

76M -Regular dialysis pt transport.

107F - yes that was one hundred and seven years, who has not been feeling top notch at home where she still lives alone god bless her.

59F - Due in hospital tomorrow to have some fluid drained from the pericardial sac. They're not sure what has caused this but she woke with chest pain and palpitations so we can go to the hospital early.

20F - IP still in the hotel but got called off.

57F - OD with intent on suicide, good quality and quantity of drugs but got found after being reported missing by concerned family. It's not the first attempt but location was only made after checking credit card activity.

79M - Misplaced his foot going down some stairs and tripped. I still can't imagine how he actually did it but he had a skin tear or lac across the top of his foot that extended down into the tissue.

49F - OD, IV unknown, extreme rigid dystonic posturing, no verbal communications, primeval screaming, NOT VIOLENT but very unmanageable. Requested back up for sedation, they took too long because we had got the pt into our mechanical restraints and in the bus before they had arrived. Trip to hospital was all of two minutes and we got everyone's attention when we arrived.

I need to do some research but I think it was Methamphetamines.

88M - Increased creatine and urea transport required.

So our observer got a good show and we suggested that further observation ride-a-longs should really be for the whole four shift block from Health and Wellness to really understand the physical and psychological stresses we're exposed to.

868 jobs/117 shifts = 7.42 Average

See you at the big One.

Taz

My legs are sore.

Two long days of extra duties has taken a toll on my legs now after my first full day back on deck.

91M - Sciatic Pain.

31M - Post ictal with increased frequency and length of seizures. Needed some Midaz and even then some mechanical restraints.

27F - Period Pain.

74F - From rehab to air ambulance to be flown home.

46F - From a sheltered workshop type facility. Sore shoulder. Supervisor told us this was a chronic condition but their duty of care required us to attend if any of the staff/pts complained of pain or injury.

94F - Fell forward off her chair and cut open her forehead and it needed some stitches.

Hoax Call to a men's club.

84F - Rapid AF 130 - 150 bpm.

An hour and a half late so that's three late finishes.

86 jobs/116 shifts = 7.41 average.



See you at the big One.

Taz

I return to operational work.

An easy day

74M - Night shift pt, we took over to let them go home.
90F - Queasy & lethargic
89F - SOB, ? a cardiac arrhythmia.
90F - Fractured a NOF fifteen days ago and nursing home staff noticed it shortened and rotated again?
53M - Varicose vein haemorrhage, no big problem pressure and elevation but his BP kept dropping when standing, even after forty odd minutes.
99F - Discharge to nursing home
82F - Near faint.

852 jobs/115 shifts = 7.41 average


See you at the big One.

Taz

I'm back, holidays have finished!!!!!!!!!!

As I get older holidays do become more important and essential for me. It was a whole week before I found an excuse to go into work this time!

I don't officially return per the roster for another few days so I put my hand up for some overtime and scored it for both days but only one will be an on-road operational shift.

The other will be as an ART (Ambulance Relief Team). We sign on at a designated Ambulance Station, our vehicle is a hard covered Ute that can hold anything from three to six empty stretchers and when crews delayed at a hospital reach a trigger time we deploy to that hospital and if the pt is not monitored we shift them onto our stretchers and the crew is relieved.

The hospital are billed by Ambulance for the ART and we have nothing but the stretcher, that's why the pt can't be monitored but active other treatments such as analgesia and fluids can be performed on the stretcher by the nursing staff.

It's boring as bat shit!
Hard on the legs!
If you get the wrong pt it can really do your head in!

But your paid really well so,,,,,,,


See you at the big One.

Taz

Mental Health Education

Well I'm in the last week of my holiday and ACAP had their monthly presentation in the Continuing Paramedic Education program this evening.

Mental Health.

Tonight we had two brave presentors from the Schizophrenia Fellowship NSW who gave of their time to inform and educate us of their side of mental health.

First a person with Treatment Resistant Schizophrenia and then after an insightful Q & A the mother/carer of another person with schizophrenia.

I believe I treat my mental health pts with respect and dignity but from the presentation tonight I still have things to learn.



See you at the big One.

Taz

I'm holding it together, so far!

Second week of holidays.
I've been to work once, to finish off that periods time sheet.
I've met up with some officers to farewell an ol' Padawan who is moving north.
Ambowife and I have been away for a trip.
We've seen a bank about how much they'll give to buy a home here (not enough and the repayments are horrid).
Oh and I made some new ribbons

Yeah, well I ran dry on ideas.
Any suggestions will be considered.
Remember these are the transfers on the end of 25mm x 900 long white satin ribbons that I always wear at the top of my ponytail.
Here's a photo of an early model,

So it is visible to the general public and management.

See you at the big One.

Taz

A fallen hero.

It is with much sadness that NSW Police have to deal with the loss of another of their ranks.

It's all over the news here so I'm not going into it.



Peace to his family and all my friends in the force.


See you at the big One.Taz