Trip to Lithgow.

A mining town on the western side of the Blue Mountains about 156klm from Sydney.

I did one of my traffic offender presentations whilst there.

Opening line 'My name's Taz and I come from the largest country town in Australia'
'It's called Tasmania!'

Well I thought it was funny anyway.

They have problems getting members of the Emergency Services to attend the presentations so Tracy and I made an overnight stay of it, taking in a few of the local historic sites as well as a trip on the Zig Zag Railway I don't have any photo's yet as Tracy is still sorting them.

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

Taz

Pretty cool scene.

My partner and I waiting to see one of our patients the other day.


The patient is on the Tall Ship behind us HM Endeavour




How cool is our office?


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

Taz

Another quiet night.

20F - Severe abdo pain, has been investigated without success but they are thinking that it may be endometriosis.
52M & 41F both at the theatre and both had syncopies after the end of the show when they stood up to leave.
29M - Regular called looking for company, knocked on the Fire House door and convinced them he was sick. We just took him to the waiting room for a coffee and a sandwich. He then left.
53F - From out of area, pissed on the streets at four o'clock in the morning stating chest pain. More like panic.

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

Taz

A night shift teamed up with an ICP

Intensive Care Paramedic, the next level up from me.
Extra drugs and extra skills.

Not that they were needed for most of the night,

34F - barred from her hostel because she was intoxicated and needed somewhere to stay, call an ambulance.
39M - Developmentally Delayed, scared of trains and travel so went to the train station???
31M - IV drug user with a infected injection site.
69M - Regular caller SOB. Had been discharged that morning but felt poorly that night.
37M - two days out of prison and straight back on the street heroin that is stronger than what makes it's way into the prison system.
Unknown age and sex - UTL.
74M - Regular caller ejected from the hospital waiting room wanting a taxi ride home, call an ambulance.
44F - Cardiac arrest? not breathing on arrival, tachycardic with a carotid pulse only and fixed pupils. CPR, secured an ET tube airway, some drugs IV got some BP urgent transport.
We found out later that it was a huge sub arachnoid haemorrhage, grade 5 (there is no grade 6). Time will tell the outcome of the success of the surgery and what brain damage has been done.

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

Taz

The next day, Australia Day, a public holiday.

38M - Alcoholic requesting help to break the cycle, I have never seen that many wine cask bladders in one room before 30 to 40 easy.
52F - Feeling unwell. Staff at the hostel called not the patient. I haven't seen this patient for for over a year and that's because she has kicked the booze and making a new life for herself. Good on her.
84F - Hospital to Hospital transfer.
78F - Dialysis patient.
21F - Respiratory distress, hyperventilation to all the rest of us.
83M - Dialysis patient back to home.
82F - Hypovolaemia, LMO seems to have increased her anti-hypertensives.
18F - Suicide attempt, unsuccessful.

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

Taz

Day shifts not that busy.

A strong showing of males in the work today.

??M - Head wound, not there when we arrived.
78M - SOB, another COPD patient who likes to go to hospital rather than comply with their treatment plan.
47M - Regular caller, disabled person who needs a lift every now and then.
65M - Chest pain.
And from the girls,
84F - Acopic with out her husband who is now in a nursing home.
40M - Domestic incident, head lac.
32M - Peddle cyclist clipped by a car who stopped checked he was not dead and buggered off, ? fractured collar bone.

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

Taz

Two O/t shifts.

Both at my home station.

First one,

We're the walking stick/ Zimmer frame ambulance. That's the way it goes, I do realise that not every shift will be an adrenaline blast.
Not to say that we didn't meet two wonderful patients.
94M - Had a fall three days ago and having difficulty walking now. A comedian through and through. When the nursing staff approach you hours later and tell you how funny the patient is and a pleasure to nurse!
101F - still live at home alone, bright as a button and quick as a whip with funny, insightful comments.

Second shift,

69M - SOB, a regular caller who does get sick and you can't dismiss him too quick.
89F - Sore knees, found by N/H staff squatting on the floor that morning.
44F - OD, by the pills in the purse a Benzo OD but there was a syringe and heroin also.
13 persons trapped in a lift, they were released by the time we arrived.
91F - Chest pain.
66M - IP, banned from a local men's hostel so he wanted an ambulance, straight to the waiting room.
60F - Heat near syncope, wanted to be checked by a Dr even though she was fine when we arrived, transported but didn't wait to see the Dr.
50M - assaulted three hours ago, now at the cop shop, didn't wait for us.
65M - Chronic SOB, refuses to comply with treatment plan, waiting room and left straight away.
56M - Groin pain and it wasn't the crabs or any other STD.

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

Taz

Way too much time on station.

This is illustrated by the fact that a complete car check was done.
The vehicle was washed and dried with careful attention given to the wheel rims.
It was polished.
And between that this happened.

23F - Sporting knee injury.
37M - Homeless, rang from the cop shop, c/o bronchitis.
??M - IP who moved on after we woke him up.
52M - IP homeless, refuses assistance.
37F - Chest pain, woken from sleep, cardiac artery aneurysm history. Stable with us.
80F - Regular Dialysis pt.

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

Taz

I'm not getting much work!

The nights are terribly long sitting on station.

34F - Left lower quad abdo pain, episodes for nearly two years with inconclusive investigation.
27F - PR bleed, syncope.
50M - Frequent flyer psych pt.
18M - Hospital to hospital transfer.
13M - Disabled pt, multiple conditions, febrile.

To finish the night at 0700

76F - The man next door is using 'Black Magic' to make her feel unwell and he comes in while she's asleep and disturbs her belongings. Can we help her to move to another Housing Commission apartment!
It could become a very long post but lets say I stuck to the line of offering transport to see a social worker at the hospital and she refused.

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

Taz

It's no better today either.

41M - Regular psych pt. Requesting a bed, a feed, help to die, to be left alone, to listen to him,,,,,, We took him in, he ran away in the parking bay, around the corner to make another triple zero (our emergency number) call and then to walk into the public entrance to abuse the triage nurse.

71M - Cardiac history, episode of chest heaviness at 0430 and 0730 hrs that were resolved with own meds. Pain free with me and stable but it needed to be checked out.

30F - Blue Bottle stings (a jellyfish) analgesia and treatment with tolerable hot water.

51F - Riding a motor scooter and got clipped by a taxi, low speed with a hand injury.

See!
Bugger all.

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

Taz

Days on weekends should be busy?

Mine don't seem to be!

Nice start easy trip with a pt for dialysis.

86F - Been waiting four days for a hospital bed in her smaller home town post cardiac bypass surgery. We get her to the airport, an emergency has popped up down south and they will fly there first so she will be on the plane for five hours!
They decide this is too long and tell us to take her back to the hospital!!!!
It's a bloody hospital not a Motel.
The hospital staff did us a big favour.

34M - Non compliant psych pt requesting medication.

90M - Unwell for three days, hasn't left his room at all today and now requesting an ambulance.
Good call, Forty beats per minute and by our defib monitor only every second one was effective!
Now I want backup.
Now I have something I can't fix with my drug range and need a higher skill level. I know this because I am a competent Qualified Officer trained to more than basic life support.
(sorry localised rant)

50F - Non compliant with meds, psych pt.

77M - Nursing home staff said he had haematemesis ????



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

Taz

O/t at the best known beach in Australia!

Gray and overcast with near constant rain.

Four jobs all up for the day.

89M - Gout he says, cellulitis I think. With no family support he is having difficulty with normal daily activities like getting food and toilet so I think he better come with me.

Assist load for another crew.

94F - who has been out with her carer all after noon and didn't think she would be able to climb the forty or so steps to her apartment. Probably true but not what you call an Emergency Ambulance for so we arranged some help for her.

78F - Dementia, scheduled for a procedure today but refused to have it so the hospital were sending her back to the nursing home.

And that was it.

I helped with some station duties and watched Cable and drank coffee for the rest of the day.

Drove me crazy!

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

Taz

The end of a job I did last May. See entry for the 14th May 2009.

The article and photos really say it all.
These make it worth the shitty jobs.

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

Taz

Second Night.

Slow start, two hours on station before the first job but it was worth it.

49M - Open head injury post ?fall on the deck of a boat. On arrival pt sitting with friend on a fence having a cigarette, it's dark so we ask him to butt out and step inside the light. Denied LOC, Neck pain, arterial spray that we didn't see until he got in the back of the vehicle and it just went everywhere, on the roof, all over the dicky seat bulkhead behind the driver's seat, down into the O2 bottle storage compartment, on/in and under the dicky seat itself, even five feet away on the treatment seat.

Now most of us use the Mercedes Benz Sprinter as a base for our ambulance's and there really isn't that much change that can be made to the layout.
For those of you from overseas this is a photo from the back door looking in, the seat on the right is the dicky seat and the treatment seat is the one on the left.

Pressure dressing, spinal precautions because of intoxication, upper body elevation, cannulation, Maxalon and fluids with a 'Bat call' to alert the receiving hospital and we're off.

41M - Homeless, had a fall nil injuries. Transport for social support.
25M - IP outside home address, woken up and went inside.
17M - IP, driving, destroyed the front end of his cousins Audi coupe in a collision.
44M - Homeless, c/o a rash all over his body, Uck. Transport for social support.
40F - Abdo pain, ? Drug seeking.

It took me and another officer forty minutes to de-contaminate the back of the vehicle after the first job, so an eventful night all in all.


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

Taz

New roster, shifted days.

Or in my case, nights.
All I did was two nights and then I'm off again.

First night.

Standby for five hours at a local festival - BORING.
Then in the remaining seven hours,
30M - small lac under left eye post assault- pt declined transport.
??M - Head injury, UTL.
29F - IP, had some sober friends who, bless them, were happy to take her home and care for her.
64M - Psych transport to the new purpose built Psych Hospital in the grounds of the real hospital that is used for external shots of Soap Opera hospital All Saints.
57M - Unable to sleep, to be fair he was a little DD. Has sleeping tablets but didn't know if he should take them this time when he couldn't sleep?? We suggested that it may have been a good thing to try before calling an ambulance. Declined transport, took his pills and fell asleep.
27M - IP had a fall but not injuried just a little unco'.
24F - IP, still not sure what we were called for, pt declined transport.
21F - IP, felt funny after a night on the tiles and thought her drink's may have been spiked, obs ok, transport offered but declined.
Duplicate call to a domestic violence, cancelled on scene.
19M - IP, floppy, drama queen, removed from the streets for everyone else's comfort.

So after the dreadful start it turned out Ok.

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

Taz

Thank you for some overtime.

A night shift up the road near Redfern, so what?
I've had no pre-sleep and I've been for a fifty kilometre or thirty mile bike ride only a few hours, ago, I'll take it.

My partner doesn't show, so they send me a level two from the station near our house, luckily she spent some time at my station as a Padawan and knows that I strange but basically harmless!

Four jobs, Four jobs, Count them FOUR JOBS!!!!!
Yep, the poor little darlin's are still cash strapped and recovering from Christmas, NYE and the general festive celebrations.

32M - claimed a dislocated shoulder, it may have been before we arrived.

20M - Nice guy attacked by an unsavoury character with a glass. Penetrating wound of the ear lobe. After cleaning it up you could see it went right through. Nothing in the ear canal luckily and the scar will be hidden by the natural folds of the ear.

37F - Gravida 4 , Parity 3, six days over due, must be time to get the forceps, rope and dynamite to get the little bugger out!

79M - Air Ambulance transfer to hospital of sedated/ventilated patient from the country.

Interestingly the Royal Flying Doctors Service (RFDS) who bring in some of the our patients, because we have our own Aero Medical Wing, that the planes, pilots and engineers are supplied by contract to us from RFDS and we put a different sticker on the wings!

ANYWAY, this plane had a new unloading arm, better than what they did have but I don't think it's quite as good as what is installed on our planes

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

Taz

Lucky me.

As is well documented in this blog I ride a bicycle to and from work as well as for most of my local travel.

I've been experiencing what felt like punctures in my rear wheel, a wobbly sensation, but it has been fully inflated.

During the week I did an inspection and found the gear assembly on the rear wheel had about two mm movement.

Being told by other riders that it was my 'gear cassette' and may only need tightening I continued to ride for the remainder of my shifts.

Yesterday I dropped it off at my bike shop, Renegade Cycles in Lane Cove and collected it today after my normal visit to the blood bank for plasma/platelets.

When they pulled the rear wheel off to inspect the cassette for any damage the rear axle fell out,,,,, in two pieces!

The rear hub, cassette and frame had been keeping in somehow but just think how lucky I have been. I can reach 40kph or more on my way home and what would have happened at that speed.

Lucky I guess. Well it's fixed now and I can't wait to go for a ride.

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

Taz

Last night.

The Sydney Cricket ground is at the bottom of our street and parking has been a problem this week with so much extra traffic.
Some of day shift have been parking on station as well making it really congested.
But I ride the bicycle so it's no problem to me other than the large number of mindless pedestrians just walking where ever they feel like without being aware of their surroundings.

36M - Lost count of his drinks at the cricket and needed to be rescued from himself.

61F - Lost count of her drinks at home alone but then the partner turned up, he was sober and embarrassed but was happy to care for pt at home.

69M - Victim of a robbery, no injuries but talked to and discussed PTSD and stuff. Left in own care.

83F - Hostel resident who slipped in the communal kitchen, very swollen knee.

Vehicle movement - bringing my ambulance back to our station after it was sent away for use on NYE.

80F - Two hours of tachycardia 140bpm, reverted as she moved from the stretcher to the resus bed.

And finished the night with a simple dialysis pt transport.

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

Taz

First night shift.

Legs were very sore after the two days.

25M - transferred to a better hospital for surgery.

47F - Drug effected and distressed that her friend with benefits wasn't interested that night.

20F - Breathing problem, ? bronchitis.

20M - Sore hip after crossing in front of a taxi, only transported for insurance coverage.

73F - Sore shoulder and wanted to talk to someone.

61M - Homeless man with a head lac who was in really bad need of some social services.

31 M - Paranoid delusions.

48M - Vomiting and Diarrhoea, very large VEBs at least every fourth beat, with occasional consecutive beats. Wonderful what you find on a complete primary survey.

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

Taz

Second day back.

25M - with twinges in the right pectoral muscle. Family were concerned that it was his heart???
So we transported as they requested and were followed by several car loads of relatives.

17M - King hit to face, just wanted to go home and it was the weakest punch I've seen.

43M - Acquired Brain Injury with Muscular dystrophy had fallen and just required a lift up.

94F - Had a fall with out obvious injury but started to crash on us twenty minutes later as we're doing some paperwork after a seemingly negative primary survey.
Call to see if there were any ICP between us and Hospital - no.
Load and go.
Asystole as we walked past triage but got her back long enough for the small family to gather.

24F - Drug effected - a danger to self, transported to sleep it off.

38F - Drug effected - GCS 7 (1.1.5), Booze & ?GHB and maybe some opiate.

43F - Migraine, pt described a migraine, has a history of migraines, the pain was too much and she didn't have any analgesia at home, not an uncommon job.
So I'm at a loss to explain why the temporary Padawan I have for two weeks decided to sell it like a cerebral haemorrhage at the little hospital near the domain.
Transported to the bigger one near the Coke sign and it was ,,,,, a migraine.

25F - Blow nearly $200 on a music festival ticket when her appendix decided it didn't like the music or something.

The night shift said that NYE was really very well behaved and probably less busy than a normal Saturday night.

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

Taz

Poor match fitness.

Tired and sore when I get home but like an athlete it will return.

Now to the work.

88F - Simple, slow, low fall to the floor, two minor skin tears dressed with some new dressings thanks to the CARE program. Left at home with daughter.
85M - Went to see the Dr but collapsed in the waiting room, abdo pain.
68M - Discharge to a N/H.
17F - 30/40 gestation, vomiting, sounds like some bad chicken the night before is the culprit.
60M - Cholycystitis - flying in from overseas (Asia) so customs were interested in if he was being a drug mule. He wasn't.
84F - Unable to walk, bad legs, needs some respite.
28M - Fall on the Kidney area on some steps, lots of pain.

And that was it

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

Taz