So this would be my fourth day shift.

My rostered partner for this shift was off so I had the pleasure of working with one of our senior level two officers who will start his last required attendance at our education centre this Monday to complete his training to be a Qualified Officer.

25F - To a Medical Appointment. Poor dear had busted her ankle two weeks ago and was going in for a review but she lives on the sixth floor of an apartment building with no elevator!
Our reason for attendance?
To stand beside/in front/behind or near as she hopped, foot swivelled and bum walked her way door the stairs.

22M - Epigastric Pain. Had celebrated a wedding and then another day of drinking with the families that finished yesterday and his guts were crook. Yes I did a primary and secondary survey, full Obs, history and discovered him to be possibly suffering Softcockitis.
He was at the Casino at nine o'clock in the morning for crying out loud.

94M - Questioning a TIA, has a history of same.

92M - Been taking the opiate pain meds but not so the Stool softeners, Constipated.

28F - with a bleeding (haemorrhage) pimple on her tongue! Did not transport.

41M - Postictal, by the time we arrived at triage the story appeared to be a history of fatigue caused seizures from early adulthood. He now has a four month old and is not getting much sleep.

37M - Pizza delivery man skittled by an non observant motorist. Abrasions only.

Not our last job but moved here because it was interesting.

29M - Odd behaviour. Gf states his behaviour has been changing all day, distant, non attentive, distracted, incoherent speech at times, vague, restlessness they had arrived by taxi at his fathers address but would not go inside was just wandering up and down the road.

Sometimes in a crab like stance others just a normal forward facing one but behaving for want of a better word Zombie like.

He was not combative but was resistive of attempts to get him in or even near the ambulance.

I'm happy with the Gf's story of no drugs when with her but before he arrived at her place last night he had been at the pub with some mates and had stated to her he had hit his head, severity, location all unknown.

Fruity smell on his breath, check BGL while he still wanders up the road, normal, it wasn't going to be that easy. There's heaps wrong with this picture, I'm not happy with what I see and really want this guy at hospital so we call for a cold response from the local constabulary and get out our padded restraints.

Without incident we get our restraints on and him on the stretcher loaded before they even arrive and off we go. HR regular, BP good, RR good, No Obvious trauma or injury,PEARL but then in the controlled environment of the rear cabin rolling up of eyes and left deviation.
Resus Bed,
CT looking for a bleed,
Medical history - Bi-Polar, nil allergies only meds Sodium Valproate.

Check up the next day, diagnosis Hyperammonaemic Encephalopathy after Valproate therapy.
Yea, that's what I thought it was too(bullshit), this might help.

Probably never going to see that again but if I do I'll never forget the presentation it was just so wrong to the normal, junked out, psycho job we normally get.



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

Taz