Similar again today.

92F - transport from N/H to Out Pts for removal of a wrist cast.

48M - Fell from a ladder at work, head lac and some neck tightness. Full precautions taken and pt very stable. Later totally cleared.

27M - Sprained ankle, did it at work so had to be transported for their sake.

75F - Many chronic conditions, today sore knees and SOB.

60M - Defib/Pacemaker adjustments have left this pt feeling crap. Almost looked pre-arrest but returned to near normal with posture and oxygen.

76F - Grumpy Nana that N/H wanted to get rid of for a day or so I reckon.

M - Fallen inside a train carriage. They tried to hold the train for us to arrive but it's peak hour on a Friday night so it departed to the next station. Some sort of leg injury, nothing about it being broken or anything.

Assist Load for another crew.

66M - Hx Schizophrenia called because he was hungry, had no money and would OD unless we took him to the hospital.

Never even saw station.


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

You've been busy but seem to have done nothing.

A bit like the days shifts.

5M - Lac to little finger.

71M - SOB, a very chronic condition.

80F - Simple mechanical fall with some minor facial injuries.

84F - Short, sharp pain behind her nipple.

68F - Hypo but her daughter had fixed it by the time we arrived.

54F - Life long Hx of SVT today it went for an hour without resolve from the usual methods, driving to the hospital it did!

83M - Simple mechanical fall with a shoulder injury, might just be a dislocation.

73M - Hosp to Hosp transfer.

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

Things that have happened on my days off.

The most important would be the celebration of my sixth wedding anniversary to Ambowife.
It was unfortunate that this was on my first day off and as you have read the post of the night before I needed sleep.

Congratulations and deep appreciation to all the returned service men and likewise to all the military personnel who have served during peace time in the Australian Defence Force.

Mowed the lawns, trimmed the edges and went on a drive with Ambowife while she photographed various odd things for later extraction with her digital magic for scrapbooking.



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

This was a better night.

Nine crews down in the sector that's what helped.

21M - C/o prolonged tachycardia. Denies all the usual causes but was asymptomatic at all time with us. Had a little bit of medical knowledge and I believe this was more dangerous than beneficial.
Three hour wait at A&E and a prescription of 'Toughen the Fu*k Up' will fix him.

67F - Cafe Syncope at a Restaurant. Crowed, Stuffy, Very Spicy food. Went home with a friend.

54F - Soft tissue forearm pain (caught a falling grandchild). Vascular and structural integrity intact, ice and elevation helping but somewhere we lose sight of the ball and end up taking the pt to hospital to get an X-ray. I swear I had the pre-packaged analgesia out ready to leave with her.

45M - Facial injuries, nothing major, had already been kicked out of our local A&E.

95F - Supraglotitis, transfer to a bigger hospital HDU.

50F - Picking up rubbish in a foyer of a Housing Department tower block and got a needle stick injury? She was drunk and that is why she undertook such a poorly calculated risk. Abusing us for her injury, abusing everyone in fact. Transport for blood tests.

25M - Found by Police who were just about to take him home when he vomited. That means we have to check him out and clear????? him before they return to their original plan. Some of the more senior Cops will just wipe them off and if it's just that single vomit from being pissed they don't call.

30F - IP, self harmed and then had a fall. Full spinal precautions due to the booze and transport for physical and mental assessment.

39M - Domestic Incident.
30F - Domestic Incident.

25M - Loser of the night, started a fight in a Burger joint and lost the fight. All witnesses state he was the aggressor.

76M - Regular dialysis pt.

26F - Alleged assault but it seemed to be more of a turf dispute about sleeping spots between street folk.

Nothing too stressful but a nice busy night.


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

Taz

Long weekend, will it by busy?

Well not on my first night anyway.

55F - Poor thing had a Sub Arachnoid haemorrhage overseas nearly two months ago. Medical retrieval via International flight and we collected, transported around the corner to a private domestic flight to get her and Hubby home for more rehab.

91F - Has the flu (for about a week), not felling chipper and family are waiting to have an Aged Care Assessment Team (ACAT) visit for some additional services or maybe some respite time but getting the ambulance to come and to try and get us to drag her off to an ED at 10pm is not cool.
She did not need a hospital ED and she didn't want to go, so we didn't.

21M - Trying to do a trick on a mates bmx bike, took a cropper, busted a tooth in half. Exposed some of the dentine and needs to see a dentist. After a primary exam without other injury concerns gave some simple analgesia now and some pre-packaged to take home.

34M - IP demanding IV fluids, couldn't just drink water because that takes to long!

18M - Looks like there's a crap batch of GHB out, GCS = 7. Other crews had similar pts also just from the one place.

9/12M - may have put something in his mouth or may have just has a mucus blob rumbling in his throat I can't tell and parents want to know, off we go.



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

One for the ASNSW readers.

Hello troops,

I've been talking to Nicole from Media about a Social Event they are planning for later in the year.

The last time there was an Ambulance Ball was approximately eighteen months ago during a difficult time for all staff with the Bullying & Harassment Commission not to mention the IRC negotiations or as some referred to it our bending over the barrel and shafting.

So Media is trying to organise something for September but different from the old 'Balls'.

Now I know they have a really fun Band booked called the Frocks.
I'm sure the ASNSW Band will also be there for incidental and dinner music.

But they would like to know what we would like to be going to, ie a Ball or Cocktail Party?
It has to be something a bit posh and special, it's not a pub crawl, so
What Ideas do you have??
Come on now is the time to speak out.

Better still drop me an email via the work network and I'll pass on all ideas.

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

Taz

Nearly her last drink.

37F - ???ETOH abuse found in a park, dew covered, found one empty spirits bottle and one empty pill bottle. BPs about 100, Pulse about 56, Temp 34.4 C or 93.9 F.

61M - Knee pain but can't decide which knee!

31F - Vomiting.

?35M - IP, had a siple fall against a wall a few scratches on the face, with Police.

?20M - ??Drunk, ??Drug effected or maybe he's just a prick. Told us where to go but we just left.

82F - Simple mechanical fall, very minor abrasion to the forehead. Decided he didn't want to go to hospital and we couldn't agree more.

54F - Scheduled by the Mental Health Team, straight to the Psych Ward. Bi-Polar/Schizoid, off her meds and totally of the rails. Not violent just ,,,,,Mad!

29M - Bi-Polar/Schizoid off his meds too.

86M - Tripped crossing the road. He kissed the roadway but no injury and refused point blank to any obs being taken. I hailed a taxi for him and off he went.

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

Taz

Back to regular shift.

75M - Had a fall around 4.00am and now had too much pain to walk.

66F - A very irate lady DEMANDING I drive her to her medical appointment. It was called in as a Triple 0 call.

86F - Nice lady with chronic sore knee.

73F - SOB, almost TIA like verbal garbage but more of a delirium really. All disappeared with O2 and stimulation then she started to have an Angina attack?????? single GTN resolved it with nil return.

20M - Opiate OD, of course he denied it but the Naloxone never lies!!! Refused transport.

81F - Discharge from the eye hospital to home.

91F - Simple slip off her chair, nil injuries good physical control and walking ability just misjudged that chair. No need to go to hospital and left at home.

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

Taz

Fearful all night.

When was the sh*t going to hit the fan and we get our normal drunken abusive pt's?

72F - Found outside a local nursing home, they thought she had suffered a fall. After going through her possessions and knocking on an address she thought she lived at I discovered she was a happy dementia pt for a nursing home miles away and that she had been reported missing and Police were looking for her. We left her with the social worker at the hospital until police could collect her.
One pleasant pt.

56M - Pancreatitis, truthful alcoholic, just needing some pain management.
Second pleasant pt.

24F - Discharge to a private clinic from ED post a less than ten second syncope.
Third pleasant pt.

59M - Diarrhoea, has eaten two containers of prunes???? no bloody wonder! After my primary examination I wanted to take him to hospital for hypotension that had not resolved, tachycardia and tachyponea and variations on the 12 lead ECG. He totally refused, he understood my concerns and what the possible worst outcome may be of not getting checked by a Dr tonight (death) but still refused in a very nice way.
Fourth pleasant pt.

18M - ???Thought??? he might have been bitten by a spider. No swelling, no bite site, no nothing. 'Go home Dude'.
He was pleasant, not bright but pleasant, number Six.

30M - Happy Scottish gent who had tripped and cut his head. Needed stitches and he was our Seventh pleasant pt.

33F - Bi-Polar, Attention Deficit Syndrome, Schizoid, Personality Disorder, Rat Cunning! Absconded from a hospital during treatment for an intentional overdose, found one hundred km away at a rail station threatening to jump????? Police wanted us to search and transport as our male officers can with our Mental Health powers. She was testing the boundaries during the transport but was pleasant enough.
Number Eight.

20something M - passed out, unable to locate. Very pleasant number Nine.

50something M - assaulted, unable to locate. Very pleasant number Ten.

22M - Mandible fracture after being king hit. Sounds like it was an innocent attack and I spoke to him hours later it was an unusual fracture mostly involving the teeth and near bone on the right side of the mandible. A very pleasant dude too, number Eleven.

22M - Push bike onto car. Yes onto the car. cars travelling along road, he's being a 'risk taking' male doing tricks on the footpath and mucks one up falls off bike onto the windscreen of the passing car.
Pleasant not bright. Number Twelve.

30F - Domestic assault. Really just a transport for the Cops.

And all this was accomplished on overtime!!

How's that?

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

Taz

Grabbed an O/t at home.

81M - SOB, discharged from hospital and placed in some very nice respite care but it looks like the heart just can't keep with the oxygen demand.

28M - ?Gastro, had V & D for five days.

24F - Pick of the work, second degree burns to the whole anterior thigh and medial aspect also from a hot cup of tea directly onto bare skin. The skin over a third of the wound had pulled away and rolled up at the bottom of the site. Cannulated standing in the shower for IV access for the analgesia, cling wrap seemed to make the pain worse so I used the Burnaid Gelpak and a bag of fluids with an atomiser.

Backup the motorcycle Paramedic but he cancelled us on the way.

26F - Depression, thing have just built up and the pills seemed the way out. While what she took was not really harmful the intent was.

77M - from Air Ambulance to a hospital, STEMI.

83F - Unwell with a long list is the easiest description.

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

Taz

No serious drugs needed on this shift.

90F - Unwell, Vomiting and Diarrhoea???

26M - Altered LOC post ?syncope face plant in the pub. Pt was concealing information also.

36F - Three witnessed syncope episodes, obstetrics issues leading to hypovolaemia. 500mls of fluids bolus on scene before transporting.

?25M - IP.

22F - Panic attack, then refused to come out of the apartment block and on ring back cancelled.

18M - Bony prominence abrasions post assault.

?34M - Hearing voices, when we arrived a delivery driver told us that a man wearing no pants was on the payphone before we arrived but had walked off.
Guess that's our pt but we couldn't find him.

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

Taz

Quiet and cool nights.

We have now received a new Defib at station to replace our old but serviable Zoll M Series. We now use Lifpak 15's, training has been underway for nearly a year when Qualified Officers returned for re-certification but some revision was required as well as training for those who have had none.
This completed I've been bunging the full set of leads on and taking Diagnostic 12 Leads at every opportunity for three days.

Our first sick person however was fated not to benefit from it, progressive EMD or PEA that was totally unresponsive to pharmacology. I was a bit down after this, the pt was conscious with our arrival and remained so for five to ten minutes while backup arrived to assist extricate but mine was the last face and voice he saw and heard. With general arrests the pt is usually GCS 3, pulseless, cyanosed and rarely warm.

6M - Cerebral Palsy, Absence seizure, perfectly described by the parents but stable with me.

34M - Mis-behaving in the Police cells, sustained a self inflicted hand injury, got verbal with me, non life threatening injury, he can wait until the Police have finished with him. Lesson 1, don't use bad words with me, directed at me it will not help your cause.

51M - suffers Sleep Apnoea, forgot to go to sleep with the mouth guard devise, stopped breathing, woke wife with an Hypoxic Seizure, they've seen it all before knew to ring us for 100% O2 and were really cool and calm. Stayed at home once we got a good GCS and competence and capacity from him.

Several hours down and an early dialysis pt who when we arrived was in hospital already for other treatment.
On the way back to station diverted to

44F - Anxiety requesting transport to hospital.

Knocked off an hour and a half late.


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

Taz

Answer to a Question.

Squeezey said...

Taz, you mentioned you had a patient with a mental health history. Have you developed any strategies to best communicate with these patients during an acute episode. We have just begun to learn about patients with a mental health issue that present for other medical problems, and how to best relate to them, so I would be interested to hear your thoughts.

This Ambulance Student doesn't mind asking the simple questions does she?

When I was attempting the Degree by distance ed from a Uni in the town with a famous motor racing circuit I failed the Mental Health Module, let me get that out of the way first.

Some time later I had a full time student with me from that institution as a ride-a-long.
We attended a pt with an extreme violence history against Police, who was armed with at least one knife, who had already inflicted some wounds to herself, was intoxicated, agitated and depressed.
The police asked if I would mind having a talk to her first just from the door.
Twenty minutes it took to have her voluntarily surrender the three serrated edge knives, move to a neutral, open area of the lounge and to accept the police to enter the apartment behind me while I sat in the same space and chatted with her.

Later I asked if anything from the Module would have helped her if that had been her in the ambo role? 'No' it wasn't really ambo centered, more nursing.

I'm very honest with the pt.
I do ask direct questions and don't apologise for doing so.
I don't tell them I know how they feel because I don't.
I maintain eye contact with them and level.
I have never felt threatened by a mental health pt, very very few are dangerous to you, mostly to themselves.
I can listen for a very long time and not switch off.
I can talk with ease to everybody.
Do you enter the world of a full blown manic or delusional pt? Yes if it helps you establish communication.
Compassion and Humanity go a long way to get them to trust you.
They usually want help.

More confused Squeezey?



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

Taz

OMG!

CSI Miami have shot themselves in the foot with medical scenes so bad I wanted to change the channel and then some new program called Trauma (drama) about American EMS and Rescue Helicopters gives me thirty minutes of poor acting, wrong, inappropriate and inaccurate procedures.

That was it.

The TV got turned off.



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

Taz

Second rostered shift, third day straight.

I am feeling a bit tired but an easy day helped.

96F - Transfer from Rehab to a nursing home.

44F - Painful left wrist after being pushed to the ground in an assault.

46F - ? Anxiety attack, interestingly she had an AMI (heart attack for the non medicals) eight days ago, had a stent put in and is now back at reduced hours at work.
Is the diagnostic bump itching?
Ours were, unfortunately I have nothing to report on her tests.

49F - Fall on the road returning to work, heaps of left hip pain, unable to straighten, it looked different to the right but need an X-ray.

36F - Post Ictal - regular pattern is a single seizure, her partner of many years collected her from work and took her home because we were happy with her progress.

23M - Borderline personality disorder, schizophrenia, Alcohol abuse, savage self harm mutilations to arms and with police in a park pissed. Sorry hospital we had nothing else to do with him.


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

Taz

Nothing really interesting.

71M - Prostate CA pt receiving radio therapy feel unwell, off we go.

68M - European tourist just arrived and about to leave on a cruise, TIA? Neurologist reckons more likely a mild CVA.

18F - Syncope left at home.

Assist another crew.

59M - Near syncope, cardiac history, transported.

55M - Suicide attempt with a broken bottle. Deep wounds to the arms but not life threatening. Just someone crying for help. I've been to him before.

52F - Known by just about every city Ambo. Today constipated, waiting room.

14mthF - really bad chest infection.

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

Taz

Overtime!

So Mum and Dad have left and I put in for some, got my home station.

30F - Lite social drinker, rang to get us to check she wouldn't die after a really big work drinks session.

21M - Rugby player, got tackled in the first game, hurt neck but player on.
Got tackled in the second game by a really big guy falling on his chest, SOB.
During Primary Survey, neck pain on palpation, collared, spine board & transport.

87F - Fell backwards, lac to Occipital, needed obs and stitches.

51M - Two previous episodes of Encephalitis, three day headache, photophobia, etc.

69F - ? Inner ear problem, Nausea, Vomiting Vertigo.

77M - Haemoglobin of 76, half what I have to have to donate blood to the Red Cross, SOB! I wonder why.

53F - Leg pain. Due for an MRI later in the month, was not compliant with analgesia regime we sat down and wrote out a simple one. Try it for one day and call back if it doesn't reduce the pain.

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

Taz

The Old's are still here!

We've been setting up a Blogger account for Mum to journal their trip.
Printing some photo's and the like so they can show us off to other travellers.

The new 4WD

The new caravan.


I went to the blood bank this morning but the donation had to be aborted as the cannula site ruptured while they were attempting to move my arm into a more comfortable position.

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

Taz

Last night of Easter.

81F - From big hospital to a little one for Rehab on a sore knee.

25M - IP, saying stupid thing to friends, they're concerned about his mental state. He presented normal to us, yes he was drunk but that's not illegal in the safety of your own home, yes he had taken prescribed medication and took and extra one or two of each but he states not to cause harm to self. He says he didn't want to go to hospital, friend says he will stay with him.
Second crew bring him in two hours later. Story's the same, friend couldn't get him to answer his doorbell or phone (maybe he was sleeping like he said he would????) so they called again and this time he accepted the transport offer.
We did everything right, by the book and had no legal reason to use our powers to force him to hospital.

23F - Metal Health issues, what we call a 'cutter'. Someone who cuts themselves not for self harm or mutilation but to release built up pressures. Usually these are of a very minor nature and the painful stimuli has returned the pt to a normal? mental state.
This pt couldn't find the blunt scissors that she would usually use and picked up a kitchen knife!
10cm (4 inch) by 2cm (1 inch) deep laceration on the thigh. Scared the crap out of her. Transport to hospital for sutures.

72M - SOB & Chest pain. Transport.

39M - Parkinsons sufferer, without money who came to the Cross for unknown reasons?!?! Found unresponsive on a bus but was talking when we got there requesting a check up in hospital. All previous presentations have been for similar.

Picked him up again after a call from Police outside the Sunrise (Channel 7) Studios wanting a lift home??? it's an hours drive. Back to a bigger hospital to wait for the Social workers to arrive at 0800.

And that's it my folks who are now joining the Grey Nomads will arrive today for a few days before disappearing into the sunset for parts not yet decided.

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

Taz

Night of the third day of Easter.

24M - Pizza Man on scooter. The car turned across him at an intersection. Minor injuries.

68M - Myalgia. Spent two weeks in Cardiac Care Unit (CCU) after becoming septic from a tooth infection that didn't produce any pain. Four days post discharge and the pain returns but he tries to self medicate and deal with it for twenty four hours before ringing us when his wife could no longer get him to the toilet.

23M - Psych transfer from ED to Psych Ward.

61F - Extensive Cardiac problems but pt is in self destruct mode and refuses valve surgery and has an ETOH problem and non compliant with Meds, presentations at three different large hospitals in the last month.

19M - IP with a fractured clavicle.

40M - Very IP on his birthday. Very good mates who did take him home.

?30M - bumped by a car.

28M - Hypo, had to give the Glucagon shot and left with his backpacker mates.



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

Taz

Second day of Easter.

22M - Small to big hospital for surgical assessment of Abdo pain.

43M - Post Ictal - would have left him but he was too slow to show competence and capacity, and he had a change to his seizure activity and pattern so he was forced to accept a lift to hospital where later in the day he suffered another two seizures.

69M - Abdo Pain.

85F - Back pain, ? muscle spasms.

86M - Discharge to home post check up after a fall.

42M - Regular homeless guy already picked up this morning post alcohol seizure, fell over on a long neck bottle of beer.

18F - Chest pain and that's what we treated for because of the description, there were abnormalities on our Defib trace and neither of us speak French.

38M - Back pain after colliding with a soccer goal post.

The Septic yesterday and the Post Ictal and Chest Pain today are the highlights.

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

Taz

Easter!

80F - Regular Dialysis pt.

78F - Discharge from hospital to home via a trip on one of our aircraft.

30F - Alleged assault? c/o face pain.

Discharge from ward to n/h, was done last night but it took twenty minutes to find this out.

?30F - IP, taxi dropped her off at the Police Station????? They were arranging a lift home.

2M - Dislocated L-elbow, got a history of it but try stopping kids from tugging each other.

95F - Discharge home after check up post fall.

27F - Suicide attempt with Nurofen. Sister found the note and we got there in time.

72M - Septic, total knee replacement two weeks ago now infected. It should never have been allowed to get this bad while at rehab.


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

Taz