No O/t these days off.

Mum and Dad have arrived and the immediate news has been exchanged.

I've taken myself off the O/t list but have still received two calls that I have had to knock back.

So off we went this morning to shop for cars.

Most economical (my speak for cheap) was a KIA Rio with a 5yr warranty, I was happy but as Dad kept reminding us we needed to look at others. Holden Berina's Mitsubishi Colt then a 2nd hand Nissen Tiida. Same price as the Rio, 4yrs old, 25k already on the clock, more solid construction, with a three year warranty, we bought it!

Now it's just a matter of getting the money from this account to that account over the weekend to collect it on Monday.

See you at the Big One and you be careful out there.

Taz

Thank God for Coffee.

31F - Near faint twice just wanted to go home with girlfriend.

61M - Who thought it a good idea to try and sleep in a McDonald's. IP, homeless, looked a bit crook so we took him rather than wait for Mission Beat to collect him.

Drunk M who fell asleep while cooking and made some smoke. We backed up another car to this Not the Big One.

35M - Rail Transit Cop who got spat in the eye. Washed it out and gave some advice.

29M - IP, small head lac and split lip. GCS decreased after unloading and he got a Resus Bay. Later showed he was just really pissed, head all clear. How many times are they but we have to assume the worst and treat as such for those 1 in 100 that aren't.

45M - IP with social issues demanding Tx.

Mum and Dad arrive tomorrow and it looks like we'll be car shopping for Ambowife over the weekend, handy that Dad was in the motor industry and even a used car salesman.

474/64 = 7.41

See you at the Big One and you be careful out there.

Taz

It's looking quiet.

The new guy's cool, I'm pretty sure he's not offended or confused by too much of what I do and say. (shhh, He's told me that he's going to check out the blog so I thought I would write something just about him!!!)

64F - Called because her BP was high and she felt dizzy. It was and I didn't feel that it was purely a cardiac issue. I believe there was a strong emotional base, so I employed the Ol' Taz charm and closer physical contact and invested some time with this very pleasant person (note I changed it from pt!). PMHx, BP (coming down each time), Pulse, BGL, Temp, 12 Lead ECG and conversation. She proposed the non transport. I agreed as Rx was completed in her home.

18M - In a fight, busted up an existing hand wound (surgical) and got struck to the head with a bottle. Been drinking for the last eight hours and since the bottle hit can't talk! EVERYTHING else was good, perfectly normal. And several hours later so were his bloods, X-rays and Scans. More hour later after Mum had been spoken to an much clearer image of the complex mental health issues he had explain the ability to totally not communicate verbally for things like cannulation and using a pee bottle.

52F - Asthma and with no meds at home. Thought giving them up along with the smokes would cure it!!!

27M - Hx of dislocation of shoulder and during extrication it popped back, Tx anyway for x-rays.

80M - Recent Cardiogenic Pulmonary Odoema. No fluid tonight just the pump pressure dropping. Bed lock and dayshift had to come and takeover from us.

It was raining from 0500 and showed no sign of letting up so a total soaking on the ride home.
Ambowife rang home from a broken down car after a hour and half sleep and I spent the rest of the day attempting to repair it and then getting it towed to the mechanics before leaving for work with that sleep the only in the last 24hrs.

468/63 = 7.43


See you at the Big One and you be careful out there.

Taz

Thankfully no rain this morning.

My newly Qualified partner turned up today.
I think I'm starting to cope with the Padawan Withdrawal I have been suffering quietly.
This will be the third roster without a Trainee.

78F - Delirium, Confusion is looks like either a CVA without physical deficit or a UTI.

78F - Recent Hx or PR bleed, pale, faint, transported.

56M - Thinks he is having a stroke, I think it's all in his head (Yes I did mean to write that) but we transport because we don't have the tools to correctly assess tools.

27M - Heroin OD, O2 and 400mcg Narc and transported.

88F - Reportedly a 10 minute syncope. Totally stable with us during transport and the two hour wait on stretcher.

45F - From Hospital to Air Ambulance to go home.

We were unable to locate the female seen by a motorist driving by who looked sad.?????

31M - Psych pt who had absconded from the Psych hospital over near the hospital that they used for external shots on the All Saints program. Luckily the was a crew from over there in our patch and it worked out great for them to take him back. Got them right near their station just before knock off.

70M - A member of the general public thought that this man needed help and tried to restrain him????? the man fought off the bloody do-gooder and when we arrived (as we have to!) yes the gent did have a poor gait, he's had a stroke and that's the way he walks. He refused a lift home so we went home instead.

463/62 = 7.47

See you at the Big One and you be careful out there.

Taz

It rained!

It really hasn't stopped.

Totally soaked when I got to work even with a rain jacket on, it just seeped in everywhere.

A very slow start at work it was too.
Three hours before the first job rolled in for me.

76F - A Twenty Five year Hx of Epistaxis. Several times a year they will get bad enough to require hospitalisation, today was one of them. It had been going for eight hours when we arrived.

51M - Ex heroin/methadone pt hanging out hurting. Sunday is not a good time to need a methadone program.

87F - Simple fall in the street, helped up by general public. Walked home and couldn't get to her floor. Proximal Humorous Pain, Iliac Crest Pain and Rib pain.

45M - 2cm facial laceration. Refused to come to hospital for glue or stitches.

65M - Assaulted with minor injuries, they caught the guy who did it too!

?55M - Call from the general public concerned for the safety of an ???? intoxicated person. The public were trying to restrain him for god sake!!! Luckily he escaped and we were unable to locate.

21F - At her yoga class. Crossing the legs to the lotus position and sharp click and the left knee locks up with major pain. With some analgesia we're just lifting to place on the stretcher and click it's good again!!! Transport for ortho exam and physiotherapy consult.

Now what are these numbers?

They're an average of my work load that includes the post just done, so in this case;

454 Jobs / 61 days = 7.44 jobs per shift


See you at the Big One and you be careful out there.

Taz

Not bad for a slow start!

62F - Febrile at 41.3 with elevated BGL.

72M - Simple head lac from simple mechanical trip, primary survey showed severe hypertension with both Systolic and Diastolic much elevated (200+/100+).

18M - Playing Aussie Rules and copped and elbow to the face, on field medics found central cervical pain that scans showed later to be worth the spinal precautions I took.

61M - Hypothermia from a rescue exercise near the airport. Discharged himself from my care before we left the scene after having the possible complications explained to him.

81F - Lower back pain, extensive Hx of cancer but scans showed no metastases but a fracture of the coccyx.

11F - Wasp sting, no airway involvement but much swelling and pain. I don't have anything to treat that in the car so transported.

21F - Just starting to experiment with Heroin, hopefully this episode today were we saved her life will get her of this terrible downward spiral.

Hope it's not raining tomorrow on the way to work.

447/60 = 7.45

See you at the Big One and you be careful out there.

Taz

I've been a bit quiet.

After sleeping the first day off I had a very important Union Sub-Branch meeting to attend the next night talking and voting about the direction of our next round of wage negotiations.

The night after that was a station meeting at work with presentations from Clinical Training staff outlining the recent additions to the P1 Qualified Officers drug kit and the developments in changing us from a protocol driven per-hospital service to guidelines and allowing for the clinical knowledge to be used.
Extended Care Paramedics to inform us of what they can provide as for non acute pts, kind of like the CARe pathways I have open to me but just more of them, such as sutures, re-insertion of catheters, reduction of certain dislocations,,, interesting stuff.

And then just an update from Management in particular was our KPI (key performance indicators) that have been dropping for the last month or so but one of our own Team Leaders has been conduction her own data survey and has figures that indicate near perfect compliance! The problem may be that the data is collected for jobs in our catchment area but not exclusive to our crews so cars from out of area may very well be what is letting us down. Further investigation to be done.

I have Fifty of my Question Guideline booklets to complete to restock the ACAP Paramedic Bookshop and that as I have posted before is a lot more time consuming that many realise.

Scored an O/t tomorrow so hopefully I'll have great work to post about.

See you at the Big One and you be careful out there.

Taz

A wet and cold night.

And it seemed to have more work, well more than last night.

78M - Regular dialysis pt back to nursing home.

Assist load, hot response for an ICP car with a pt with decreased LOC.

60M - Urinary retention.

59M - gobbled a few boxes of Paracetamol, his liver is stuffed but they send him to an HDU (High Dependency Unit).

22F - Wrong place, wrong time got beat up. Facial injuries mostly, the left eye was swollen shut and the may have been early battle signs on the left side also.

59M - Decreased LOC, Tachyponea, Ashen palour. Many things it could have been so called for ICP backup and treated as Pulmonary Odoema.

38M - Brought himself to the attention of Beat Police and felt the cuffs hurt when they were on!

65F - Chronic Alcoholic, been on a bender and seeking help.

440/59 = 7.46

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

Good Grief! What a Sunday.

39F - Abdo pain, similar to previous episodes of Gale Stones.

49M - Mental health Hx and he 'Mainlined' Methamphetamine yesterday and is hearing bad voices

74M - Post Op for CABg and returning home from city hospital.

And that's it

Three jobs over the entire twelve hours

432/58 = 7.45


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

Taz

New roster.

I start it on my second day shift and single.
Luckily there in a new Padawan on station (this will be their third shift) who's partner is going to be later so we'll team up.

40?M - Passed out, outside a Mexican Takeaway! that's you first hint.
GCS = 7 (1,1,5) my sternal knuckle always makes 'em move.
He's spitting, he refuses to speak or open his eyes but the pig can roll to the edge of the stretcher and spit on the floor. His friend says he has had some pills (MDMA, Ecstasy), most likely some GHB and alcohol all quite deliberately, he is totally responsible for his current state, which as we pick him off the roadway included urination and defecation in his jeans and it stinks (did he have some Tex Mex ? ) None of it got on us but not a nice way to start the shift.

34F - In Police custody and had some abdo pain, there are known issues with her upper left quad and would be happy with some simple analgesia (which Police can't issue) and left to complete her business. Too easy.

79M - Deceased, I spent a little more time here as it was her first one and to carefully go through the process of identification no life signs, asystole, nil pulse, nil resps, very cold peripheries with some core warmth, dependent lividity, rigor,,,,,

72F - Dementia, ??? septic ulcer on leg. You know how you can provide much comfort with simply holding the hand of the pt? This one would reach out for your hand, move it around to get the right position and then dig her unclipped finger nails in and she was gritting her teeth with effort and snarling at you!!!

47F - Chronic knee pain. Does have pins and screws in one and one screw has come lose and the other knee is worn out!

51F - Transported to detox clinic.

44F - on a long haul flight she got chest pain with radiation eight hours out. As there always is there was a Dr on board as well as one of our local Ambos. In flight treatment, Aspirin, Nitrates and O2, fully resolved and nil return for the remainder of the flight. Full primary examination, nil pain but known history and refused to got to hospital will consult LMO. Everyone has the rights to poor decision pathways.

429/57 = 7.53

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

Taz

Wedding bells are in the air.

Of course I'm not meaning for me, we're already married.
We both got text messages today informing us that Ian has popped the question to Haley while they were away on a week holiday in Fiji.
Haley was very kind and took me under her wing for my first year in Sydney, I was her flatmate and a friend. Ambowife and I are of course very excited with this news and as always wish them both lots of love and happiness.

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

Taz

My last shift of the current roster.

I lose my partner and gain a new officer to our station but not the sector, he used to work near Australia's best known beach.

The weather got cooler and that may have slowed down our normal punters last night?

77M - Slipped in the shower and looks like a fracture neck or Humerus or shoulder.

53F - Chest pain, resolved when we got there and with a cardiac history.

60F - Chronic alcoholic transferred from big hospital to little hospital for detox program.

53F - No acute medical problem, Hx of MS, fully wheelchair bound absconded from a very much southern nursing home to come to the big smoke to see a few movies. It's now after midnight and there is now trains home??? Police called us, it doesn't naturally fall into ambulance work but we are social workers too. Transport to the safe environment of a hospital till the morning. Turns out that a Missing Persons report had been filed by the nursing home after they found her missing.

40M - Opiate OD, not that deep and popped up well with 800mcg Naloxone IMI after a good five minutes of oxygen first. To students always give them plenty of oxygen first, less likely to come up swinging and pissed with you.

89M - Dialysis pt.

I'm off to have a chat to the Service in Tassie tomorrow.
Lots of mixed emotions and a lot less surety of why, a bit like My Fair Lady, I've grown accustomed to her (ASNSW) face.

421/56 = 7.52



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

Taz

What a boring night.

59M - first onset of Sciatic like pain, talked him through it and her refused offer of transport opting to self medicate at home and see his own DR.

41M - flown in from the country, Renal Colic, by all accounts the stone was big enough to need a team of miners and some TNT. The country hospital should of been able to do that but the third degree heart block they found on examination was good enough to get a trip to the big smoke for a pacemaker.

53M - Regular IP asked for an ambulance to be called at a back packers. You know they're crook when they are quiet and compliant.

24M - You know what a 'Man Cold' is, well this dude had a "Man Sprained Ankle'. The drug kit was all out of Toughen the F*&k Up pills. Transported for X-ray to find out that his overseas student health insurance had expired and he would be footing (no pun intended) the whole bill.

77M - A regular dialysis pt.

And that was it.

Something new, I've calculated the average work load from the total jobs divided by the days worked when I started my new notebook at the end of this shift so 415 jobs over 55 shifts equals 7.5 jobs per shift.

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

Taz

Second day.

78M - COPD but really SOB this morning. Got the sats up and resp rate down and transported.

1M - Febrile for two days even with some paracetamol.

Called off and assist load.

93M - SOB, cardiac in nature (can't remember the details that's just what my notes say).

38M - Lateral neck pain post re-ender MVA.

95F - Transport to investigate daily vomiting.

49F - Severe abdo pain and it was.

The first and last pts really needed us.



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

Taz

I'm a bit behind in posts.

Sorry, but I was really tired after each of the day shifts.

47M - Regular disabled person who sometimes needs help to his feet at home.

65F - From a nursing home, febrile for two days, looks like cellulitis in the right leg.

13M - Playing rugby, has a history of a neck injury last year and his parents are letting him play again!!!!!! A tackle, spinal pain, cervical spinal pain, I may have spoken a little too loud whilst on the field but this should have never been allowed to occur.

79M - Transfer from big hospital to a little hospital for low acuity care. Problem little hospital has no beds and big hospital didn't ring to check. Take pt back to big hospital and jump the queue waiting at triage because this is their stuff up and I'm refusing to get bed locked on their error.

79F - Minor injuries from a small fall but needs an Aged Care Assessment.

72M - Has a paced ticker, walked up a steep hill on this warm day and felt SOB and pre-syncope at the top, thinks it might be the pacemaker, all symptoms resolved when we arrive and for some reason nobody was interested in vasodilation with a bum ticker. Transported to a check up.

32F - Daily methadone, 750ml of port and a couple of Benzo's, I'd be more than nearly unconscious. Transport to sleep it of safe.

95F - Discharge to N/H.

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

Sundays are quiet.

37M - Chest pain.

78M - Peripheral vascular disease Hx, c/o leg pain, ? DVT.

32M - Deceased, unknown cause.

38F - IP with Police, domestic issues and she stayed with the Police.

31F - IP, thought it was a good idea to have a sleep on the footpath????????? left with Police.

75F - Chronic undiagnosed abdo pain, off to hospital again.

And that was it.

I gave some platelets and plasma today and there is an introduction to a randomised trial on a new style LMA at work tonight that I have to attend.


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

Only Seven Jobs.

Evenly spaced over the whole night, a bit slow for a Saturday night.

44M - Chronic Alcoholic getting the unsuspecting general public to call an ambulance for him. 'I'm having seizures' to the hospital and straight to the waiting room, he can sometimes get a little aggressive if he has to wait too long for a coffee, sandwich and blanket.

22M - Recently diagnosed with ectopic ventricular beats, benign, but still of a concern to him. We did a 12 lead (unremarkable at that very moment) he also not surprisingly suffers with anxiety so after some reassurance he declined transport to hospital.

73F - Transfer from a small hospital to a big one for increasing episodes of abdo pain from a chronic condition.

22M - SHAKING! his friends told me they had been smoking pot!!!! I estimated after their story that he may have smoked one joint (mixed with plain tobacco). Look I used to be a herbologist but I was having difficulty keeping a straight face. What kind of Uni student are you if you can't handle the effects of a very small bit of Mary Jane. I carefully explained that these effects were generally harmless and would expect them to fully resolve in the next two hours even if he went home with his friends. He still went to hospital.

20F - Hysterical Intoxicated Female just look at the mess she made in the back

It leaked under the door seals


'I'm not drunk' she says!


And her friends are too weak to pay out on her about how she behaved and the mess she made of my ambulance.

24M - Stabbed, well in hindsight there was a wound to his pectoral region but it wasn't sucking, good sats, BP and symmetry of the chest must to do about nothing much.

35M - Hx of Pleural effusion recently that had been drained but the lungs were good and clear all the way down. I'm going more down the pleuritic infection

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