Tiresome Tuesday.

A complete change from yesterday from one dreary job to another.
There was good work out there but it just never found it's way to our radio!

84M - Regular client on of our Dialysis pt's.

28F - On the 'Nod' outside a retail outlet and they called us. Our friends in the other blue turned up and as there was nothing wrong with this pt, medically they took her to try and get her home.

54F - From a Dr's to hospital for low BP post dialysis?? thought that was normal and she was able to take oral fluids. Anyone got more info on dialysis.

65M - Possible TIA.

25F - Anxiety episode.

UTL

84F - with a three year Hx of abdo pain, most likely gallstones. Not really distressed, has opiate tablets for the pain and why did they think it was a good idea to send her to the hospital at seven o'clock at night????

596 jobs/81 days = average of 7.36


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

Taz

Just another manick Monday!

16F - Unresponsive on footpath at nine in the morning,,, strange. Low blood sugars, oral gel didn't do much to improve her so some super strength in the vein.

55M - Syncope and work, left for the wife to collect.

Assist another car load a pt.

77M - SOB, a very wet congested chest.

54M - Luck he was having his Hypo in a market that had a security guard who lives with a diabetic and recognised the hypo. When we arrived it was done an' dusted, all resolved all we did was confirm with the glucometer.

49M - Deliberate Unresponsiveness!!! Shock, had got some very bad news at work and fainted and was then unresponsive to them, tried it with me but I'm well trained to get a response from you. No medical reason but plenty of emotional/psychological ones to remove him from there.

18F - Period pain, a direct request was made to the call taker that she just wanted us to transport to the ED for analgesia and I'm not going to say any more about it!

39M - Got robbed, went to the cop shop and they called because he was 'on the nod' (opiate drowsiness). Denied any illicit drug use just his daily Methadone, lying sod, does he think I came down in the last shower?

79F - Chest pain

586 jobs/80 days = a 7.33 average.

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

Taz

An interesting question.

So I pulled an O/t shift that started from the station near where we live but was worked at a station some ten kilometres away.

During the shift one of the other officers asked me where I got the enthusiasm to write a blog which is to the most part about work.

If you look at the first post I didn't see the point of this blog stuff. I didn't even think that I would have enough to talk about to make regular posts.

Mostly I write this for me, probably for the same reasons anyone else writes in a diary as that is all a blog is, just online and it can be private by acceptance of the author or public such as mine.

I love my job and whether or not anyone reads it I'll keep writing the blog to deposit my thoughts, emotions and feelings about what I do. The fellowship of the EMS/Ambo bloggers is another reason, I have learnt from the experiences of others and I have been able to expand the knowledge of others without subjecting them to a shift full of my ol' timer Dad jokes.

So what work did we do,

84F - Aphasia, not talking, that was it! No abnormal Obs, equal strength able to stand, alert to her normal state per the nursing home staff she just wouldn't open her mouth to speak or eat.

92M - Return to nursing home from the hospital post treatment for what was thought of as constipation but was ascites, effusion and accumulation of serous fluid in the abdominal cavity. ascitic, adj.

43F - Came down as back pain and that was probably something to do with the floor she was on after falling out of bed. Pt was living in a group home with other special needs persons. Assist to feet and off she scoots to the toilet without a single pain. Left in the care of the house carer.

29F - Vomiting and diarrhoea, had eaten a salad bought late from a kebab shop. Stay at home love, your warm, in a safe comfortable environment and you know who's arse was last on that toilet.

29M - Anxiety attack. He said that he had consumed five cups of coffee in six to seven hours. (Insider joke, local crews expect to see me at hospital with a travel mug [2 cups] of coffee at all times, all shift) Stayed at home.

82F - SOB, hypertensive, looked and sounded like the early start of pulmonary oedema, transport and a very late finish.

577/79 = 7.30, just in case you don't know what this is jobs/days worked = average.

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

Taz

Meet a fellow blogger today.

Flo was in town and we arranged to met at Central Station for lunch.

Nearly six hours of shop talk, pt reviews and protocol verses guidelines.

Why do we blog, etc, etc

A pleasure to meet you ol' son and look forward to doing so again.



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

Taz

My turn to go away.

I took the next trip away to work with a peer at the beach of the Bra Boy's.

46M - Fainted while eating an apple, there was some abnormal ventricular readings on the three lead ECG but only every now and then, I think he just took too big a bite and maybe had a vagal response to the increase pressure and suffered a simple syncope but transported to clear him anyway.

70F - Dry raspy cough, three day history and really just needed some advise on how to manage at home that night before going to the chemist tomorrow for some cough suppressant.

6M - Ear infection and the biggest and nastiest looking cold sore I've ever seen.

69M - IP and asleep on someone's lawn, we tried to find out where he lived without success so we had to take him to the hospital. Their records showed we were two building from his place but also way to intoxicated for us to leave alone at home if he didn't live with someone.

87M - Regular dialysis pt and again by the time we returned to station, signed drugs in, cleaned the vehicle and I drove back with the morning traffic I knocked off two hours late again.

571/78 = 7.32

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

Taz

Late knock-off!

I should have kept quiet. Stuck at the hospital with the last pt of the night and knocked off two hours late.

We have an extra officer on our line at the moment so three and a half crews. The boss has asked for those of us not acting as training officers, if we could take turns being the single and therefore being sent away to another station for the shift.

My normal partner took the first shot for the team and worked with a reduced hours officer at a nearby station while I had the pleasure of the new officers company. She's from out of area so I treated to let her drive, navigate and learn the area.

47F - Quadriplegic pt decreased urine output, the notes also said a headache and elevated BP!!!
Hello we go, Autonomic Dysreflexia - also known as 'Hyperreflexia', is a medical emergency that may occur in pt's with spinal cord injury at T6 or above.
The condition occurs as a result of a massive, uncompensated cardiovascular reaction of the sympathetic nervous system triggered by an irritating stimulus below the level of the injury.
May present with:

• Sudden Hypertension
• Pounding headache
• Bradycardia
• Sweating and flushed above the level of the injury
• Skin pallor and goose bumps below the level of the injury
• Shortness of breath and associated anxiety

Got all excited and it really was just a simple positional issue with the catheter.
Left her at home as with some re-positioning of the pt the flow re-started.

55F - IP, about a bottle of sake we were told, domestic issue with husband drew the attention of security at the casino, violence against them got the police and us called.
I drop my guard with females and she managed to kick me during the primary survey! Out came the pt restraints
There is a leg belt also and when fitted to the stretcher the whole rig prevents the pt from escape, acts of violence to staff, self harm and issues such as positional hypoxia.
Issued a section on the pt to activate my powers under the mental health act to restrain, detain and transport against their will a pt I judge to be mentally disturbed and a danger to themselves or others.

36M - Known schizophrenic pt who's depot IMI meds were not holding off paranoia. Compliant and seeking help.

40M- Very intoxicated with a small facial lac but it was the booze that was the real problem and he needed to be protected from himself trying to walk off. Easy enough to convince him to come each time he wanted to go by just asking him where the blood was from and why.

45F - first trimester with a PV bleed.

28M - Was in trouble with the Law, feeling depressed about it. He was with some of our local Cops and in their own words he wasn't a bad fella so they were going to try and help him out so SNR for us.

96M - In a nursing home now and tried to walk unassisted and fell. Five centimetre laceration on the crown of his head. It needed stitches as I could see skull beneath it, no neck pain and no LOC a very delightful gentleman.

566/77 = 7.35


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

This is freaky, Knocked off on time again.

Only one job I'm going to follow up from today's batch.

58M - Chest pain, from the Casino, wouldn't say how long he had been there or how much he'd lost. Transport anyway.

30M - Drunk Irishman, now did the alleged 'King Hit' make him speak gibberish or was it the no doubt heroic amount of alcohol he's drunk. Seven hours later he was still sleeping it off in the A&E. No fluids up so he'll have a god awful hangover.

75M - From Big Hospital to Rehab.

52F - Taking normal daily meds, gagged the wrong way and got one stuck, maybe near her glottis or maybe down the trachea? X-ray was inconclusive so they took her to theatre to pop a scope down her throat and have a look.

76M - Decreased LOC, with stimuli inappropriate answers, in good health, out driving with the wife (he was the passenger), obs ok, maybe the BP was a bit low for his age, ECG normal. Equal weakness to whole body, speech not slurred, no facial droop. CT came back clear, bloods showed nothing but four hours later I would have given at best a GCS of 13 (4,3,6) with poor ability to retain new, recent information like 'it's a Sats probe, no you can't take it off'. This I'm going to follow up on.

48M - Strained his back playing golf, tried no simple analgesia or medicated rubs or heat paks, just called an Ambulance.

75F - Abdo pain, per her no urination or bowel motions for a week. No bloody wonder it hurt. She had been attempting to correct at home with pharmacy medications without success.

559/76 = 7.36

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

Taz

How's that, knocked off on time.

Not a common thing.

39F/M, Umm Transgender - Heroin OD in a 30min hotel.

93F - Discharge to nursing home.

81F - Family concern for deterioration in the pt's overall health.

56F - Lost the use of an arm four days ago and has been waiting for it to get better before she rang us. No Idea what might be the outcome with that long a wait.

54F - Chest pain, well when she finally got around to telling me the full story it was more like epigastric pain radiating to the right flank post eating chicken.

26F - Boyfriend troubles, she shouted and screamed he called the police, I came and assessed that she was not going to harm herself, hopefully she was going to cut him loose.

2M - Fell off the slide in the park and landed on the bark underneath. Not a mark on him and floppy and unresponsive on scene. En route he's kicking up a right proper tantrum. Seems he's a breath holder and that was what he was doing at the park only to now find himself in the ambulance with me. Winded himself and chucked a tanty.

23M - Chest pain? Walked into a shop and asked to use the phone to call an ambulance and then walked off. It's six hours before the Football kick off being broadcast in Darling Harbour, there are thousands of extra people on the streets. UTL

552/75 = 7.36


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

Taz

O/t Tonight.

At the station near where they shoot the Masterchef program.

53F - Anxiety attack, she didn't recognise it as such but that is what it was! She was convinced it was an anaphylactic shock reaction!!!! Treatment,
Monitor, the pt love's a machine that goes ping.
That red light thing on the finger with numbers, the pt love's something with numbers for them to read.
Oxygen, every one on ER and All Saints got Oxygen so it must be good, even at 2 lpm.
BP cuff left on the arm and inflated regularly. Don't have to remember what it was just so the pt is distracted.
I think she left the waiting room some three hours later.

25F - The Flu. I've just used all my sarcasm above but you can guess, left her at home with instruction for self care.

90F - Simple mechanical fall, fractured NOF.

26F - Anxiety attack, student with an exam in two days. Talked her down and left her at home with the husband.

21F - Lumbar back pain, didn't want to got to hospital! so I don't understand why she rang for an ambulance. She had her own simple analgesia but had been taking them every twelve hours instead of every four. They'll work better now.

84M - Pulmonary oedema that was just starting, conservative treatment and transport of our only other sick person for the night.

544/74 = 7.35


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

Taz

I have a new follower!

Hello KayCee,

That make ten official now although by the maps there are many who just drop by for a read rather than becoming a follower an getting feeds of the most recent postings.

Welcome to the window to my world as a Paramedic in Australia's largest city.

If anything I say doesn't make sense please drop me a comment or even a personal message to the gmail address.

Even Ambowife doesn't understand me some days and we've known each other for nearly twenty five years.

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


Taz

So on the first day on the job what did we do in the new car?

30M - Butane flash burns to face, second degree partial thickness. No direct airway involvement but face burns can always creep up and sting you in the arse!

54M - Collapsed at home after ten drinks. Scotch we were told. My mate was not impressed the dude vomited over his boots. Slept it off in the hospital bed.

45F - One of our regular legends, anytime you hear a car going to this street you know it's to her. Left her at home with some blankets because that's all she needed from us. A sad case but frustrating all the same.

63M - Chest pain. No history of cardiac issues but a very recent and large stress history of a house sale and relocation after forty years in the same place.

20F - Pregnant, due now and with labour pains lasting two minutes about eight apart.

89F - SOB, chronic issue that has been getting worse over the last two days.

So real trauma, Drunks, a legend, chest pain, an new life about to begin and the ever popular SOB.
Welcome to the city new car.

538/73 = 7.37


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

Taz

It's arrived!

My new baby has arrived!



The Mascot has a new dashboard to sit upon to glare at the world!



He has a new seat to sit upon!


Do I look happy?

You bet ya'



They didn't really give me my own number plate.
Ambowife Photo shopped it for me.


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

Taz

Overnight temprature as low as 8 degrees C.

That's a nice winter's day in Hobart!

2M - Bath water scald. Umbilical to top of his penis (ouch). Lots of water and a little analgesia and off we go.

85F - Family's concern after a very small fall and an abrasion on her cheek. Met all the criteria for an uninjured pt staying at home under the CARe program.

24F - Abdo Pain, 32 weeks gestation,,, first baby, had a big vomit just before loading and felt really better.

42M - Lac on eyebrow, wanted to go to hospital.

20F - IP, peaked too early staying in with the boyfriend now.

26F - GHB OD, I must say I missed this one. Yes decreased GCS but cold, not clammy, no dystonic movement at all, I guess because it was a petite female I didn't give enough pain to make her pop up with that startled rabbit look the G's have.

23M - Assault witnessed by police, two significant lac's to the crown of his scalp, taken in for sutures.

21M - Assault captured on CCTV and the bad guys caught straight away by the Police. Oh the pt was sucker punched, hard fall to pavement and neck pain. Fully cleared later.

19F - IP with her not so pissed boyfriend. She was competent just too pissed for him to get her into a cab. My ability to walk fearlessly into the street and with authority stop a taxi helped out with that problem.

And that was us for the first night.

532/72 = 7.38


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

Taz

My ambulance is gone!

We have five on station for the three crews on shift.
All permanent staff have one of these five allocated to them.
Mine is 439. It has over one hundred and six thousand kilometres, it's done it's time.
It was stripped and taken two days ago.
My new ambulance hasn't showed up yet.

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

Taz

The day that followed.

30M - Hypo (1.1 BGL)! We are now authorised to use IV 10% Glucose for pt that are not able to take oral glucose. This was the first one for either my partner or myself. Worked a treat, pt recovered and was able to eat to increase and sustain his BGL and stay at home under the CARe program.

41F - Anaphylaxis, wide spread urticaria and a huge tongue. First shot of adrenaline worked great but we gave another at hospital as the symptoms were returning. Still it was really nice to have a real anaphylaxis to treat.

29F - Known epileptic, witnessed seizure, has had it for about ten years, well medicated and compliant with them, usual to have a seizure every three months which was about now, no current illness nothing unusual and her mum was coming to pick her up. Did CARe on her to.

66F - SOB, combination of IHD and emphysema.

77M - Pre syncope, rigors, clammy, pale, hypotensive, epigastric pain. I reckon a belly bug.

95F - Transfer a pt from the really busy big hospital to the quiet smaller hospital.

95F Cardiac Arrest, good CPR on our arrival but,,,,, 95yrs???? we gave two minutes of compressions and then diagnosed PEA (pulse-less electrical activity) or EDM (electromechanical dissociation).

523/71 = 7.37


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

Taz

Sorry I'm late.

With the posts. The shifts were just long and then there is the cold ride home and well I let it slip preferring to look after number one first. Sorry.

First day shift then,

37M - Call from Police, concern for drug effected male. Admitted to IV use of Methamphetamine yesterday, his body was starting to show the signs, welts, abrasions etc but his brain still GCS=15 and he didn't want us.

69M - Pain from left gonad to flank!! Ah I hear you say he has renal colic or a kidney stone. Urination very normal, no discolouration, decreased flow, increased frequency or pain,, maybe a torsion???

50F - Chest pain and a single vomit. Yes there was a cardiac history but why were you being picked up now from the Casino after playing the pokies for the last NINE hours since midnight????????????????? Medical care was provided but not much concern.

52F - SOB, clear lungs but shallow resps. Pleuritc cause most likely. I've been here before, genuine folk with ill health who try to look after themselves. Same quality medical care and lots of concern.

52M - Alcohol abuse, depression, social welfare.

55F - Fell in a well known department store at a display that I know has tripped other shoppers. Looks like a minor wrist injury and a vaso vagal when they tried to stand her up.

80M - SOB, elevated troponin that the GP wanted checked. Triage told me that the fact the pt had only one kidney would raise the troponin a similar amount. Pt had a Hx of anaemia but appeared a good parlour but Hb returned at 75!!!!! No bleeding acknowledged by the pt so needs further investigation.


This dear 79F was the restrained passenger when T-boned by a bullbar'd 4WD. Completely uninjured, just couldn't get out. So our kind Police Rescue (pictured) cut the door hinges and out she clambered.

57M - Chronic cellulitis wanting a warm bed and some food not shared with thirty other homeless men in a hostel. Call the ambulance and try to sell this ol' swollen leg as something else!

516/70 = 7.37


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

Someone needs my Platelets.

I received a phone call at work last week from the Red Cross Blood Service asking if I could change my next donation appointment from yesterday to today.

Of course I could it's on my days off.

The girls inside were quizzical about my appearance as it wasn't on their paperwork.

I'm on a special donation for matched donors/patients.

There's some poor sick person out there waiting right now for my platelets.
It made the donation all that more fulfilling.

The is something altruistic about donating whole blood or plasma/platelets. I was determined to complete the double bag donation they needed so I was even more upset every time the alarm sounded for low pressure, my valves usually flutter during the draw process and sometimes enough to stop it.

There is always a huge demand for all of the products collected by the Red Cross.
Yes it's a needle, suck it up.
You can have a milkshake, tea, coffee and sandwiches, snack paks or a hot dog afterward.

So again, if you don't donate give it a go HERE

Remember, what I donated may save your life, would you do the same for me?

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

Taz

You don't always get Great work on overtime!

And today was one of those shifts.
A late call and I had to drive as the bike's in the shop having a six month service.

Teamed up with one of the Padawan who belongs to another on station and we did this,

67F - Left hip and lumbar pain, non traumatic.

74M - Gout - has been stuck in a chair for thirty odd hours unable to mobilise.

56M - Nausea, no vomiting just nausea.

56M - Hospital to hospital for surgery on a prolapsed disk.

86M - Rehab Hospital to proper hospital to have a procedure.

Got stuck at hospitals, got seven minutes of official lunch break and took all day to do these five jobs.

But that's the reality of our job, it's not always busy with trauma.


507/69 = 7.35


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

Taz

Weather warning to surfer's, yachtsman and bicyclists!

And the heavens opened an' the world was washed!
Ten minutes into the ride to work rain had forced it's way through the rain jacket and was pooling in the chamois in my knicks. I was wet everywhere and having a ball.
Riding through all the puddles, playing dodge 'em with the cars driving through the puddles, some cars didn't come out the other side!
The Boss just shook his head at me, called me an idiot as I walked into the station proper with water raining off me.


First Job for the night sounded like the Big One!


This wall (Image from Google Earth) collapsed due to the rain. The cars parked in front of it, similar to these, were crushed but no-one was in them. Rescue had gone over the site with thermal gear and didn't believe there was anyone trapped under the rubble so it really was a storm in a teacup. Ha, ha, ha, ha

60M - Threatening Self Harm, was very obviously disturbed and while totally compliant with us later needed to be restrained.

36M - Transfer from a small hospital to another small hospital but closer to home for him.

19M - Facial injuries, I don't think he has ever been hit in the face before, because really they were rather minor.

33M - had a fight with the girlfriend and dropped a heap of 5mg benzo's that his GP had given him. Why do these Dr's get off giving these depressed pt's bottles of 50 tablets of dangerous drugs?

20M - Running across the road, slipped on the wet white lines and a taxi may have driven across his foot. He was walking, didn't want us but we checked him out and then left.

Last call was to the unconscious pt who has left the scene when you arrive.

Will try and snatch some O/t, get the bike serviced and spend some time with my best man who's up here from Tassie to play in the Australian Defence Force hockey tournament.

502/68 = 7.38


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

Taz

Missed the rain riding in!

How disappointing a night must it have been that the title of the post is about the weather????

39M - Claimed chest pain, claimed to have had it before, left sided radiating to jaw and arm, was hyperactive, sometimes hyperventilating and dystonic like posture, Dr was happy to confirm my suspicions that it was nothing to do with the heart but more the mind.

84F - Back pain that decreased her tidal volume that made her more SOB than just her asthma that was also playing up.

72F - Migraine, for three days, rings up at 1.00am Anxiety issues appear to be the trigger with her adult daughter away at the moment.

85M - Couldn't wee so he came to hospital. They've taken care of that now so we took him home.

45M - Central Chest pain. Even before he told me about the four different AMI's he's had and the stents I knew this one was cardiac. Not infarcting as such just really bad angina, you know what I mean, I just haven't written it right.

?50M - Who really didn't want us but the Police, who actually told him to grow-up and go away.

495/67 = 7.39

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

Taz

Up on time this morning.

Arrived with plenty of time to even trim the beard.
Nice weather too.

54M - Sounds like a focal seizure that develops to a partial. Anyway GCS was 15 and he didn't want or need immediate transport.

48M - It came down the Data Terminal as ?? Broken Leg! A cold response was what our Computer Aided Despatch system put on it and this time I can't complain. The Dude was doing circuit training and had strained his calf muscle!!!! Given self care instructions and released back into the wild.

57M - Syncope, found on the floor in a train carriage. Hypotensive, Gastro Upset, Cold! Nothing insidious found I think he was just crock with common ailments.

96M - Hypertensive, 218/100, got discharged five days ago after two weeks in-patient treatment for the same. It appears that his two anti-hypertensive meds had been reduced to one????? returned to the same ED and there was a change to be made to replace the stopped med but it just never seemed to happen.

12M - Spontaneous Pneumothorax! with an X-ray to prove it. We really were the transport only.

44M - Fell over on his motorbike! And fractured his right clavicle. Did it on the promenade at Bondi Beach (Bondi Rescue weren't there). It wasn't moving, he was stationary. OMG, How embarrisment!

42F - Recent discharge post treatment for pulmonary embolism but the SOB has returned today.

36F - We were querying an Urticaric Reaction to something, anyway no airway involvement so we got to use our new anti-histamine tablet with good effect.

Good day, some interesting work.

489/66 = 7.41



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

Taz

I slept in!

I checked the time on the alarm but I didn't switch it on.
Shit an hour over sleep.
Good thing I normally arrive at work an hour and a half before shift starts!!!!

3M - Not sure how this young fella did it but he got his fingers stuck in the space between the door and the door frame. Mum and Dad didn't know what to do and called us. Out comes the crowbar from the back of the car and crack! off come the door. No damage to the fingers Mum will take him to the GP later.

Job cancelled en route.

41F - Slipped on so wet stairs and cracked her elbow. Possible fracture.

82M - Stumble/fall onto ground. Facial tissue injuries that needed more work than we can provide.

81F - Had a fall five months ago and the lumbar pain has not gone away. Never saw a Doctor at the time of the fall.

50M - Schedule by the private practise psychiatrist. Threatening harm to self and others.

42M - IP, feels depressed, he's that low at the moment that he's drinking Metho.Took him in to see if the hospital social workers could help.

Called off on a backup job and

75F - Tripped inside the Department Store on a floor display, landed on an out stretched hand. Maybe a humerous or shoulder injury.

481/65 = 7.40


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

Taz