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30 September 2010

Oops, slipped back into boring.

60M - Pedestrian hit by car, there was another crew on scene, ours was a duplicate call for their job.

87F - COPD, Sp02's of 88% after six of her NEBs. She needs a hospital but not for much longer.

22 mth M - Swollen sub-mandibular region, febrile. Transferred to a bigger paediatric hospital.

54M - Went to bed pissed, got up to go to the toilet still pissed and fell forward and scratched his nose. We discussed options and he stayed at home.

53F - Several vomits and three Losses of Consciousness after taking only two prescribed antibiotics. I wasn't worried about the vomits more the LoC.

And something like five hours on station, boring.

873 jobs/118 shifts = 7.40 average.

See you at the big One.

Taz

29 September 2010

We had a ride-a-long today from our own administration.
A non clinical person who will be coordinating our 'Health and Wellness' program.
The day started slow but picked up later.

76M -Regular dialysis pt transport.

107F - yes that was one hundred and seven years, who has not been feeling top notch at home where she still lives alone god bless her.

59F - Due in hospital tomorrow to have some fluid drained from the pericardial sac. They're not sure what has caused this but she woke with chest pain and palpitations so we can go to the hospital early.

20F - IP still in the hotel but got called off.

57F - OD with intent on suicide, good quality and quantity of drugs but got found after being reported missing by concerned family. It's not the first attempt but location was only made after checking credit card activity.

79M - Misplaced his foot going down some stairs and tripped. I still can't imagine how he actually did it but he had a skin tear or lac across the top of his foot that extended down into the tissue.

49F - OD, IV unknown, extreme rigid dystonic posturing, no verbal communications, primeval screaming, NOT VIOLENT but very unmanageable. Requested back up for sedation, they took too long because we had got the pt into our mechanical restraints and in the bus before they had arrived. Trip to hospital was all of two minutes and we got everyone's attention when we arrived.

I need to do some research but I think it was Methamphetamines.

88M - Increased creatine and urea transport required.

So our observer got a good show and we suggested that further observation ride-a-longs should really be for the whole four shift block from Health and Wellness to really understand the physical and psychological stresses we're exposed to.

868 jobs/117 shifts = 7.42 Average

See you at the big One.

Taz

27 September 2010

My legs are sore.

Two long days of extra duties has taken a toll on my legs now after my first full day back on deck.

91M - Sciatic Pain.

31M - Post ictal with increased frequency and length of seizures. Needed some Midaz and even then some mechanical restraints.

27F - Period Pain.

74F - From rehab to air ambulance to be flown home.

46F - From a sheltered workshop type facility. Sore shoulder. Supervisor told us this was a chronic condition but their duty of care required us to attend if any of the staff/pts complained of pain or injury.

94F - Fell forward off her chair and cut open her forehead and it needed some stitches.

Hoax Call to a men's club.

84F - Rapid AF 130 - 150 bpm.

An hour and a half late so that's three late finishes.

86 jobs/116 shifts = 7.41 average.



See you at the big One.

Taz

25 September 2010

I return to operational work.

An easy day

74M - Night shift pt, we took over to let them go home.
90F - Queasy & lethargic
89F - SOB, ? a cardiac arrhythmia.
90F - Fractured a NOF fifteen days ago and nursing home staff noticed it shortened and rotated again?
53M - Varicose vein haemorrhage, no big problem pressure and elevation but his BP kept dropping when standing, even after forty odd minutes.
99F - Discharge to nursing home
82F - Near faint.

852 jobs/115 shifts = 7.41 average


See you at the big One.

Taz

24 September 2010

I'm back, holidays have finished!!!!!!!!!!

As I get older holidays do become more important and essential for me. It was a whole week before I found an excuse to go into work this time!

I don't officially return per the roster for another few days so I put my hand up for some overtime and scored it for both days but only one will be an on-road operational shift.

The other will be as an ART (Ambulance Relief Team). We sign on at a designated Ambulance Station, our vehicle is a hard covered Ute that can hold anything from three to six empty stretchers and when crews delayed at a hospital reach a trigger time we deploy to that hospital and if the pt is not monitored we shift them onto our stretchers and the crew is relieved.

The hospital are billed by Ambulance for the ART and we have nothing but the stretcher, that's why the pt can't be monitored but active other treatments such as analgesia and fluids can be performed on the stretcher by the nursing staff.

It's boring as bat shit!
Hard on the legs!
If you get the wrong pt it can really do your head in!

But your paid really well so,,,,,,,


See you at the big One.

Taz

21 September 2010

Mental Health Education

Well I'm in the last week of my holiday and ACAP had their monthly presentation in the Continuing Paramedic Education program this evening.

Mental Health.

Tonight we had two brave presentors from the Schizophrenia Fellowship NSW who gave of their time to inform and educate us of their side of mental health.

First a person with Treatment Resistant Schizophrenia and then after an insightful Q & A the mother/carer of another person with schizophrenia.

I believe I treat my mental health pts with respect and dignity but from the presentation tonight I still have things to learn.



See you at the big One.

Taz

14 September 2010

I'm holding it together, so far!

Second week of holidays.
I've been to work once, to finish off that periods time sheet.
I've met up with some officers to farewell an ol' Padawan who is moving north.
Ambowife and I have been away for a trip.
We've seen a bank about how much they'll give to buy a home here (not enough and the repayments are horrid).
Oh and I made some new ribbons

Yeah, well I ran dry on ideas.
Any suggestions will be considered.
Remember these are the transfers on the end of 25mm x 900 long white satin ribbons that I always wear at the top of my ponytail.
Here's a photo of an early model,

So it is visible to the general public and management.

See you at the big One.

Taz

09 September 2010

A fallen hero.

It is with much sadness that NSW Police have to deal with the loss of another of their ranks.

It's all over the news here so I'm not going into it.



Peace to his family and all my friends in the force.


See you at the big One.Taz

08 September 2010

New follower.

Hello to ain girlz.

Welcome to the blog.

I'm on holiday so it might be a tad boring for a week or three.

See you at the big One.

Taz

05 September 2010

For the term of his natural life.

I come from Tasmania originally, a penal colony over two hundred years ago and the post title is the title of a book about the life of a convict.

My original plan was to get trained here in NSW and then return to Tassie. Circumstances didn't allow properly for this to be attempted until this year in May when I flew to Hobart for an interview.

The six week period that I was told to wait before expecting further communication from them grew to just short of four months when I received the 'Dear John, thanks, but no thanks' email on Friday.

So I have the clear message now that the training and experience I think I have are not what they're looking for, it's time to move on with our life.

We've been renting and it's time to see the mortgage brokers and try to enter the property market proper .

A chapter closes and a new one begins

See you at the big One.

Taz

04 September 2010

Last O/t before holiday.

No spots in the city so I took the Bra'

71M - Febrile, nauseous, weak, transport.

46M - Homeless with an arthritic knee. If we didn't transport he would just call back. He wanted some analgesia, somewhere dry, warm and a captive audience,,,,,, Waiting room.

44F - Anxiety, calm, reassure and leave with family.

Called to 3 drunk Chinese students. This sounds more like something Campus security should be dealing with but we got called off anyway.

49F - Anxiety, calm reassurance and leave with family.

69F - Severe headache, Hx of subdural haemorrhage eight months ago.

42F - A developmentally delayed pt who likes the social interaction of the waiting room. Talked into managing her ????? vomiting in the comfort of her own home.

10M - Little bit of a chest infection made worse by the condition of the emergency housing they have moved into this week. Two other siblings in the house so Mum opts to have us give a NEB to ease his breathing and take all of them down the road to the medical centre in five hours when it opens.

'I need an ambulance' and hangs up. The details list the apartment building but not the apartment. Nobody comes out - UTL.

Assist a Medical Retrieval team that are just transferring planes at the International Airport.
Where is the pt being transported to?
New Zealand, Christchurch where there has been a 7.0 earthquake during the night.
Four hours we are trapped with this pompous Dr who can't understand that the airline can't just magic him and the pt onto the ground in NZ and that he is the one being paid well to look after the pt and I'm not his nurse bitch!
In the end after hours of 'we'll update you in another twenty' as to whether the flight will happen, it's cancelled and a day shift crew are sent to transport the pt to a hospital until travel plans can be made.

A nice way to start the holidays with a fifteen hour night shift!

847 jobs/114 shifts = 7.43 average.

See you at the big One.

Taz

A not busy night.

But a shift of odd jobs.

A single officer in a full ambulance went out about half an hour before shift start.
Had a pt in the back of the vehicle but couldn't transport single.
Shift starts with no spare vehicles to takeover his pt and no vehicles available for the crews on station waiting.

We get a single responder to transport us from station to the middle of the city to do a 'Hot Transfer' and take the pt to hospital.

38M - IP, fell over at the train station. Head lac, but thought complaining of unspecified back pain might get him a bed for the night. Apparently left hospital a few hours later when told it wouldn't if the was no injury.

19EMO M - took just enough paracetamol to need examination but not enough to be serious. Dr examination notes even noted that the pt appeared thrilled with the activity and attention of the A & E. Transfer from small hospital to large.

16F - Very mild dystonic reaction to medication. Transport for observation.

50M - Cleaning his tracheal stoma and accidentally pushed it in and swallowed it.

48F - RN visiting the city for a medical conference has a three hour Hx of vomiting and diarrhoea and is really just physically exhausted. An anti emetic and IV fluids and transport for further and she'll be right.

85M - From private hospital to air ambulance for trip home post Pacemaker insertion.

837 jobs/113 shifts = 7.41 average


See you at the big One.

Taz

02 September 2010

Busy Night.

Called on early for an assist load.

Elderly gent with recent hip replacement slipped in the bathroom and looks like he popped it out. It was a tight spot so the crew on scene called for extra hands. It was a dislocation we found out later.

25M - Intentional OD on booze and pills. Very likely normal for him but the Men's Shelter will not accept you with this on board if you the slightest bit drowsy without a clearance letter from a hospital. Anyway we got called off it for!!!!

17F - Near drowning, well immersion really. IP going out on a harbour cruise stepped to the edge of the wharf to vomit and fell in. Police were already there and jumped in after her and dragged her out. Thing is did she hit the pontoon six foot out from the wharf or not and how did she get the lac on her chin????? Mechanism is enough to throw the works at her.
Hospital said she had aspirated some salt water,,, well dah! everyone who swims does a little and as pissed as she was I bet she gasped as she went in. Lungs were clear and equal with me and I was more concerned with her level of intoxication and cervical spine injury. Blood tests later showed a BAL of 0.26,,, five times the legal limit to drive a car.

Payphone job, someone threatening suicide. I'm not being callas but the ambulance was parked 25 metres from the payphone. I was sitting at a street cafe having a coffee in plain view of the payphone. Someone was yanking our chain. Unable to locate.

?50M - called by a Christian Youth group who were running a soup kitchen like van to an IP street dweller who gave us a mouthful and them when we arrived. He could tell me the shop door he was going to sleep in tonight and had no need of me or so I was told.

64M - IP, a bad case of wobbly leg syndrome. A very pleasant gent who was still sleeping it off five hours later in the small hospital in the city.

14M - Abuse Hx, foster homes, temper control issues, ADHD, called to him at the train station.
Had cut his hand on a bottle when in a rage, the choice was Police cells or hospital. He absconded as soon as we arrived. A very sad story.

57M - Asthma, felt an attack coming on and couldn't find his puffer and called us straight away.
Even after two NEBs his peak expiratory flow was only about 360 or 60 below the 75% mark for his age and height. Hospital we go.

60M - PR bleed. And what a good one it was. Some thing's sprung a big leak in his GI it was running out of him.

74M - whilst at the Gym yesterday doing weights he thought he felt a twinge in the lateral aspect of his neck. He calls at 4.00am when he couldn't sleep from the pain. Have you taken anything for the pain? 'No'. Christ it makes you wonder. Simple analgesia supplied and instructions to see his GP tomorrow or today as it was then.

831 jobs/112 shifts = 7.42 average

See you at the big One.

Taz

01 September 2010

Plain simple day, nothing exciting.

Well nothing jaw dropingly, OMG that is..

Having a coffee with other crews we get called over the north side of the harbour, their different people over there.

28M - Hyperventilation, calm reassurance and all the things you do and he's right and signs the card with my normal thing of 'Now you've signed your promising to see a Dr or ring 000 if something changes!'
Saw him later in our local hospital, sent in by his Dr who thought he BP was low and may have caused the hyperventilation. Everything came back clear, it was just the environmental and exertion triggers that cause it.

94M - Hot backup to a crew, we're an easy twenty five minutes away through the traffic.
Get called off for a closer crew, we're still on the Nth.

94M - Same job, the other car got tasked to a higher priority. Five minutes into the run we're called off again to Hot backup a single officer.

74F - Syncope on the 15th hole doing the back nine at a very expensive & exclusive golf club.
By accident she had taken a whole anti-hypertensive rather than a half, not really that significant. Rapid AF mostly about 140bpm, no Hx so lets have it checked.

Clear the hospital, another job about twenty five minutes in the other direction that was wrongly booked as an emergency transport when the pt was really suited to our Pt Transport service.
94M - Haematuria, Hx of Bladder CA, IDC in situ, asymptomatic.

Back to the south side of the bridge for a;

49M - With Police, has spoken of self harm in front of them but never did with me. I convinced him to come due to his tachycardia (160 bpm). He denied any substances, he was lying and I believe he was in a manic crisis. Triage agreed and was treated to the right secure rooms.

15M - Clutz fall and a possible ? posterior dislocation of right shoulder. Immobilise, analgesia, transport.

53M - IP who was sitting on the floor and overbalanced backwards and hit his head on the wall of the apartment, minor lac that really only needed some glue or stitches and a tetanus shot.

60M - Restrained driver in low speed MVA. Airbag deployed and he was sore in the sternal region. No obvious deformity, paradoxical respiration, sub cut emphysema. Able to tolerate having ribs sprung and deep respiration with out pain. Declined Tx.

39F - Alleged domestic assault, requesting Police and Tx to see the social worker. Both parties were IP. There were no physical injuries and this pair are known to have a blue (fight) when they get drunk. Violence against women is unacceptable but I wasn't getting too upset or concerned about this.

821 jobs/111 shifts = 7.4 average


See you at the big One.

Taz