It started off slow.

And never really got busy.

We got coffee, drank it, was thinking about we should really buy another if we're to keep sitting at the cafe table for this long and the fist job drops down.

72M - From hosp to air ambulance for flight home, it's 15 min to the airport and the departure time isn't for another 2 hours.

5F - Alleged to have fallen down some stairs. Has a minor abrasion to her elbow, knee and shoulder. Is running around with cousins and only stops to show us where it hurts (elbow). Yes the height was 2m or 6 foot, but really look at the pt, does she look injured? Unable to use more direct language to make Mum understand we have to transport because Mum's cousin thinks we should.

16M - Yep he was concussed post three player collision during a basketball game. Transport to be observed. Dad was great, I say this because he identified himself as a anesthesiologist at our local hospital but also openly stated that this was all out of his comfort zone and we 're the experts. Unlike the other gent who identified himself also as a Dr (it was a privates school gym) who indicated to us that it was important to get a BP first for our conscious, talking, has a radial pulse, nil obvious physical injury pt rather than a neuro exam.

92M - ??, The job was for an unresponsive pt at a nursing home. He's demented, he opened his eyes if you touched him. He'd track your movement he just wouldn't talk. Not uncommon allowing for also being born and residing in Asia for 50 yrs. The daughter is a fuss budget worry wart who blow the whole thing up. We had to transport and the hosp did real well at a basic workup and get him back home quick.

31M - More carnage on the basketball court. Different one this time. Concussion again! And working himself up into a tizzy about not being able to remember the event. Transport again for neuro obs nil other obvious injury or deficit.

44M - ?? seizure not responding. Long story short, confirmed seizure Hx from TBI, meds on scene, one witnessed seizure focal and developed to general, with friend. 90 second seizure with us same form. 5mg/1ml Midazolam IMI, pop in a line and have a 5mg/5ml ready to go and transport. My current partner who goes back to school to get her qualified insignia in Nov had never had a pt seize on her before always just having post ictal pts so she was stoked at the job. It was a good job well handled everything just went right first time.

29F - IP, stupid and anxious. We were being played but again those word 'I want to go to hospital' and we're hamstrung.

See you at the big One.

Taz

Well rested and ready to work.

It just wasn't happening today though.

79F - Vertigo, BP was a bit high but nothing to really worry about. Turns out to be a non symptomatic UTI.

22mthM - Transfer from adult hospital to children's hospital after initial treatment for burns.

75M - Having a reaction to some analgesia, vomiting. He elected to ride it out at home.

45F - Really severe urticaria to wheat. Adrenaline and transport.

45F - Found unresponsive at work. Hx or traumatic brain injury so everyone jumped to that but the breath and checking the plastic drink bottle under the desk said vodka was more to blame.

30F - Sleeping at work desk. Denied any benzos but was doing a really good imitation.

57F - Hit head on window yesterday and rings over 24hrs later with suspected concussion. no deficits, no complaint other than 'I might have concussion'. How would people cope without us?

40F - Absconded last night from a ward before a transfusion. Became unwell at the friends place, they called us.

50M - Hosp - Hosp transfer, abdo pain.



See you at the big One.

Taz

Did I use the new skills 1st shift back?

Do I really have to answer that?

Of course not!

Out of ten jobs responded to, only one single patient was put on the bed or received any medication.

39M - Regular IP caller, I even guessed it was likely to be him from the location and presenting problem. Something was wrong with him which was easy for me to know from the many times I have seen him before but a tip for the 'new to the street' folks, when your regular homeless/alcoholic person tells you they're drinking much less than normal or not enjoying their smokes. There's something sick with them.

51M - Suicidal/Depressed. A War Vet who's stuffed in the head from PTSD.

33M - IP who felt suicidal.

38F - Respiratory distress (the PC way to describe hyperventilation), calmed her down (problems with teenage daughter) we left.

37M - Sore eye for the last 36hrs. Why call at 1.00am??????

15F - Abdo pain. This was the sick one, she looked right in line for a surgery consult, appendix.

24M - Single punch to the face and he now has two bottom lips. It needed transport.

??M - Horsing around in a tree pissed and fell out. If he could get up and bugger off why call us?

??M - Just doing a tour of the red light/club area and the police flagged us for a gent with a haematoma on his forehead. He stayed with us for only as long as he needed before slipping off into the night.

21F - End of the night partying shouting fight somehow got us called. No health issues.

See you at the big One.

Taz

Been awhile since I posted about work.

If your one of those stalker types and I have had a stalker, many many years ago, it was a girl too!
You may have been counting the days to keep a track of my movements?
You may have thought that I had chucked it in?

Truth is, I've been back at school for re-certification and compulsory training.

It's supposed to be every 18 months and is completed over your two day shifts and first night. That's not that you train at night you do three days at school and return to one night shift.

Increases in the skills set of our P1 or Qualified Paramedics commenced this year.
Cardiac reperfusion trials have been operating within the state for over a year for out of hospital thrombolysis. This trial has been extremely successful without a single adverse event.

Qualified 12 lead diagnosis of a STEMI on our Lifepak 15 defibs along with transmission of the ECG and bypass of the ED directly to the Cath Lab is the minimum standard for a P1.

So 12 lead ECG's were de-mystified. I've read books but it didn't click, I just needed the right instructor and we got her. The rest of the mystery around a 12 lead can still be held by ICP's but that to will be slowly taught to the rest of us in the coming years.

After re-cert a P1 may now administer adrenaline to a pt in cardiac arrest. This one has bugged me for years, they're dead when we get there mostly why has it been so long for us to be approved to give embalming fluid to the dead in a hope of making them less dead??????

The CARE program that I have been part of for the last two years has now ceased and these low acuity jobs are now being incorporated into the core skills of officers so if your not CARE trained you get instructed at re-cert. It's not a big leap in practise just a proven package to allow you to leave a safe pt at home.

After years of talking about it the larygascope and Mcgill forceps have been introduced to remove that half a side of cow from the throat of a choking victim.
A new traction splint called a CT6 and a military based arterial tourniquet where also part of the training.

So that is what I have been up to.



See you at the big One.

Taz

Another road trip.

As regular readers will know I am a presenter with a program run by the Police and Citizen Youth Club (PCYC) in NSW for Traffic Offenders pre-trial.
Eight sessions for
Police
Ambulance,
Drug & Alcohol councillors,
Brain Injury support group representative,
Legal,
Road Accident Victims support group,
Dangerous Behaviours,
Road and Vehicles.

In rural areas they have whole day sessions on the weekend (four in one day) due to the travelling required and sometimes have difficulty getting a qualified presenter.

So Ambowife and I travelled to a new part of NSW this weekend to do a presentation.

Disputed cherry capital of Australia.
390km west of Sydney.
Goldrush site in the 1850's.

It's a beautiful place to visit and make sure you enjoy a meal at the Services club (cheap and very large) as well as a visit to the Temora Aviation Museum.

See you at the big One.

Taz

Biggest blood and guts for a while.

6mthF - Toppled on a play mat, bumped her head and scared the shit out of Mum and Dad. Transport was more for them.

74F - Syncope, Dehydrated, it's hot and she's been running around town shopping all day.

20M - IP sleeping in the front of a Thai restaurant. Between us and the Cops we got his family to come and collect him.

57M - Thinks he strained a calf muscle this afternoon and the sports rub isn't instantly making it better. Right up there with 'Man Cold' and he wanted to go to hospital. We didn't take him straight to the waiting room we stopped at triage first.

30M - Just checked him out for the Charge room Sgt.

29F - Domestic Assault. Left with Police while they picked up the prick.

25M - Standout job for the evening, multiple stab wounds front and large slash wounds on his back and neck. Six minutes from on scene, primary survey find all the wounds, call for extra hands, quick dress wounds, obs, get a line and hang some fluids to bring his BP upto 90Hgmm and leave. One of two victims, it's in the news.

35M - Neck cramps that came down as chest pain. It was all muscular and a let down from the previous job.


See you at the big One.

Taz

Why do I go on about nice patients?

I guess they're not that rare, though in the middle of the city in the party zone it can be rare to have a run such as we have had.
Both day shifts nice pts, but will it continue?

27F - Gas flare-up on the domestic stove top. Same name as my Mum which is rare in itself as I have never in forty plus years met one. There she is in her undies in the shower and in walks this hairy Ambo, with grace and dignity we protect her modesty while she is centered on her injury. We hold an honoured position in society with such trust of our pts and we should never forget it.
Her burns were minor and she needed obs for any later airway development only.

90M - Assist off the floor and then duel with his rapier wit while I assessed him. He was amazing with the content of his conversation and humour from his younger days to current events. Left at home safe.

80F - Syncope, has only been on dialysis for four weeks (last was this morning) whilst also having her BP meds changed three days ago. When it failed to respond to posture we took a trip to hospital.

82F - As bad a case of angioedema as I've every seen. The cause is unknown and she was in hospital five days ago with same and the month before spent four days in ICU tubed nasally because of the size of her tounge. I wasn't happy with the lack of response to my adrenaline treatment, I gave her three IMIs with seemingly nil effect where an oral antihistamine and steroid in hospital had a very quick response.

36F - Vomiting but I think her hypotension came first.

And thus we finished another shift without verbal or physical abuse or manipulation and having had the pleasure to help each pt.

See you at the big One.

Taz

I said 'it's been quiet!'

Now I get punched and abused at work if I say this (which I do) because everyone knowns for sure that it will curse you to a busy day.
It's just the same as the phone or pager goes off as soon as you sit down with a cup of tea or just as you sit on the toilet!

39F - Mixed her dose of insulin, nothing big we conculsted her diabetic clinic and they were happy for her to stay at home with a friend and self manage.

38F - Cyclist v Car, mostly soft tissue injuy but the parkland authority would like her to be assessed and some of the swelling may of hid something else.

33M - Dislocated shoulder, has been waiting for the re-con surgery which is in three weeks, the joint is so buggered it pops out if the wind changes direction.

89M - Fall, lower leg skin tear. We transported for an Aged Care Assessment also.

96M - Had a fall but was uninjuried.

70M - Chest pain.


See you at the big One.

Taz

And now that Sydney has cooled down.

I get to go back to work.

Hardly worth it.

32F - Abdo pain, 400 metres from a large hospital, cancelled.
30F - GHB overdose as well as both her friends, we needed another car as two were GCS = 7.
57F - Lower pelvis pain, sudden onset and finds it difficult to walk.
22F - Tourist with an unmedicated elilepsy Hx of one seizure per year had it today.
93F - Vitacall alarm, cancelled en route.
88M - Suspect a NOF and it's usually there.
Assist another crew with a seizing pt.
51M - SOB, emphysema.

No lunch breaks and worked overtime to boot.

See you at the big One.

Taz

No stuff up's tonight.

While Queensland braces for a cat 5 cyclone Sydney swelters in the heat 30+ degrees at night.
I was stuffed just riding to work and the change room was a balmy 36 C meaning you just instantly sweated as soon as you got out of the shower.

We did some work but I forgot to write it down after shift as I am performing an acting station officer role for the next two rosters and after last night I had duties to perform and was just so wasted that I forgot, pure and simple.

The only major concern for me was the severe leg cramps I was suffering around 3AM, three weeks of not wearing footwear and now back into the heavy work boots. Some simple analgesia and slow stretches and a bit of a sit down with them up on the recliner chair and I got through.

I don't think that I'll put in for any O/t as I have an order for my books from the Paramedic Shop to complete and I can't let them run out as I appear to be the fourth most popular item in the store (per the list on their web page).



See you at the big One.

Taz

I was so off my game!

Patient treatment was alright.
After so many years you don't lose anything when on holiday but the rest of it!

29F - Post Ictal, epilepsy alert found in her bag and the bystanders had done a brilliant job of protecting her and keeping her dignity until we arrived. Transport for observation as she not only gets Tonic/Clonic but weekly partials.

30M - IP, homeless, aggressive, left with police no medical problems.

50F - The bus driver had to brake extra hard as some stupid pedestrians walked out in front of him and my pt fell badly on her coccyx. X-rays would be a good idea.

The we refuelled and our regular station had a broken diesel pump and after we found another open I picked up the wrong bowser and put 14 litres of unleaded into it.
It had to be towed to workshops where we collected a loan car and wasted two - three hours.

14F - Already breaching her bail conditions is found drunk in a park 200km from her home with some unusual goings on. Police came with us.

29M - Abdo pain, I don't think it was renal colic but he was crook.



See you at the big One.

Taz