Shift Hours.

In response to a question from NP Odyssey.
My hours are 7 to 7, 12 hours. We have day and a night shift so the roster is two days, two nights and then days off (5).
Not all ambulance services in Australia do this and not even every station in our state of New South Wales. Rural stations have their own rostering systems designed to cover their much different work load.

So while I'm here I may as well post about the last shift.

??F - Rang someone and told them she was going to commit suicide by a heroin OD. Half an hour later the Police and ourselves still hadn't found her. UTL

35M - In the Police cells obviously drug f*&ked and getting worse. Crystal Meth with heroin and the ride was getting more and more painful for him. He behaved himself and was pleasant to us and the Cops at all times so we're happy to transport and luckily the hospital were happy to give sedative to bring him down.

24M - IP, got king hit and reckons he doesn't know why. If the behaviour of his pissed Irish muppet friend was anything to go on I would think they got mouthy with the wrong people.
Spinal precautions because he's pissed and claims amnesia. Later after sobering up it was confirmed that alcohol was the only damage he sustained.

40M - Been off the grog for about a year and has been on a bender for four days. Walked out of triage for his own reasons.

28M - Claims to have been robbed after missing out on a bed in the homeless men's hostel but that was 5 hours ago. Why would he want an ambulance now? Because he's looking for a dry, warm waiting room. Our little hospital in the middle of the city does that real well.

43F - Post op transfer from hospital to air ambulance base for flight home.

See you at the big One.

Taz

A Flat out night shift.

55M - Known IP who lives in a park I cycle through to and from work. Seen to have a fall/stumble and it was called in. Real practised drunks bounce just like babies. He was uninjured and didn't want me interrupting his drinking time.

18F - IP fallen, minor lac to zygoma, swelling and epistaxis. Hospital glue should do the lac just fine and leave no scar.

45M - In the police cells. Giving false information to the police and he didn't give me the right details either. Thoracic muscular pain after it took three big cops to get him into the cell. Left in their care.

37M - Night manager of a backpackers who tried to step between two guys having a dust up. 25mm or an inch laceration to his zygoma but it was going to need stitches.

Three cars called to three different chief complaints at the one location for the same pt. We assisted the first car.

60M - Came to the notice of the police for what was just some bad luck and nothing illegal. They wanted a psychiatric schedule and he wasn't nuts just a different individual but I took him just to get him off the streets. I told him just this and that he could get a feed, hot drink, a bath and some fresh cloths at the hospital. He liked the sound of that.

18F x 2 - Assault of a sexual nature. Look I'll get hammered by the female and politically correct people, but wearing dresses that didn't cover their arse these two got goosed (fingered on the bum or genitalia usually from behind) on the dance floor of a place known as a meat market.

Yes everyone should have the right to go out and be safe, wouldn't that be a wonderful world but in reality you can cause a lot of your own harm from dress, behaviour and venue choice. You are responsible for you safety by your actions and bad shit will happen if your not careful. It's the way of the world.

Assist another car at a scene that had three brawl pts but only one needed transport.

20F - IP, blood alcohol reading of 0.23% transport for safety.

24M - States he banged his head on a door, not deep but long lac that will need some glue.

30M - Out from his group home for a night in the bright lights and action. Had a few drinks and then a vomit and is complaining to rail staff at the train station about his throat feeling burnt. Suggestions of a cup of coffee or such to wash the acid away fell on deaf ears he wanted to go to hospital.

27M - partial de-glove of medial left ankle post falling onto a terracotta pot while attempting to climb up to his apartment balcony after a night on the grog and forgetting his keys.

See you at the big One.

Taz

That's the way you do it!

And the rest of the post has nothing at all to do with Dire Straits.
A full on last day of the roster.

84F - Vertigo, distressed but none of it too bad. She was able to move around her apartment but did need the walls to steady herself. With all the obs good it was looking like the inner ear and she did want to see a Dr. We haven't rushed the job because there's no need so as we exit the building and make our way to the vehicle there appears a relative. Discussion,,,, 'Would it be better if I took her to her own Dr rather than you take her to the hospital?' What do you think we said?

62M - Anxiety over a strange sensation in his right hand! He has a Hx of some kind of stroke as he called it 6 yrs ago (numbness in finger tip pads of left hand was the only symptom and never resolved), the tingling on the right had resolved when we arrived and he didn't want to come with us but was going to see his LMO.

98M - Prostate CA, abdo pian and some cathater issues. Fragile cargo.

55M - VF arrest, witnessed, excellent CPR till we arrived, one shock asystole, run the drugs another shock or two we're at hospital,,,, today was his day die. We're sorry for the loss to his family and workmates, everyone did the very best they could but there comes a time.....

10M - Was playing a game called Stacks were the idea is to get one kid on the ground and then get as many kids as you can stack on top! It happened over an hour ago before he complained of neck and lower back pain. Spinal precautions and transport.

86F - Stood on a grape in the supermarket and from bystanders did a slipped on a banana peel fall, you know arms and legs spinning everywhere. C/o right midshaft thigh pain. No deformity she just can't straighten the leg out, sounds like a muscle tear or a ham string.

84M - Asystole arrest, again excellent CPR on our arrival but the drugs did nothing and we called it on scene.

74F - Parkinsons, stiffens up every now and then and can't walk any more. Today she was near enough to the couch to fall onto it and wait. Many hours later some one called and she was able to knock the handset off the phone and tell them to call an ambulance. Uninjured we were able to call family who came around. The normal carer was herself in hospital and the designated family member who was meant to be there hadn't arrived yet.

84F - Dementia sufferer who had wandered away from home. The police had found her but didn't know what to do as there was no record of her on any of the names or addresses she was giving them. Just as we're about to leave to take her to the hospital as this was a medical missing person a relative turned up.

And that's the way we did it!


See you at the big One.

Taz

The roster is nearly over.

Which really has nothing to do with the post, it just is.
Today is the second last day of the roster and tomorrow is the last and then I get a new partner.
But back to today,

76M - Has just completed today a three week ocean cruise and has slowly developed a very nasty chest infection.

13F - Cut her finger in art class, had a vaso vagal response and fainted and we got called even though the school had it's own RN (registered nurse) on duty. To dot the I's and cross the T's we transported.

34M - Industrial accident, turned out to be just a minor incident in the end. While cleaning a roller press his hand got caught and drawn into it. There is a 16mm gap between the two large rubber rollers and while nothing was broken and there was no motor/sensory deficit it's going to hurt like hell for the next week easy. Transport for workcover clearance.

74F - Simple mechanical fall and fell on her arse. She really just wanted someone to tell her it was OK to stay at home and self manage with rest and simple analgesia. After I had assessed her I agreed with her.

75F - Found very disorientated at a train station. We recognised a hypo straight away and commenced treatment but due to the fact she was alone we had to transport for pts safety.

29M - Felt odd and called an ambulance.
That's all I'm going to say about this job.
This is all it deserves.

Did I mention it's the last day of my roster tomorrow and I get a new partner after that?

See you at the big One.

Taz

I can't believe your still walking!

The Blood Alcohol Concentration limit for driving in Australia is 0.05 grams of alcohol per 100ml of blood. The calculation is similar in the US but I believe the limit is 0.08.

50M - Fallen in the street, maybe intoxicated. Take him to the special small hospital in the center of the city for the uninjured drunk person, to confirm that it is alcohol ask him to provide a breath sample,,,,,,,, 0.360%. Leave at hospital to sober up.

??F - Fallen on street, UTL.

56M - Seen by Police being lead off by a female person of ill repute who quickly disappeared as they approached. Remove him from the streets to the same hospital for the same reason. Provides a breath sample of,,,,, 0.392%

16M - Whom relatives say was threatening self harm, he denies it and has a good turn on the events of the evening but duty of care and of someone his age we have to transport.

60F - Thirsty and restless. Anxiety and depression, I've met her before. If it wasn't for her age and being at home, the way her mouth was smacking you'd swear she'd popped a pill (Ecstasy or MDMA). She could take oral fluids, had an appointment with her LMO in two day and there was no clinical reason to transport, after we had told her this she just said OK and went to bed leaving us in the lounge room to let ourselves out.

30F - Throwing the worst ever pseudo fit. My partner gave her a reality check and some good sound advise and we hailed a cab for her to leave the club she was outside of.

50M - I've got sore legs. IP and on the nod although he denies any opiate or such. Just a knob who later got kicked out of the hospital for just that, being a knob, in-operable.

16F - Anxiety attack and thinks she might be pregnant, why this becomes ambulance work at 5 am on the main drag in the city I don't know.

57F - Doing a good job of describing sciatica. She's never even heard of it.

I've got my parents arriving in a few days before they collect the caravan and continue their 'Grey Nomad' trek around Australia as well as a day of tutoring at the University of Tasmania's medical campus here in Sydney. They have very cleverly organised for Qualified Officers from ASNSW to be approached to provide tutoring on our days off as a secondary employment.
I also have a Traffic Offenders presentation.

No rest for the wicked.

See you at the big One.

Taz

Atmospheric Decontamination!

63M - Found by Police sitting on the ground after vomiting and falling out of his wheelchair. He's an above knee amputee, he's not a Vet he just got an infection that wasn't treated. They stopped to assist him back into the chair but his first word were 'call the Ambo's I've vomited'.

Denies any pain, alcohol, drugs or medical Hx just keeps telling me he thinks he needs to go to hospital to have this single vomit investigated. Everyone else on scene is standing upwind but I can't due to his position. The smell in unique, I'm shallow mouth breathing and the smell is still invading my olfactory nerve after smothering my taste buds. On the way to hospital my partner drives with her head out of the window.

I never let on how bad I found his stink, I do my basic obs and engage the pt in converstation to try and gain a better undertanding of how he got to this point in his life.

Some poor agency nurse gets the job of showering him and destroying the cloths and we leave all the doors open in the evening breeze for 30 minutes before spraying half a can of deodorizer inside.

Other work was,

54M - Abdo pain, he was a day shift crews pt and we took over to let them go home.

53M - Chest pain, not an MI more likely a conduction problem.

91F - Post treatment discharge to N/h.

19M - Minor head wounds, left in own care.

23F - Street dweller found asleep by Police, sometimes they call us to check them out, sometimes they just move them on.

69M - Self discharged against advise from the small hospital in the city and found again by Police disorientated at 4.00am in a McDonald's store, we returned him to the hospital.

82M - Transport to Airport for Air Ambulance flight home after successful draining of a sub-dural haemorrhage.

And that was the night shift for me on St Patricks Day!


See you at the big One.

Taz

Just a day at the offfice.

62F - Her first trip from home to dialysis, this is her fourth or fifth session the others were done from the hospital ward.

45F - Out for a run, uneven footpath, didn't tread well, probable ham string injury.

40F - Vomiting and diahorrea at work. Had taken a powdered zinc supplement not prescribed for her, guessed how much to take and was now paying the price. I didn't know much about zinc but my partner did. There are many different types for different treatments, overdose is easy if not prescribed and these symptoms ususally are the result. Pt being a bitch is not a usual symptom, it must have been an underlying condition.

72F - Deceased.

49F - At a conference felt ??? unwell stepped outside for some air. Was noticed by security to be behaving odd and we get called. We ended up as the third vehicle put on it, not lights and sirens. Nearly an hour later we arrive. Pt GCS = 15, sitting up, has had some O2 therapy, Sinus rythym c/o tingling or numbness in left arm, 'floaters' across the field of vision in the left eye and.......... about a six second pause and the pt asked what we had been talking about. During our time with the pt we noted similar events or episodes of aphasia/dysphasia so my money was on recurrent very localised TIA's.

91M - Fecal impaction. What can you do?
Well if he had been an Accountant you could have given him a pencil and he would have worked it out! Boom boom.

59M - SOB, Chest infection, a good one.


See you at the big One.

Taz

Saved a life.

44M - Job came down as a post ictal, known epileptic and IVDU with pinned pupils. Seeing as the 400mcg of IMI naloxone brought him up in less than five minutes it was drug OD not a fit. Somebody didn't share their hit.

20M - A tourist, at a cafe, the staff called because he seemed disorientated,,,, I'm still not sure why but we left him there.

35F - Known anaphylactic reaction to a bee sting aged nine. Stung by a wasp today, I could hear the stridor in the backyard as I stepped onto the property. Adrenaline is a good drug.

84M - Six minute LOC, GCS = 5 (1,1,3), 40 bpm, 10 RR, clammy, cold, central pulse only. Sinus rhythm, O2, posture and a very slow increase in GSC and eventual measurable BP. No pain, SOB or ECG changes. Conservative treatment and transport for further tests and assessment.

93F - Wrongly discharged from hospital to her nursing home, we are now returning her to complete her rehab under full care there.

See you at the big One.

Taz

Shift Swap.

I had the wedding of my ol' flatmate and friend Hayley in January and had to get some shift swaps so I could attend. One I was owed from like five years ago and I was getting some lame excuses and dodging from others and had to get a new one that I paid back this weekend.

89M - Nursing home ?? Pneumonia, hot, crackling chest at least he was still conscious and with it.

61F - Syncope, carrying that much weight around you'd expect the pump to have occasional trouble getting blood to the important parts.

65F - Fall, mechanical on a bad footpath.

50M - Test riding a motor cycle and stacked it. No injuries and he didn't like my suggestion, 'You broke it, You bought it!'

65M - Transfer from LMO to hospital for follow up on chest pain. The defib didn't have the chest leads so I lacked serial prints and only had the LMO's copy that really showed nothing. My gut said it was cardiac but not ischaemia and to disregard the ST elevation I could see in the three lead. Treatment en route didn't change. Five hours later we were back at this hospital, pericardial effusion. Go gut!

68F - Hosp - Hosp, for review of suitability for transplant.

37M - Back pain that now had a presentation of numbness of the thigh, he could still walk ok just numb. Why call and ambulance, because they're soft co@ks.

No meal breaks and half an hour O/t.

See you at the big One.

Taz

My partner rang in sick.

So I travelled to the next station to work for the first time with a classmate of mine who has continued to the Intensive Care Paramedic level. This doesn't mean that we got better work!

19M - Motor cyclist V Car. Lucky boy a very minor knee injury.

63M - Falls, assist another crew only.

39M- Official diagnosis WANKER and drug user. He didn't want us so we told his under the thumb G/f to call if needed.

38M - IP++++ who lost the fight to hold up a bus stop sign and fell asleep on the ground. We just got him of the street and out of the public eye.

23F - IP++++ same as above.

54F - Post ictal but by herself in the Casino so transported for her safety.

18F - Abdo pain, also at the Casino but three hours later. I'm going down the FAS path.

The last job came in late and this turned into a 15 hr shift.

See you at the big One.

Taz

Take two and call your Dr in the morning.

That was the only drug I gave out tonight.

62M - Transfer from medical centre to hospital. It's a 90 second drive if the three sets of traffic lights are green so I didn't have time to do anything and the Dr had initiated treatment for the rapid AF.

56M - Near syncope, he had stacked his pushbike earlier in the day and fracture his clavicle. Discharge from hospital where he had self presented, with a referral to the fracture clinic in a few days. At home he had tried to put on some different cloths and the movement caused pain that caused him to nearly faint and the family panicked. Left them some pacacetamol and ibuprofen.

54F - Basically a panic attack. While we're there we discuss meds and find she's not been compliant and it appears to be from a lack of instruction and understanding of what the meds are for, so now we educate her and then when we're happy leave her to go and see her LMO tomorrow for more help.

40F - Fell on her back during a drunken slow motion tussle with another street dweller over a blanket. There was no deformity or break in the skin but she wanted a sling to show everyone else that 'see I'm injured' and we left her because she didn't want to got to hospital.

68M - Walking up the stairs from the toilet without the light on and took a miss step and a tumble. Just a few minor skin tears that I dressed and left instructions for care and left at home.

32F - 13 weeks gestation and it appears to be a miscarriage.

24F - Sexual assault or that's what the job came down as. It turns out she had just lost her wallet and wanted the police for that?????

32M - Anxiety/chest pain. Nice dude so I took him for a checkup but none of us thought it could have really been cardiac related.



See you at the big One.

Taz

Suicide Monday never came.

That's what some call it, the Monday after a BIG weekend of partying and that's what Mardi Gras is about.
So Monday, the parties have stopped and the drugs are wearing off and the high is crashing. Usual to expect an increase in drug related calls and depression but it just didn't seem to manifest this year. This may have had something to do with the 3 litres of GHB (Gamma-hydroxybutyrate) seized by Police the night before the Mardi Gras Parade as well as the heightened police presence in the City.

After waiting nearly three!!!!! hours for our first job, and I jump another crew for it, our day was like this,

81F - May have ascites but she wanted to go to hospital rather than seeing her own Dr.

51M - PR bleed and found it difficult to stand??? maybe the lack of blood inside your veins and arteries .

66M - Started a new medication TWO WEEKS ago and called today because his feet felt cold (in 25 degree Celsius), his family thought it may have been a reaction to the meds??? but he was better when we arrived after he had laid down for awhile. They had even spoken to his Dr who still said get the ambulance. After reviewing all the numerous facts and using sound clinical knowledge we left him at home.

51M - Chest pain, in Police custody! you know this has quality written all over it but!
Indigenous background, well documented to be prone to cardiac problems.
Diabetic, type 2 and well controlled per him.
Has had a triple bypass, 6 yrs ago.
3 Lead showed nothing and right there and then he was much too emotional with the police (he wasn't a bad crook but he had broken several laws and was going to be going to see the judge for them) in the cells it just wasn't going to be useful to get a 12 lead.
Out in the car with him calming down there was some elevation in the septal leads but nothing else. We had already started basic cardiac care with O2, aspirin & nitrate for the 5/10 pain reducing with treatment and en route we left it at that with two more ECGs. Hx from Pt was that he also had further partial occluded vessels but until he gave up smoking surgery wouldn't happen. Anxiety, that was my diagnosis, yes underlying cardiac Hx but he wasn't having an arrest, he was having a good old plain panic attack and with my new authorised 12 lead ability I can justify it.

66F - Fell backwards of a ladder in a shop bruises on the central spine. Nil motor loss but some 'tingling' in the lower legs. Collar, transport.

And that was the end of the day, five jobs and we still didn't get an official meal break with delays in the hospitals.



See you at the big One.

Taz

And now the cleanup begins.

But that was it, there had been so many extra crews in the city the night before there was no cleanup work post Mardi Gras.

30M - Asleep outside the motel he was staying in. Well he got that far we woke him up and pushed him in the door.

31M - Had just arrived in the country yesterday and goes out on the turps straight away. Woke up on a beach with a glass beside him, takes it down to the waters edge to wash it????? it breaks and nearly cuts off the pads on the palm of his hand, needs stitches.

58M - Walked into the cop shop and they thought he was mad. I know he was. GCS = 13 from the wildly inappropriate language, ranting on about sexual deviation, habits and desires, aliens, space travel, computers buried underground that monitor computers above ground complete gibberish.

13M - Stacked his bike, wearing a helmet, abrasions and two minor lacs. Dad was going to transport himself after we assessed.

52F - J walking between intersections and tripped on the medium strip. Upper arm pain, severe. Tried to sling, lots of analgesia and xray showed a fractured humerus and dislocated shoulder.

19M - Sharp, severe pulling pain of testicles. No joking he has a family Hx of torsion so he needs to be assessed.

82M - Groin pain, was flank pain yesterday,,,,, Renal colic's my bet!

89F - Skin tear on her shin that I couldn't bring the skin back together on and I think she is non compliant with her meds that she needs an aged care assessment.

88M - Police called us for threatening behaviour and wanted to schedule him but I think there is something more medical behind this so I took him to the ED.

See you at the big One.

Taz

Mardi Gras!

So after dropping it on facebook (I'm not a regular user) the messages started coming in.
The Ambulance Service Acting CEO was also in the parade with us so I didn't flash or moon anyone.
I restrained my usual dress for the night which would have included rainbow sequined epaulettes, rainbow colour hair piece and a very large purple pimp hat. I had just the hair piece in.

Lots of hurry up and wait ant this is a bit of what it looked like.

That's me walking along at the rear of the ambulance section as we start to walk up Oxford Street.





See you at the big one


Taz

Are you doing anything special for the weekend?

I am!

I'm marching in the Sydney Gay & Lesbian Mardi Gras!!!!!!!!!!!!!!!!!!!!!!

As an equal opportunity employer ASNSW is supporting the parade by allowing members who are not heterosexual to participate in uniform as well as allowing other staff who support them to as well.

There'll be no leather chaps or baby oil but a lot of love and respect for all our friends and workmates.

I came from Australia's largest country town,,,, Tasmania (as a born and bred Tasmanian I'm allowed to say that) so while the sexual revolution was very mild in Tassie the change I was exposed to here in Sydney was possibly mind blowing.

But they're just my mates, my really, really good friends, people who allow me to hug and kiss them whether they have boobs or not.

So as I'm not able to work either as a normal crew or as special events coverage I can participate still.

Wave if your there and shout Taz!!!!!! or watch online or cable.
I'll try to get some photo's from inside the parade.


See you at the big One.

Taz

The chain dragged last night too.

9mthM - Accident in a restaurant with soup. The parents said it went over his leg and arm but stuffed if we could see anything. So then they're wanting to know why he won't calm, we explained that at his age if some had splashed on him it would be most likely the worst pain he had experienced in his very short life. My partner and I aren't parents and this wasn't their first child but here we are explaining early childhood learning and development. They took him home to self manage.

81F - NSTEMI being flown in on air ambulance and we took on to the hospital.

41F - Had felt a few palpitations, a sharp pain left side that stopped and a little dizzy. All obs normal but with regular PVCs say every 10 beats. We see PVCs on ECGs all the time but usually in the aged, with a cardiac Hx or much less frequent. Tx of pt and up sell at the hospital because they role their eyes when you get all excited as a newbie by a PVC but clinical decision makes this a possible acute danger if the PVCs start and don't stop.

73F - The only pt to get serious drugs tonight. Had a fall in the house and we suspected a NOF and wrist fracture. Confirmed as such later.

32M - Hyperactive, just starting the psychotic slippery slide from methamphetamines. I have seen him before and he can be entertaining in a very dark and sick way for us, but he's going to also become a drain unless immigration give him back his passport and he returns to Ireland.

And that is the completion of this current block of shifts.

See you at the big One.

Taz

One sick pt for the shift.

The night started off grand with a police special 3 for 1.
There'd been a big brawl and the local cells were full and these three likely lads had been transferred to our local nick for processing and decontamination.
Two and a half cans of capsicum spray and they had been about to set the dog on them before they had complied with police instructions.
Just drunk tourists.

73M - SOB. While with a history of asthma the presentation was not normal and we discovered that he also suffered with a very large hiatus hernia that allowed a large portion of the stomach to shift into the chest cavity and therefore also impede respiration.

35M - Police called, second fight he had been in tonight and with minor head lac and a resolved epistaxis they were eager to haul him off for a reservation at the custody cells.

34M - In custody, asks for an ambulance for stomach craps. It's a common call as I'm sure it is with other EMS from around the world. When asked if there was any reason for the craps (trauma, previous Hx, etc)' Oh yea' he says, 'I'm really hungry and they won't buy me any more food'. To his credit he was offering his own money but he wanted the police to cease their duties and buy him a midnight snack. I got very close to the concrete speech (toughen the f#*k up), we left him with the police who confirmed they wouldn't be calling us back.

??F - Self harm, problem was what was her location? With the cops at one and us at another before we both drove to a third, our attendance was cancelled until they found her.

27M - Man Flu His mummy, who had driven to his apartment at 5 o'clock in the morning was going to drive him to a hospital closer to where she lived.


See you at the big One.

Taz