I'll be on holiday's!

For the next three weeks so posts may be few and far,,,, or not!

77F - Possible prosthetic hip dislocation.

55M - Who needs a debt consolidation service and social work but not an ambulance. Poor use of resource by area health workers who couldn't understand him over the phone so sent us to do their work. We got some phone numbers of available services like the Salvation Army and AngliCare.

63M - Witnessed arrest (VF) in the airport, first responders straight away on scene doing good CPR, had an AED and had delivered 6 shocks. We ran our entire protocol and then some for over an hour and transported but it was called at hospital. Good job well run and managed by all.

21F - IP, nice and polite.

32M - Opiate OD, took 1.6mg of Naloxone and agreed to come to hospital for an hour of observation but agreeing inside and actually getting in the vehicle turned out to be two different things. He totally understood the dangers of dropping off again but refused to come with us.
You can lead a horse to water,,,,,,,

14/12F - Febrile and not responding all that well to antipyretics.

And a thank you to Lauren and Anon for their contributions on Calls for Answers from the Floor on that ECG. In hindsight I think it was the BBB or may be a chemical imbalance but I'm waiting on the hospital to get back to me.

See you at the big One.

Taz

Nothing of interest in this lot.

30F - Syncope.
68F - Dizzy.
33M - Claims to be post ictal.
41M - In Police custody, the usual sore wrists and nausea.
41M - MVA, no injuries.
55F - Frequent flyer left at home.
78F - SOB, probable UTI.
04F - May have been an allergic reaction.

And this took us 13.5hrs to complete.

See you at the big One.

Taz

14 hr Day Shift sucks!

It took two hours before we got our first job but it was worth the wait.

61M - STEMI, had the pain for 15 minutes, we spent 5 minutes on scene and we were in the cath lab 15 minutes later.

50F Unwell at the hairdressers,,,,,, we weren't needed.

56F Back pain, chronic.

73F - Stroke way outside the window for treatment.

27F - Period pain, we didn't rush to the vehicle and she had rung back and cancelled.

43F - Complicated issues dealing with several deaths in the family and depression.

70F - Syncopy.

See you at the big One.

Taz

Call for answers from the floor.

Yeah I said answers!

Check back to the posts on the 15th Aug re a 45M without major symptoms but coming up with STEMI criteria and then the next post where he was discharged 7hrs later.

Nausea, vomiting and EXTREME lethargy were his symptoms.
No pain, chest or otherwise, no drugs or alcohol.
PMHx septicaemia 2/52 ago from lymphoma?

Here are the sanitised (identification removed) 12 leads I captured.




I have forwarded a request to the Director of Medicine at the A&E as well as one of my educators but what do you reckon??


See you at the big One.

Taz

They were all ladies.

Our pt's,,, even the last one, he really was a bit of a girl.

65F - Post ictal, known epileptic, normal to suffer multiple daily seizures, transported.

16F - IP, fell asleep in a internet cafe. Able to walk but not much else. Transport to sober up.

53F - I know this pt, notorious alcoholic who used to give us grief but has been off the drink for three years. Falling off the wagon right now but the runs are on the board, she's done it once, she can do it again and do it for longer. Booze is harder than illicit drugs because it's socially accepted.

78F - Fell in the bath about 8 hrs ago but the pain is getting to bad. Still refuse analgesia during transport.

25F - IP, had got back to her hotel but had somehow made it into the staff cafeteria and made herself comfortable there before found. They were concerned but I'm happy that she has just had a very lucky escape after way too much booze and that it's OK to stuck her in to bed and leave her there.

25F - IP somehow has given herself a small scalp lac, nothing in it but you should have seen the crocodile tears when the family turned up to collect her.

31M - Seen earlier in the night at the ED for an ankle sprain and was given some analgesia with codeine and it looks like he's having a bad trip on it (hyper sensitive) he thinks he's having a cardiac issue. He wanted transport even after it was all explained to him.

I'd been feeling like shit all shift, gut ache, mild fever but at 0600 it was 9 degrees C or 48F and I have a temp of 38.7C (101.7F). I'm taking paracetamol but I'm still sick and have only had one sick day in the 8yrs on the job. I pull through to knock off time and crash in the recliners in the muster room. One of the day crews offer/insist to drive me and the bike home. I dive straight into bed and sleep hot and solid.

Feeling better now, I don't stay sick very long.



See you at the big One.

Taz

Nothing Cardiac tonight.

Nothing real that is.

58M - Taxi driver hit on the right front corner (45 degree) c/o scapula and thoracic/cervical pain without any motor/sensory deficit.

19F - Post MVC (about an hour ago) while loading the car onto a flatbed the pt mentioned that she had had a headache. Not that it was a bad one or that it was unexpected or a surprise. The tow truck operator called us. I came, I talked, we discussed like adults, she went home for some simple analgesia and TLC from Mum.

52M - You know this job is wrong, chest pain but we have to chase the pt to several locations before he can commence his woeful acting. I can't leave you if you ask for transport but,
You can pass Triage,
You can collect a category of 7,
You can wait in the waiting room.

95M - A simple mechanical fall resulting in some skin tears. Dressed there at home and discussed with daughter LMO seeing the pt later today and arranging home wound care nurses. Great outcome and put back to bed.

31M - HT, anxiety, alcoholism.

30M - GHB dystonia. Nothing really that the hospital will do, his GCS is 15 he just has really annoying twitching,,,,,,, well don't do the drug if you can't hack the side effect.

See you at the big One.

Taz

Another STEMI!

And this one went to the cath lab after they had checked my diagnosis or rather the 12 lead my Lifepak had done.

I have to follow up the one from last night because despite my 12 lead showing a STEMI and the hospitals also indicating it he was released 7 hrs later and I want to know what it really was.

69M - 4/7 vomiting and diarrhoea.

85M - A neighbour was concerned for him. He lives cluttered and dirty but he knows that. It's his lifestyle choice. Left at home.

86F - SOB, chronic.

??F - Unknown problem from an unregistered mobile phone. The address given turned up nothing. UTL.

44F - Abdo pain and it wasn't period related, sounds like her appendix.

48F - Absolutely no cardiac Hx, slim and health and a classic Inferior Infarct.

27M - Found in a car unconscious from opiates.
21F - Found in a car unconscious from opiates.
Yes the same car that had a baby in the back seat in a capsule. Thankfully they had some sense to park before they shot up. We transported for Obs and both the Police and I called Child Protection Services.

See you at the big One.

Taz

3 over 80, 3 under 50, nearly.

That's the ages of the pts today if you didn't guess.

83M - From Hospital to air ambulance for a flight home.
89F - Decreased mobility.
85M - Had a slow soft fall and needed a hand up. Left at home.

51F - Infected tooth socket and can't keep the oral AB's down.
40M - Gastro that's shown no signs of letting up after three days.

45M - That terror job 30 minutes from knock off,,,, Anteroseptal STEMI with no symptom but lethargy and nausea.

See you at the big One.

Taz

What did I do on my birthday.

Seems to be a big question on anybodies lips when they find out it's yours.

I had a surprise birthday for my 30th, but I knew about it. I didn't spoil it for the wife (first one) who had organised it and acted very surprised with the whole event.

I got a low key event for my formal coming of age at 18

I think that 16 was the big one for me, don't know why.

So after I had a sleep after the wasted night shift, I woke to find Ambowife had returned home so I set too opening my present

Read the card first!

Then get into the box!


Try on the present, yes just a pair of slippers



Blow out the candle and don't forget to lick the chocolate of the bottom of the novelty candle.


My special day in pictures.



See you at the big One.

Taz

It'll be my birthday when I finish.

So unlike most who might of wished for a slow night so that they could rest ready to celebrate during the day.
My latest birthday is less important than the life I may save so you as a regular reader should know what I was wishing for.

Didn't happen!

86F - Rehab hospital to ED with rapid AF.

26F - A piss poor OD attempt but needs help.

86M - Left arm and chest wall pain.

31M - Air Ambulance to a small speciality hospital for surgery.

And that was it.

I must make note of the night crews and on-coming day crews who found out by a social networking site that it was indeed my birthday and over the intercom sang me Happy Birthday from our vehicle plant room while I was finishing off our paperwork in the Muster Room.
Thank you guys, an extra special one next year with my half tonne milestone and there will be a party.

See you at the big One.

Taz

Cool nights and little work.

90F - Prosthetic hip and this is the seventh dislocation.

84F - C/o thigh pain but there seem to be a few social issues involved.

44M - Got punched in the mouth and was making a statement at the Cop Shop and they called us to have a look. Nothing much in it, he'll complete his statement and make his own way to the ED for a clean out and stitch.

42M - Vomiting, interstate visitors without much resources in a motel so I gave him some anti emetics and transport for fluids and maybe some tests.

79F - Discharge from hospital post a pacemaker to the air ambulance base for a flight home.



See you at the big One.

Taz

Sunday slowed a little.

There was a lull in the early afternoon that was the problem.

35M - From a small to large hospital for some surgery.

84F - Syncope in church. Has done it before offered a trip to hospital and she accepted, kept the husband happy.

89F - Nursing home thought it was a stroke, I'm going for the UTI as there was no weakness, no Hx of TIA's and there was mild fever.

26F - Another biking accident, clipped the rear wheel of her hubbies bike and stacked it. There was a 'Fun Run' on so there were St Johnnies everywhere and god bless them she was splinted and packaged ready for us to collect with her ?# R radius.

Update on 48M with #clavicle from yesterday, saw him this morning and was waiting surgical review with imaging showing a nasty # of the scapula also but no neuro symptoms or concussion all from wearing a helmet.

30F - # R Wrist playing soccer.

MVA - UTL, even reading the notes it sounded like a hoax.

33M - IP and didn't quite make it to the train station or the taxi rank. Very nice and polite regular upstanding member of the general public who has just got caught out by the booze.

58M - 3/52 flu like symptoms, LMO gave a course of AB's with moderate success but return of major symptoms temp of 40 C (104.0F) 2/7 ago. Med Hx, type 2 diabetes, 1 x bypass and mitral valve replacement 3 yrs ago. Has had uncontrolled hiccups for the last 8/24! I'd like to follow up on this one.

And that was it.



See you at the big One.

Taz

Now it's work coming out the Whazoo!

Change in the roster first I'm teamed up again with my partner from the last shift for three weeks.

74M - One of our regular dialysis pts. We're late and he's going to be pissed off. We get called of for a higher priority just short of his address.
25M - Fell off his skateboard and cut his head open. Bleeding had stopped and in looked like a simple scalp wound that he didn't want to got to hospital for. He's decision.
38M - Agrivated a known back issue five weeks ago. Has been doing everything he can with specialist appointments, physio but it's now included a numb foot so off we go with the only analgesia I'll give for the whole shift, not for the lack of trying.
45M - Been bite by a human. Called off for a higher priority.
Unconscious M at the train station. As we arrived on the platform he was pointed out to us getting on the train. Not so unconscious.
81M - Assist off the floor with no injuries. Can stay at home.
84F - Sat down on a wall to rest a little on her daily walk and enjoy the warm weather we're having and somebody called an ambulance for her. She didn't want one! She didn't need one!
6M - At home with an epistaxis. As we pulled up out the front they decided that an ambulance was not needed.
49M - Unconscious in a park. IP woke up with gentle urging from me and we gave him a lift to his hostel.
81M - Hospital to Hospital transfer with foot cellulitis.
84F from a hostel to a hospital with bilateral lower leg cellulitis.
48M - A fellow cyclist who was involved in a multi-bike stack. # clavicle.

My partner was starting to wilt with three hours to go.

See you at the big One.

Taz

And the next shift no emergency work.

61M - Very hot cafe, uncomfortably hot, eating, describes a faint, witnesses describe a seizure but pt isn't post ictal with GCS = 15, luckily from him I diagnose a cafe syncope rather than it being an epileptic seizure but we transport for obs and I explain to my junior partner what the difference is.

47M - Been drinking all day and decides to driver around and see the Ex. Cops become involved and he shoots off his mouth and talks about suicide and we all have to go to hospital because you can't take back those words once said. Depressed drunk with a suicidal Hx at a hospital that's not coping with the number of ordinary sick people already.

28F - Drank a little too much which opens up a dark place that she normally hides and she picks up a knife and opens up a goodly portion of her anterior forearm. Just down to the adipose no vascular injury or tendon but needs surgical closure and some counselling.

And that was the night.

I have one of my Traffic Offender Intervention Program presentations to do on the days off.

I've also worked out a way to bind my patient question books with wire combs without having to incur the expense of re-tooling and intend to produce some of those as the national conference of Paramedics Australasia is being held in Sydney in October and and as my book is still their shops highest selling text book (what a wanker) I better have some on hand.

There are also episodes of Combat Hospital, Dr Who, Torchwood, Eureka and several other TV show to watch online during the days off.


See you at the big One.

Taz

Two Emergency Jobs from Nine!

So my partner for the next two shifts only, doesn't show and that leaves me single and shafted away to another sector and station for the shift.
No biggy I know the area and my new partner's a cool dude and we worked well.

36F - C/o URQ abdo pain to good Samaritans in a hotel. Claims 20 x vomits and diarrhoea. Recent release from a correctional facility (still in prison greens) admits to meth use today. You know when someone's trying to convince you that their crazy and do odd stuff but check every now and then to make sure your watching? She didn't. After discussing with me the angels I see and the darkness I live near and Satan moving around the shore she was too busy talking to a spot 5 foot in front and 2 foot off the ground to notice any of us.

81F - A happy dementia pt lives at home with Hubby. Now for some reason or maybe none really she took her nightly tablets and then took his! There was nothing nasty in his meds and it was only one tablet, after a quick consultation with Poison Information I was happy for them to stay in the comfort of their own home.

53M - From a group home being discharged from hospital after a fall.
88F - Discharge back to her nursing home after treatment for skin tears.

46M - Conscious VT! His only medical condition is this busted heart, CABgs x 4, stents x 3, tricuspid and mitral valve surgery and now a random arrhythmia.

29M - Confirmed LOC by his words 'I woke up wondering how I got in the gutter' from a brawl but people are allowed after displaying competency and capacity (to receive, believe, retain and explain) to make bad decisions and while no obvious signs of injury were there that's why they need the imaging and neuro obs.

28M - A different brawl, right sided minor facial injuries.

28M - Same brawl as above, right sided minor facial injuries and concussion symptoms.

74M - Type one diabetic who's OD'd (accidentally) on his insulin, after I'd pumped enough sugar into him to make a dentist's convention proud & we got his GCS back I explained that while being at home with his lovely wife to watch over him would normally be acceptable after a simple hypo his was nothing like simple and would need to come to hospital to be observed and managed. Our range of treatment for diabetic emergencies is under 4.0mmol/L or over 17.0mmol/L, he was 1.5 on our arrival and the best I got was 2.2.
And that made him my second true emergency for the shift.



See you at the big One.

Taz