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09 November 2011

The Wife said 'You always get good work on an extra shift!"

And there was, an interesting medical case, an OD/Cardiac Arrest that was philosophically discussed later, and the very first long term deceased my partner has ever seen and this was discussed by us afterwards also.

50M - Decreased movement. I know this person on a casual basis and I could see the unsteady gait. In the last 10/24s increased numbness/altered sensation in peripheries, vertigo and ataxia. No trauma current or past, no drugs or abnormal occurrences, no current or recent illness! Even more interesting was 12/24s later the symptoms were progressing!!!!
87M - Angina pain. Feels just like his last episode (10yrs ago) when they gave him 5 grafts. Started about 4hrs ago but has nearly gone now. The wife made him ring, God Love Her. I think he was due for a check-up and this was a warning sign plus they never gave him any nitrates for emergencies.
2F - 2/52 Hx of respiratory illness not responding to pharmacology's and still quite unwell.
78F - Know trauma under treatment but pain management has gone out the window today.
29M - Opiate overdose suspected leading to cardiac arrest. No shock just O2, CPR and Narc with Adrenaline resuscitated the body but here's where the philosophy comes into it.

A young fit ready to live body was probably always going to respond very favourably to our treatment. But what of the brain. Our clinical pathways have been developed further to provide times researched from evidence based best practise to signpost when we may consider not starting (example;15/60 asystole with no CPR prior to our arrival). We arrived well inside this but how long had he been down before discovery?
Everything we did was correct and textbook and generally what is believed to be in the pts best interests and nothing in it would I change but it makes you think?

90F - A beautiful person with a loving family who needed all the TLC I could muster and it was my pleasure.
73M - Found outside on a footpath unable to stand or walk but appearing to make sense in conversation (there was a language barrier) no wallet or other ID and then I find the chocolates in one jacket pocket and the sugar cubes in the other?! A Hypo, easy to fix, contacted the wife (they did live at this address {every noticed that, how many hypos almost get home}) and release him to her care after we get the BGL up.
??M - Deceased. There was no need of us to enter the room. It was obvious from the hallway downstairs but my partner had never encountered this type of incident and there were resources rushing to help us if I didn't call them off. I'm sorry that a person that I didn't know has past away but is a common part of our job and one that must be dealt with professionally. Disturb the scene as little as possible and tell the Police what you did touch. When you can handover to the Police get away from there and discuss it with your partner. None of us are invincible to the constant exposure to what we see and this one may be what breaks the camels back if not managed properly. Most services have either Peer Support or Counselling services, use them because we need you out here with us.
83M - DVT, after getting unloaded well all day this the last one of the shift cocked us up, 2 1/2 hours overtime on the last job.

See you at the big One.


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