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29 February 2012

My 1st Fishing Lure Patient.

48M - With just that a large lure connected to the tri barbed hook that was embedded in his index finger. Being an experienced fisherman he had tried to pull it out but it was in too deep and the barb was doing it's job. Transport to the Hand hospital for removal.
54M - Quadriplegic who does not have complete paralysis who needed his legs straightened after an episode of cramping. His carer only comes during the day and we do the rest of the time.
26M - Claims to have taken Methamphetamines (very poor quality if he did) and is pinging, looks more like a three toed sloth. There is no real doubt that he has been doing illicit drugs but he has also been presenting by himself or with various crews during the night at hospitals and being a serial pest. This I don't know until I take him in and get a serve from triage.
31F - A localised reaction that may have been an envenomation from ??? a spider. No airway involvement and anti histamines not really working.
65M - Worker on a construction site, a piece of machinery rolled and he ran but something hit him on the head. That's the story from him, nobody saw it there was no LOC or other pain just a minor lac that would need closing and the Workcover paperwork completed by the Foreman.
89F - Heat Stress, the couple of GTN sprays she took for what sounded like a muscle twinge didn't help either. Cooling helped and she went on her way.
13M - Dislocated shoulder during school sports.
26M - Motor Scooter rider who went over the bonnet of a turning car, two grazes and that was it. Very lucky. 

Be Excellent to Each Other and See You at the Big One!


27 February 2012

First Day of the new semester

 I'm having a crack at the degree again by distance education from UTAS. There are others from my station doing it also and the plan is to help each other out and conduct study groups to assist. Time will tell.

32F - Disorientated, there was something going on with this lady appears to normally be a high functioning individual but everything is a jumble for the last 48hrs and there is no alcohol or drugs involved.
19F - Had a dizzy spell on the train. Decided to have her Aunty collect her and take to a Dr, I'm Ok with that.
55M - Near syncope episode at work, shit BP, pale, clammy, vomits no chest pain and has had an artificial aortic valve op over 10yrs ago. Tx
81F - Had a minor fall at home and just needed a lift.
Naked female in carpark - As any serving Ambo will tell you, there is never good looking nude in our game! Thankfully Unable to locate
88F - Had a minor fall at home and just needed a lift also.
52M - Post ictal or something like it, he has a huge neuro Hx and his social worker had found him at home acting inappropriately.
21F - Just found out she's pregnant and the father wants to get ride of it but her family will support her decision and she doesn't know what to do and it's all to hard and she wants to just wind the clock back four weeks and to many pills are not the answer.
My son in in fact my stepson, his mother raised him as a single Mum we didn't become a family and live together until he was mid teens. It was hard for her but she would have never aborted him and that was her decision. Hopefully this young lady can make one that she can live with.  

Be Excellent to Each Other and See You at the Big One!


26 February 2012

Syncope and Fractures

That seemed to dominate the meager work tonight.
57M - Witnessed pre-syncope at a men's hostel and still pale when we arrived. They thought it may have been a seizure but described a perfect pre-syncope event and the BP under 80sys helped. Basic Rx with posture and O2 for investigation.
60F - Suffered an episode of near to fainting but was all better when we arrived. Left at home as per her wish.
29F - Hx of Tachycardia and generalised weakness but so far it's idiopathic.
38M - Up a tall ladder on a job site and fell but caught his leg in the rungs and dislocated/fractured it before contact with the ground. Loads of analgesia before we could move without too much pain. While I'm not allowed to show you his x-ray even if he gave me permission, which he did but I declined, there are so many on the net I just looked through them till I found one the was almost a perfect match.

  There are all kinds of images must look there more often to see if there is an x-ray to demonstrate my posting.
52M - Who had fallen 5m wacking a concrete ledge on the way down. Good sized lac and it appeared depressed but it was the last job and I've been on days off so never did get to follow that one up.

Looks like hot and wet weather coming in.

Be Excellent to Each Other and See You at the Big One!


22 February 2012

A night of mixed fortunes.

87F - C/o hip pain but without the usual #NOF tell tales. Treat it as such and take her in for an x-ray.
17M - Neck laceration post suicide attempt. We arrive just as the note from the Police does on the MDT telling us the pts Mum has driven him to hospital.
90F - Skin tears post mechanical fall. Cleaned and dressed them in preparation to leave her at home to see her LMO tomorrow but a few minor social and health issues have scared her and she requests Tx for assessment for possible placement in assisted care.
28F - Intoxicated Anxiety. Sad a young couple who are chronic alcoholics, bouncing off each other with anxiety issues that steadily build and build until they have talked themselves up into needing an Ambulance.
They got me, both of them knew me from random previous incidents (they look familiar but). Give them the good news that neither of them are going to die. Then separate them and we talk to them individually reassuring them and doing basic obs to confirm their ok and then bring them back into the same room and they're normal again and really sorry to have called and happy to stay where they are at home. I only wrote her up as he was just collateral.
31F - Sudden onset of severe headache not responding to recommended simple analgesia for the last 7hrs. No trauma, BP normal, no motor/sensory deficit, no Hx a very clear story of events leading up to presentation and had been doing everything you could ask of a pt to self manage. 7.5mg of Morphine got it down to a 2/10 pain from a 10/10.
63M - Going home by Air Ambulance post op.

Be Excellent to Each Other and See You at the Big One!


20 February 2012

International Pts today.

84M - American with APO/chest infection, in fact his chest sounded that bad probably both. Didn't talk much to him, Da! but to his traveling companion and personal physician was very impressed with our kit and Rx.
68M - # wrist, confirmed by the Dr on the cruise boat he is traveling around the world on. Ortho consult.
25F - Way too much to drink on her Hen's night and her stomach is all spasmed out from vomiting. It was self inflicted but she had been trying to self manage for 7hrs before the Hubby to be called us because they're from out of town and didn't know where the hospitals were.
55M - A very lucky man. Sitting at the lights when (we believe) a BMW slammed into the back of his car at approx 60kph without braking because the drive was having a Hypo. Precaution on everything due to the mechanism but our guy was basically uninjured.
43M - Developmentally delayed pt who likes to travel on trains but can't find his way home. Knows the drill when lost approaches Police or Rail Cops and asks for an Ambulance to help him. Has a card with the name and details of the group home he lives in. Now they're an hour drive away, none of us are taking him home as that reduces the area responses so he'll have to go wait in the hospital waiting room. It has a TV, he's happy.
74F - It's a warm day and this pt got up after 20 minutes on a Bus and felt dizzy? Totally asymptomatic on our arrival and left after a basic exam to sit in a theatre and watch a show.
38M - Intellectual problems Hx this pt got angry with nobody it appears and smashed an empty bottle on his own forehead and then at hospital cut up proper with staff and other pts and was ejected. The head would heal but with him fussing with it it may take awhile and leave a minor blood trail.
21/12M - with Mum in the toy store and had a fall onto a display case. 10-15mm cut right in the middle of the forehead, no LOC, much more interested in Thomas the Tank than us. A good job for glue just we don't carry it. I think this was his first 'major' injury because Mum was a bit shocked still when we arrived. played happy all the way to the children's ED. 

Be Excellent to Each Other and See You at the Big One!


18 February 2012

Three days of riding and back to work.

1st Day - 60km
2nd Day - 50km
3rd Day - 50km
My arse is not staying sore as long and my shoulders and neck are likewise not hurting so long.
That's 400km since I got it and another 5 weeks before I take it in for it's first service.

So I've turned out pretty sweet for my first day, rode the old bike in to work and feeling fine.

73M - Hosp to Hosp transfer.
61M - Tourist who felt really unwell but by the time arrive to discuss transport he preferred to self manage.
Pedestrian V Car, we got the make model and registration of the car and a description of the victim but couldn't find him anywhere.
??M - Has a cut lip, is located at an establishment and decides to catch a taxi to hospital.
32M - Swollen Palatine Uvula, thinks it's from some mystery allergy. I ponder this, he attended a wedding reception last night got hammered, snored like a jackhammer and has suffered trauma instead?
40F - Tachycardia, not SVT just tachy at 140bpm for the whole time I'm there and for an hour or two after I leave. I saw her still in the ED 7hrs later and they had got her down to a resting 100 with drugs.
Called to a Blind Woman who had a fall in public but had got up and walked off claiming to be uninjured.
Good for her.
36M - Seizures, status, 6 in 20 minutes.
38M - Nausea and vomiting associated with head movement, no prizes the inner ear.
26M - Massive brawl that he copped a kick to the head, approx a minute LOC, # Zygoma and significant lac to the forehead. Mass casualty incident that we arrived at first, Padawan got to see the difficulty of field triage and moving to the next pt without stopping to Rx the 1st you find.

Good day. 

Be Excellent to Each Other and See You at the Big One!


15 February 2012

The weather kept them at home.

All crews reported a quiet night.
88M - Hosp - Hosp transfer ICU to ICU stable GCS 15 pt.
53M - Has probably hit rock bottom of alcoholism, started drinking methylated spirits (metho).
30M - In Police custody and has a heavy heroin habit and is starting to hurt. It's 2AM, the hospital won't give him methadone or any opiate so until he gets really sick or into the Corrective Services system post court appearance food, hydration and see if they can turn down the cell lights to help him sleep.
7M - Croup also has Cerebral Palsy so there are added difficulties in managing the pt but it was bad enough for nebulised adrenaline and Mum held that mask there until I had to pull it away because the poor little tyke was going to bust a cork he was so upset, but hey it worked and he was without symptoms all the way to hospital.
??M - GOD, this was my first time meeting him, I've met several different persona's claiming to be Jesus but never GOD. His arguments were very good and in fact I believe he did have part of it right, all the major religions have a single central deity but what they fail to realise is that theirs is not better but more likely the same being as the other religions revere! Now don't go and flog me with religion, I'm not interested but he had some good points but was a tad delusional for his own good.
66F - Chest pain. atypical but no obvious changes on the ECG but not resolving either. A sensible mature woman who was concerned enough to do something out of the ordinary and call the ambulance, we transported to clear her mind.    

Do some riding on the days off.

Be Excellent to Each Other and See You at the Big One!


13 February 2012

Warm night but I didn't get slammed with drunks.

First up was a call to our local Cop Shop, one of My Cops had been knocked out while making an arrest.
Full R1 response, no letting the New Padawan look up the address I'm telling him where to turn.
The pt (26F) had regained consciousness and continued to assist her partner with the arrest and was in the charge room doing the paperwork when we arrived.
Despite claiming to be OK and there's nothing wrong with me I put my foot down and told her it was not negotiable and her boss sealed the deal for me. Cleared several hours later after obs and examination she returned to the station and I believe driving a desk for the remainder of the shift.
21F - 4/7 fever, been taking anti-pyretic meds with little reduction of temp, has seen her LMO for the last two days and had IMI antibiotics and a script for orals and been taking them as well as had bloods taken but her B/f called because she was now displaying mild confusion. God love 'em, they've been doing everything they can to self manage and the illness has just got the better of them. On the face of it some might roll their eyes and shrug it off as just a flu but these young people were actively trying to heal themselves and I thought displaying an uncommon amount of common sense.
69F - Tourist who's ankles started to swell on the flight over 5 days ago and have been continuing since. No known cardiac issues, never had this before but kidney's maybe involved with a decreased output noted.
30F - Took a tumble down some stairs, not intoxicated (accidents do happen) no # just 2 little lacs and a magnificent contusion down the anterior aspect of her tibia. Doesn't need us as she has called it a night and is going home to put her leg up, take some simple analgesia and rest.
18F - Acknowledges being drunk, apologised, her friends apologised for not being able to physically manage her into a taxi and take her home. Polite, respectful and appreciating what we're doing.

I'm starting to think I've been transported to another dimension.

Major incident in a popular party precinct with an active Police operation that requires an ambulance on standby.
25F - Seen on CCTV to be in some trouble walking, police and us are responded. Just as we arrived she had a big magical vomit that usually fixes most drunks and waddles off and into a Taxi.
64M - To anyone else asymptomatic and even maybe to a less experienced paramedic too but to his partner and me having a hypo. Actually that makes me sound like a knob. I was told by his partner that he was an insulin dependent diabetic so I would have been looking for the signs but there weren't any (diaphoresis, slurred speech, irritation, aggression, lack of coordination, intoxicated like behaviour) but yet there was something that with the knowledge I had gleaned about these two, their lives and such in the last 30 seconds since walking into their home at 0400 in the morning that showed the pt to be off. BGL of 1.3. Food and time it was 6.4 when we left.
20M - Who admits to being intoxicated but managed to get home. Got angry with himself for getting this drunk and punched an unforgiving wall. Tx for an x-ray of what I have always called a Boxer's # but I am informed can be called a Dickhead # because that's who tends to punch a wall because they're trying to impress a chick or intimidate another male in the wee small hours of the morning. Nice guy, silly thing to do and he wasn't a dickhead.

Be Excellent to Each Other and See You at the Big One!


12 February 2012

Average Age 72 and a half.

88M - Assisted Living Facility, had a fall during the night and sustained a minor scalp wound. Staff had done an excellent job of cleaning and dressing but the family wanted an Ambulance to come and have a look. So we did and complimented the wound care and left the poor blighter to have his breakfast.
88F - Getting aggressive with staff at her Assisted Living Facility. In particular those of a darker skin tone as well as regressing to her native tongue, Russian. No diagnosis of Dementia and with me a uniformed adult male was pleasant. Not febrile but the was the odour of a UTI that was proven by the hospital.
75M - Fell forward on an escalator and got a few good scalp lacs that looked like he'd been clawed by a lion. Needed stitches.
82F - LLQ Abdo pain that her LMO wanted investigated.
72F - Who had a syncope after a very minor MVC and the responder thought should go to hospital. She was on her way home with fresh meat from the butcher and she is the sole carer for her invalid husband. There were no injuries, she just fainted. We dropped her off at home which was nearby.
34M - Smuggled grog into a men's shelter and got sh*tfaced! Dumb move, they have now black banned him and as they can't turf him out onto the road we have to collect him and take him to hospital to sober up.
69M - Fell backwards on an escalator and apart from chewing holes in the seat of his pants didn't injure him but he wanted transport to have his Parkinson's checked. At 7PM he went straight to the waiting room for a long wait.

I've been asked why I call some of my partners Padawan's.
As everyone would know Padawan is Jedi for learner.
I don't like the way some people say 'Probie' and as I mentor the trainees I get in the light and the force they have to be Padawan's.

Scary in my world?

Be Excellent to Each Other and See You at the Big One!


10 February 2012

New Roster, New Partner

A Padawan in fact, not brand new I'll be his second mentor but older than some of my recent partners and we remember more common things like music or TV shows.

79M - Regular Dialysis Pt.
83M - Tumble at home and a few skin tears. I can dress them up OK but they will need changing and observation during the healing process. He already has a Community Home Nurse call in for another issue so I give them a call to discuss it and have his nurse there within 10 minutes (she was in the area). Reviews my work, is fine and helpful with accepting to take over the job and allows all of us Health Professionals to leave the pt at home and out of the hospital ED.
28F - Near Faint. Lots of stress from family issues, working long hours, not eating regularly, has run herself down. We have a good ol' chat about it and opt for a 'fix what can be fixed' self manage style starting with her having the rest of the day off.
56F - Found unresponsive in a shopping centre toilet, OD I thinks on the way in as most of us would and it was just not the opiate one I thought it would be. Alcohol (BAL 0.441 I'm told later) and possible Benzo's. Transport her and she didn't leave the ED for over 24hrs.
73M - Has had his larynx removed and has woken to find the plastic bit off the stoma gone. He believes he's inhaled it. Needs an x-ray.
22F - Tourist who went swimming at a beach and ended up in some difficulty and swallowed a a goodly amount. Attended the Life Guards on duty and had some O2 but was still also feeling SOB. Transport for observation.
84F - Syncope with chest pain of mild exertion,,,,, a cardiac review of this young lady might be in order as there is no Hx. 

And that's how we spent our first day of the new roster together.

See you at the big One and Be Excellent to Each Other


07 February 2012

Continuing on with Anonymous.

Anon's reply,

woah settle down, I didnt come on here to critise any one, mearly was commenting on the sarcastic mention that a fellow officer was moving to a rural station "where they do as many cases in a month as we do in a shift." by their own choice.

I didn't say that any patient was more or less important, just that we do still actually work out here.

And I acknowledge that and apologise to you if my post blasted you Anon.

I've had a few personal attacks and can be a little quick to jump to defensive prose and the written word can so often not truly represent the intent of the words even with good intent and punctuation.

Take this for instance,

My blog is not a Pissing Contest!
- It wouldn't be much of a contest anyway.
My blog is where I choose to write about my day and the interesting characters I meet!
- You regularly deride your 'interesting characters' for being soft/drunk etc. Also, the listing of every job you attend is boring, bombarding the reader with everything you've done in a day doesn't make compelling blogging. You could take a leaf out of Mr. Reynolds blog and focus on one emotional or interesting job and draw your reader in, or you could continue listing all the shit you attend in Sydney and driving away potential readers who ant to connect emotionally to a well written blog, not a list.
My blog is open for you to read BUT you don't have to!
- I won't continue to read this blog, as the owner seems to be a petulant little 3 year old who can't handle differing opinions to his own.
My Blog is an open constructive and positive environment!
-Your blog is public domain, and the public are not required to be positive about your daily list.
DON'T come here and hide behind Anonymous, put your name on it!
- as the owner of this blog you may set commenting so that only google accounts may comment. If you allow anonymity in your comments don't act like a bitch when that is exactly what you get.
"Don't Criticise me!"
- If you put yourself out in the public domain you cannot expect that you can say whatever you want and not receive any kind of criticism. More evidence of the petulant 3 year old you really are.

Finally: Job Volume is not > Job Quality. Sure you attend a lot of jobs, but how many of them require you to use your brain? Or adapt to a situation where you have major trauma and you are hours away from a hospital that has the facilities you need. Your job in the city is monotonous and boring. Just like your blog.

Ticked someone off and that's ok, they're allowed to be ticked off, it's a free world.

See you at the Big One and Be Excellent to each other!


It's not a contest Anonymous

 Anonymous wrote the following,

So you sign off see you at the big one, just wondering when that was? My last shift on a rural station, industrial accident crane fell on a pt, High speed MVA, and gun shot wound to chest. Don’t judge us based on the number of jobs we do, we just don’t do the sh*t in between.

In my Ambulance Service it is a common farewell to fellow officers indicating that we generally operate as individual units and the only time we come together is at a major incident.

Great work Anon, but you sound a little tense by your choice of words and syntax, aggressive even.
It should be very clear to a Paramedic that much of my work is Low Acuity, to my patient it is rightly or wrongly important, even urgent.

So lets get the rules straight,

My blog is not a Pissing Contest!
My blog is where I choose to write about my day and the interesting characters I meet!
My blog is open for you to read BUT you don't have to!
My Blog is an open constructive and positive environment!
DON'T come here and hide behind Anonymous, put your name on it!
Write your own Blog and send me a link, I'll follow it!
Don't Criticise me!

As Bill S Preston Esq and Ted "Theodore" Logan are apt to say

Be Excellent to each other! (Bill & Ted's Excellent Journey)

See you at the big One.


04 February 2012

Last night of the Roster.

And I'm feeling a little of my age.
Last weekend we travelled to see a friend and attend her twins baby shower.
The men went to a nearby lake with the father and his brother with his ski boat and had a BBQ and rides on the ski biscuits. I've not done this before and after they couldn't make me fall out I retired undefeated and unknowingly very tended. My lower joints are stiff and sore, walking is a chore, strangely riding the bike isn't but that doesn't help when I'm at work.
Simple analgesia and hang in there until my next days off and rest up good.

30F - IP, emotional trigger leading to extreme intoxication.
39M - We are to call him Jesus of Nazareth! Need I go further.
16day old M - Hospital to hospital transfer for some surgery.
64M - Conjunctivitis, has seen his LMO but in his current drunken state believes the meds he started today should be doing more. He decided after a lengthy consultation that we were correct and he should stay at home.
Assist another crew.
32M - On the nod post opiate use and denies even though I found the whole paraphernalia. Needs to be watched.
31M - Same as his mate above.
18F - IP, claims she watched her drink be spiked and still drank it! Yep these are our future movers and shakers, the leaders of our community and country. God help us. BAL = 0.150
49M - Fever and sore throat, he decided to stay at home too.
21M - Alleged assault, yeah right and for no reason too? He did not wait in the hospital but left straight away.

See you at the big One. Taz

Partner still sick.

So worked with an officer who will be leaving the city for a rural posting (her choice) in a month where they do as many cases in a month as we do in a shift.
01F - Single responded to this to assess and report on transport. Has had a fall each of the last two days with an ED presentation and cleared/discharge. Woke this AM with a vomit followed by a significant epistaxis now responding normally. Tx in the family car (normal environment and they have a capsule) crew followed.
36M - Slipped in the rain going down on one knee. Very painful and doesn't look like a patella injury such as dislocation turns out it was #.
26F - Back pain with a very significant Hx including surgery.
74M - Vertigo and nausea, provisional diagnosis an inner ear disturbance that had also been suggested by his LMO and he was waiting a review by an ENT specialist. I can only help with the nausea the ED will do the rest.
75F - Psychiatric transfer from a little hospital to a bigger one.
28M - A psychotic, paranoid with extreme religious overtones.
33F - Syncope.

See you at the big One. Taz

01 February 2012

Partner was sick.

But I knew about this sick day.
So I worked with another peer from station whom I've had the pleasure of knowing since she came along on the induction ride-a-long shift many years ago and the first thing she got was a Cardiac Arrest in a public place.
Assist another crew to lift a pt up off the ground.
??M - Unconscious and dying! Talked to a couple of dudes walking away who said the pt got better and left.
69F - Slip in the rain and # Humerus.
53M - First ever seizure. Denies all probable triggers.
??M - Told someone at the Pub he had chest pain and they called us. He met us on the street having a smoke with a beer in his hand saying it was just reflux from drinking too quick and cancelled us.
25M - Turned up to detox with a BAL of 0.331 they were worried by his drowsiness and called us, he just got up and left which I was amazed he could!
19M - OD on Heroin who swore black and blue that he was only asleep when we chucked in the oral airway and bagged him up or jabbed him with some Naloxone and waited ten minutes for him to come up. He left the scene also.
84M - Septic somewhere! 

See you at the big One.