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29 March 2012

It all happened before midnight!

The work of course.

92F - LMO had requested her to return to hospital after tests had shown her troponin elevated.
?38M - Od on Oxy's in a men's Sauna. After naloxone he refused further treatment by fleeing the scene.
42M - Who took a very slow and controlled tumble in the street and a passer-by  was concerned. A graze on his scalp was the only injury and he didn't want transport as there was still some liquor in the bottle.
Got the last of the current study done and then some sleep because the next job was five hours away.
52M - COPD, well known just wanted an O2 driven Neb to get him going.

Now home to sleep and prepare for a school presentation tomorrow for a high school of new or soon to be learner drivers. Start the next week of study and get some miles up under the saddle.

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

Taz

Got my new bike back from service.

At two months it gets a free tighten and re-tune which it needed. Some of the gears were jumping and slow with changes as the cables had stretched. I have ridden just over 600km or 372ml in those two months and that's not including the 450 (280) I rode to and from work on the old bike.

It was time to get some more new gear too.
My helmet was ten years old and while never having sustained an impact or exposure to excessive heat had become worn out inside, I'd replace most of the lining so lets step up there $180.00 but I'm doing the mileage to warrant it. Another set of bib shorts and a matching top, they do make you more comfortable on a ride with better support and the quality material doesn't chafe and keeps you cool, there is and Australian Pro Cycling team for the first time on the world tour and will be at the Tour de France this year called Green Edge and the shop did me a deal on a set of theirs the helmet and a pair of new shoes so I better get out there on the days off and do some ridin'.

31F - Stepped on a soccer ball and landed on the outstretched arm. C/o elbow pain and unable to straighten very minor possible deformity that may only be swelling, needs an x-ray.
56M - Stepped on a knife and cut the bottom of his foot. Not a big one for me anyway but he just saw all these bloody foot prints everywhere he walked. Possible healing complications from where it is and that he's a diabetic, transported.
22M - Called to checkout the pt after he had been punched in the mouth. Haemorrhage had stopped, there was a lac inside and an ED would do nothing for it as the mouth heals very fast. Some precaution advise about TMJ complications or swelling and analgesia and off he went home.
3F - Country family in the big smoke for a concert and tried all the home remedies before ringing us. I gave a neb of bronchodilators but had to step it up to the adrenaline when the retractions increased en route and that fixed it.
21M - Trying to sleep across the road from a men's shelter. They called concerned for him, they're the one's who kicked him out for possible drug use in the toilet and he's just trying to sleep. I did talk to him and check basic obs and then gave him a blanket.
29M - To many Xanax make you fall asleep and on the footpath is not the place to do it peacefully 'cause I get called and come and stimulate you with sternal rubs and questions. Transported for no other reason than to remove from the public view. 

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

Taz

27 March 2012

The textbook rode on the dashboard all day.

I have to come up with a better strategy for study while at work.

82M - The job came down as a stroke but that was just the N/h staff panicking. The is an issue with generalised mobility that we will transport for however.
59F - Transient absence episodes. May be cerebral may be behavioural too.
56F - Anxiety. Calmed and happy to stay at home now we have broken the cycle.
59F - Allergic reaction to unknown.
26M - Case worker and the Cops called, increased manifestation of his psychosis needing Tx.
?33M - Deceased in a house, drug related.
41M - And I can't read my own notes so I have no recall of what was wrong with him but it can't have been serious.
27M - Rode down the last 5 steps of some stairs on her Bum, not intentionally. Tourist who was worried that something may have been broken. Well padded spot I didn't think so and the x-ray agreed.
25M - Left arm numbness, transient. 


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

 Taz

I'm trying to study at work.

It's not really working, Comms keep sending jobs down.

80F - A long Lie, she says she took a simple mechanical stumble around 2130 last night and whilst uninjured and able to move about she's unable to get up, I'm happy with the story and drop my suspicion index for any complications like crush injury or the like from compromised circulation. C/o Femoral pain so treat it like a NOF and then overcome the poor egress with a pt on a scoop stretcher. It got done pt was comfortable it just took a long time.
??M - Call was made from a public phone at a Bus Interchange and the notes state that the caller was rambling? We couldn't find anyone and the usually eagle eyed security hadn't seen a pt either, UTL.
?38M - Trying to sleep in the middle of the day on the ground next to a bus stop. IP who while agreeing to come with us (more to remove him from the critical eye of the public) to hospital changed his mind and was released near a park where, I embarrassed to say we don't think twice about a person sleeping under a tree at any time of the day because it is usually an IP sleeping it off. That may offend some of the sensitive people but that is the dirty ugly truth in a big city.
75F - Gastro and God love her she has tried for 4/7 to manage at home. Fluids IV even though she is able to tolerate oral it's not enough and her BP was dangerously low, something for the nausea and of we go and get an upgrade to Resus to commence treatment rather than waiting in line for a sub-acute bed like we do with the ones that ring after the first 4hrs of gastro and want the hospital.
56M - Metal health Hx and was feeling funny.
11/12M - Who whilst has had a very significant medical Hx in his short life has today had a floppy episode and held his breath for 10-20 seconds and scared the shit out of Mum and Dad. He looks fine to me but considering all his Hx and even though I think I can explain everything that they report we Tx for them.     

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

Taz

24 March 2012

What a difference a day makes.

I'm wearing holes in the station carpet!

82M - From little hospital to be one for an IDC.
27F - Anxiety attack, left at home.
41M - Alleged mugging, just go home and fess up that you blew it on booze and hookers Dude.
64M - Septic crisis still early at this stage but well picked up by the nursing home staff.

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

Taz

Here I am!

Sorry, I've been trying to catch up on my reading for Uni (how you doin' Wade)
I don't know who thought that with full time real employment there was enough time left after basic living to attempt two Uni modules. So anyway I forgot to post, alright?

48M - Opiate OD, almost got him to come to hospital for observation, crews are reporting some really heavy gear on the streets knocking even our well managed users off their perch, but the little O2 and naloxone I gave him woke him up to much.
29M - With what sounds like gastro and with symptoms only for the last 6hrs was happy with being told he wasn't currently dying and that to follow some simple self management guidelines it will get better, Oh and a time scale to ring us back on if it didn't.
32M - Being a di&k with the Cops and they requested us to run an eye over him to see if it was anything other than behavioural. It wasn't he was just yanking their chains. Left with them.
76M - SOB and Vertigo, not obvious but transport for investigation. Released hours later with a clean bill of health.
Transport of a Psych pt from a clinic to hospital with a benzo OD but got called of for,
80F - Headache that was moving from one spot to another and then another and then another and yet another on her scalp. Stayed at home to see if the paracetamol I gave her worked first.
25M - Not really liking the consequences and tailend ride from his night of booze and bad cocaine while in the cells. Life not in danger cleared to be monitored by tthe Police.
55F - Epigastric pain,,, pancreas may be?
63F - It's pissing down now and she lost traction in the wet on her scooter, #clavicle.
44M - Hypothermic and decreased LOC, no response to naloxone, turns out to be benzos that he took during an all night session at the tattoo shop having ink.   

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

Taz

18 March 2012

I'm late!

We didn't finish last night on time, in fact rather than a 12hr shift it turned out to be 14.5hrs so I slept really well. Too well, I'm an hour late getting to work but seeing as I am usually very early it's more or less on time. But it's never right is it, you feel behind the Eight Ball all day.

23F - IP on a public bus and the driver can't wake her. Of course we did and worked out where she lived which was on our way to hospital if we were to take her there but it turned out that once woken although pissed she was competent so we dropped her at home.
Assist another car with extrication of their pt.
88F - SOB, she has COPD or emphysema so no surprise.
45M - The newest male public nuisance in the area. Been in with various crews three other times for drug abuse today alone. ODs in a public place, we get called and bring him in. He waits for an hour or so and leaves and does it all again.
?60M - Deceased in his car on the road. Looks like he just died, people do that.
26M - Abdo Pain, elected to see his own Dr.
21F - Abdo Pain, wanted to see hospital Dr.
47M - Suffered a seizure like event from the contact of Police handcuffs with his wrists. Then after letting my Padawan do the basics (after I told him what was going on) I then gave the pt some basic leading lines like 'this oxygen we've given you should have you waking up really soon', and the like but he decided that he wanted a little more attention so he got the sternal rub, lucky I was reaching around from behind because although he tried to take the stimulation, it won out and he threw a few well delivered punches to where he thought I was in front of him. Well now the gig's up and I let everyone know that he's been bunging it on the whole time and I want nothing to do with him.
Police arrest him on the original offence and we leave.

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

 Taz

I'm stuggling to walk.

My left hip and butt are so sore.
I thought it was a nice day and would go for a ride on the roadie out along one of our Freeways.
I was having such a good ride, it's just long uninterrupted sections on the shoulder of the road on the breakdown lane which is usually wider than a normal lane, yes it's littered with debris and there is heaps of traffic but they're not near you. I was averaging 40kph for a long time and I wondered if I was getting a double assist from the aerodynamics of the truck with a push of displaced air as they came up from behind and a suck forwards in the vortex as they went past?
So I kept on going and turned onto another Freeway and pretty soon saw that I had just under 50km clocked up and still had to get home. 90kmn (56 miles) I rode and am I paying for it now.

75M - Regular dialysis pt.
45F - Traumatic penetrating injury, severe hypovolaemia I estimated a litre under the pt alone and Police told me of a 'lots more' in the building. Scope and run, 5min on scene 6 in travel and she's in the hands of the Drs. She lived.
87F Immobility, ?UTI.
53M - Shoulder injury after a tumble down a stair.
35M - Requesting a de-contamination after someone spat on him.
70F - Rapid AF and Whooping cough.
43M Seizure from known trigger reading no other epilepsy Hx last event >2yrs ago.

I feel better riding home. 

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

Taz

13 March 2012

61M - Hx of Brain Tumour and Lung CA focal seizure activity witnessed when we arrived but developed to a generalised seizure of more than 5min. I got IV access and when there was no significant decrease after the 5min gave 2.5mg Midazolam diluted that assisted the bodies natural inhibitory function. Pt has been in good health, afebrile so cause internal.
39F - Abdo cramps.
2F - Brought in to an adults hospital post ? febrile convulsion we transferred to a Paeds Hospital.
24M - Cultural inability to tolerate western alcohol (now you know I'm pisses with this one). Do not spit, vomit, kick and abuse me and my ambulance blaming it on the booze when you only blow 0.076 on the breathalyser. That's two drinks over the limit on driving. There was a whole rant here but I can't print it.
18F - Who had paid for her own drinks all night and got back to the backpackers alright but then felt strange so her drinks must have been spiked and wanted us to check her out. Hello everyone, drink spikers have one agenda and it's not to pay money for drugs to make you feel funny after a night on the grog and your experience of intoxication at age 18 is not even a scratch on the 35 years of research I've done.
47F - Our Social Nuisance who has now been informed by Police that the next stunt she pulls will have her arrested.
62M - Liver pain, and probably septic as well.
23M - Got as far as the train station but was having a bad ride on the drugs he had willingly taken at a club and sort assistance. I'm fine with that he was kind of cute in the rabbit in the headlights way. 
     

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

Taz

It's stopped and there was even sun!

That was while I slept because we're into our night shifts.

90F - The local Cops had called us to come and assess this pt. She had called them but during their handling of that matter they were concerned by her train of thought and belief that there were secret doors and laser beams in the walls. This was one very well educated lady involved in the early development of research she says of diabetes and she knew her stuff alright. She did not present a danger to herself, others and on all other levels was a competent and capable person with a GCS=15. The marbles don't have to be stacked straight when your 90!
63M - Haemotemesis
18F - IP one of the most wasted I've seen in a while. Transport to the little hospital in town and got hold of her B/f who came to collect her. She'd been out with school friends and they called when she got maggoted, never thought to stop her getting like this in the first place.
20M - There is a music event on tomorrow and he and his brother have come to the Big smoke for it. Problem is he's peaked about 12 hrs too early. Didn't even register the big bore cannula for the anti-emetics and fluids.
59M - Wanted a Neb to relieve his SOB. Asthma like symptoms associated with anxiety and he has come out for the night with the wife without his puffer. I heard no wheeze, good colour and Sp02 was 100% but I'm not in his body so I gave him the neb and when it was finished they returned to their Motel room.
26M - Decreased LOC and suspecting GHB OD.
28F - Period pain but she has endometriosis and that makes it a whole different ball game to me.
22M - Straight up I asked him how many lines had he done. He was the perfect stereo-typical cocaine user tanned, bling, man scaped, clutching his crutch and twitchy. Couldn't remember the lines but estimated 2g of powder! F*^K Man no bloody wonder, tachy at 150 and it didn't look like it was coming down any time soon no other problems thankfully but he needs monitoring at least so got him to come with us.

An interesting night, never got near a computer to have a look at any of the Uni stuff for this week, I've only just finished the 1st weeks work and now it's the end of the 2nd I'll really need to buckle down on my days off and knock some of this over. Hello to any of the other 400+ students Australia wide who are doing either the Utas course or their Paramedic Conversion I'm hurting with the load too.  


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

Taz

12 March 2012

And the rain just keepts coming.

44M - The pt hadn't called someone thought they saw him fit and rang. He seemed terribly aware and asymptomatic.
35M - Motor Neuron Disease and sometimes needs help off the floor but was just about to cancel when we walked in having done it himself.
36F - Again someone thought they had fitted and rang an ambulance. Pt was ok and just resting.
45F - Flank radiating to groin pain. Renal Colic.
73F - Angioedema, from what she doesn't know with onset nearly 24 hrs ago.
44M - Detoxing from alcohol and mentioned that he had chest pain. Clinic have their procedures and I have to transport for a Dr's clearance letter.
91M - Off his food was the reason for transport on the nursing homes paperwork.
47F - Social nuisance, claims mental health issues, a different one, cunning like a fox if she recognises you she'll arch up to get Police involved. She has been fully assessed by a number of Pysh specialists and what she is after is permanent placement in a facility, to have three square meals a day, and no responsibility. Hasn't been around for a while but I've read three case sheets from other crews that have gone to her in the last couple of days. In one door at the hospital, gets told it's not on and leaves by the other door.       

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

Taz

08 March 2012

Australia is flooding!

Not where I live thankfully but the rain over much of the country has been incredible.

58M - Flying home after surgery.
37F - Near Syncope.
35M - Suicidal.
61F - Requesting Detox but I think I was used as a taxi because she left soon after triage.
30M - An old face of a regular Meth Head. Haven't seen him in years and he buggered off when the jig was up that I knew him from old.
61F - # left patella.
37M - # right ankle.

I think I'm going to have to get a second set of riding shoes for the winter because if the summer/autumn is this wet nothing will dry by end of shift in winter and riding home in wet gear is awful.

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

Taz

06 March 2012

I thought it would be quieter!

There is a Really Big Event in the city this weekend and I would have expected more to be conserving their energy for the big party and it's still pissing down and major flooding is happening in several states.

A man, slipped on some pavement in a busy area. Someone called the Police who passed it on to us and we couldn't find anyone, UTL.
51F - Felt unwell, what you would have to say as asymptomatic feeling off isn't a quantifiable symptom but the pt was hypertensive with a diastolic of over 100mmHg but did not want transport and opted to see her LMO which is her right. Pt autonomy.
70F - May have been tachycardic (100-110bpm) for a short time before we arrived, NESB so the daughter is on the phone to translate. All her obs were fine in fact they were great and as this was a one off and not witnessed by us and not really that concerning we asked the pt what they wanted to do and she decided that maybe they hadn't needed to call an emergency ambulance and would stay at home. I was fine with that. 
20M - It's raining Cats 'n Dogs and he's dodging traffic not at a pedestrian crossing but in the middle of the street and got clipped, very minor abrasion. Everyone has swapped details (the driver stopped) and Police were happy that no serious injury was sustained we all went our merry ways.
91F - Bradycardic, very weak didn't want to go to hospital but follows my suggestion that what I'm seeing on the ECG does need to be investigated tonight. Follow up was very brief, Kidney failure.
39F - Known pt with Mental Health issues has a current infection on her leg that isn't healing well and hurts so she stabbed herself in the tummy. Well that is over selling it really and I am aware of the unknown damage a blade can do on the other side of the dermis but for all my probing I don't think it had made it past the adipose tissue even.
Teenager sleeping in a fast food outlet. Still amused that this is an ambulance job, yep some people are a little sluggish to wake at the far end of a night out but she's with friends?? so the magic sternal rub woke her up just pretty after the more PC gentle shake and soft spoken word didn't. It has to be something more stimulating than the environment of a fast food outlet on one of the main party street at 4AM.
38M - Alleged overdose of GHB, he was on something but unsure as to what. He was straight enough to tell us he wanted to go to hospital and to stay awake and walk inside.


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

Taz

05 March 2012

A quite night gave me time for other things.

A University has offered a conversion course for qualified paramedics with diploma or advanced diploma to work for a degree by distance education.
A group from my station have applied as have a lot of officers from other stations, the interest has been generated by the fact that for the first year at least they are waiving the fees, it's free.
They have a particular platform for delivering the program that requires adjustment of settings on even our clunky old work computers so I need to do them ASAP.

83F - Sat on the couch holding her hand while listening to her story of being assaulted by a rouge wheeelie bin in the street that knocked her to the ground. There are no injuries, no reason to take her to a hospital but she still needs my help now. We chat and engage, she's a bit of a flirt, so am I and bit by bit, little by little the frail, helpless ol' lady is replaced by a confident articulate senior citizen who now dashes around the home to get a photo to show me. My works done here, we'll leave soon.

52F - Post renal dialysis is weaker than normal, tachycardic, nauseous and has vomited and this is still at the dialysis center. They request transport.

18M - A good 50mm irregular shaped laceration in the area of his left eyebrow. He's had a previous sporting related lac at the same site and during a scuffle with some security guards a glancing blow has reopened it. It needs a lot of stitching to close this up. He's a good lad, drunk but not a social misfit and returns civility and respect I give him.

59M - Post ictal??? I think it was more of a bit of attention seeking.

63M - Abdo pain.
  

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

Taz