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30 June 2012

The cold can't keep them away always!

It's either been cold or wet but the natives have to stur or suffer cabin fever if they don't go out to the city and pub, clubs and strip joints.

24F - Pregnant and today c/o chest pain that appears to be pleuritic in cause.
63M - Suffering a psychotic event and the Acute Care Team called us to attend and transport.
70M - IP who stepped of a bus and fell forward and head butted the pavement in front of a Dr from the ED who was one their way to night shift.
74F - Attending a large ethnic wedding and had been drinking and dancing and siffered a near syncope event. We had cleared the pt in no time at all but it took us ages to calm everyone else.
Police job, Domestic Dispute, cancelled on arrival.
25F - Abdo pain that she thought was from not eating,,, yeah I know what your thinking but until I'm authorised to refuse peoples demands to be transported to hospital and not have to defend myself from an often over zealous Standards and Conduct Unit transport them I must.
25F - ?# ankle, UTL
29M - Laceration to the face from a bar brawl, it needed stitches.
44M - Claimed chest pain, shame was we had seen him at hospital earlier, were aware that he had been cleared and discharged. We were also aware that he had got another crew to bring him back again later claiming chest pain because it was cold, dark and to far to the train station and got read the riot act by Triage. Denied chest pain and promised not to call again unless he was really sick or Police would be coming with us next time.
79M - Regular Dialysis.

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

Taz

Cold Night, Quiet Streets.

37F - with a cut palm from trying to catch the falling glass vase, never a good idea it always seems to end in tears that one. It needed stitches and we had to transport the her lovely three year old as well because Daddy was inter-state tonight.
56F - Abdo pain and vomiting.
19F - IP, one of those few who are still nice when pissed.
35F - Agitated Meth Head who wanted to go to hospital. For God knows what 'cause she never told me or Triage.
75M - Regular Dialysis.
Started early and finished late.

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

Taz

27 June 2012

A full day full of variety!

A bitterly cold start to the day but it soon warmed up, well with work that is,

19M - A sheet of plate glass fell on him (80kg) cervical neck spinal pain on a building site good fun. Safe extrication and treatment saw him discharged later in the day cleared of anything other than muscle pain.
73M - Biggest damn epistaxis I've ever seen, been going for over an hour, he's on blood thinners and I reckon 400mls of blood loss on scene that I saw!
82M - SOB.
55F - Bystander quick dialled Ambulance without telling the ?patient? she went back to her office building.
88M - Dizzy, no obvious cause.
18M - American Backpacker horsing around and lacerated his eyebrow. A steri strip or two go him patched up.
29M - Panic attack, resolved and left to go home.
66F - Fell on some bad paving and hurt her knee and ankle, no obvious injury but requesting transport.
Looking for someone in a wheelchair at a train station! Still don't know why but Police got there first and called us off UTL.
36M - Ascities.

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

Taz

New Day, New Week.

So Ambowife was away on the days off and I had some visiters from home do a sleep over before catching a plane this morning to Europe.
Youngest patient today 64 years.

79M - Regular dialysis transport.
85F - Medical appointment.
64F - CA patient who is vomiting after the lastest round of chemo and unable to get it under control.
74M - Fall at home and while would befefit from an Aged Care Assessment Review refused to come.
93M - Fell this morning but not found until early PM. Shoulder pain and cold, needs a more detailed assessment and did allow me to transport. Had a rib fracture, bleeding internally and needed a chest tube as well as investigation into prolonged bous of bradycardia that he didn't have while in my care.
86F - Sepsis, probable pneumonia.
71F - Hospital to Hospital transfer.
73M - With a scalp wound post fall but the fluctuating GCS and recall worried me.

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

Taz

22 June 2012

I recommend this company.

Screen Country

I purchased a new laptop and it's screen fractured after six days.

It was considered that I had dropped it because that's the only possible option.

I didn't, there wasn't any external damage but how do you prove it.

The warranty was refused but I could pay nearly as much again to have them replace just the screen.


I'm comfortable on the Internet, with eBay and Paypal, etc

I did some research.


You can tell a lot from the Web Site of a company, the wording, grammar, date it was updated, follow a few links and Screen Country looked OK.


From Canada they got a new under warranty screen to me in 5 days after placing the order.

It would have been 4 days but we were out and missed the UPS man.

It was easy to order.

The product was exactly what I ordered.

It was a very very competitive price, in my hands for $107.00.

AUS and USD are about the same at the moment.

They even have videos and instructions on their site if your not sure how to replace it.

I don't believe I will ever need this company again but you might!

Take my word for it you can trust them and their service.

 

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

 

Taz

That wasn't so bad.

I know my limitations, I'm aware of my short comings on clinical knowledge but Jesus there's some silly shit that they include in Paramedic Degrees.
It reinforces why we get some of those grads who think they're DR material out on the road and it's up to us the slower, dumber, 'not real Paramedics because we don't have a degree' Road Dinosaur staff to protect the public from them until we can slap this silly shit out of them.
Having said all that and after a whole pot of coffee I finished the exam not feeling gutted. There were to be seven different exams randomised so I must have got the easy one, lucky me.

??M - Sexually abusive to the call taker! So why dispatch an Ambulance? We couldn't find him.
??M - Chest pain but walking and giving stupid locations as he walked? I reckon it was the same dude.
33F - Passenger in a car crash (witnesses confirmed she was the passenger) Pissed as a Cricket as was the driver reportedly and totally fine, luck but, the car side swipped a domestic trailer hitched to a 4WD and a rail from the trailer entered the cabin behind the passenger seat rather than in front and then possibly causing a penetrating injury. Left with Police.
66F - NESB (Non English Speaking Background) Gastro and we couldn't get the message across that home was the best place to stay.
25M - Facial injuries after being assaulted, by the time he was going off for a CT the Cops had caught the six offenders. One eye was  fully shut.
79M - Found by the general public at a train station seeming a little confused, the Cops are called and call us. This very pleasent gent could tell us everything up until about 2005/6 we worked out, with reasonable clarity. He had no idea what town he was in and he had lived here at some stage, I located six different addresses in three diferent states up until March this year in the document in his suitcase. He was clean well groomed and the clothes in the case were likewise clean and looked appropriate for travelling. He was aware of his confusion and accepted our transport to hospital to protect him and investigate the possible reason for the confusion, infeaction, disease, age, and for social workers to try and locate his family. My partner was going to follow him up the next night.


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

Taz

Asleep on station!

Well I tried to after our morning rally to draw attention to some industrial changes we want passed by Parliament. A couple of hundred turned up, would have been nice to have more but apathy and laziness particularly when there is no focus point like a pay rise of possible immediate loss of conditions is hard to battle.
So after that I went to work and made bed up and tried to get some sleep before the night shift and while I live next to an Airport the bunk room is on the street and there is construction going on next door as well so during the shift if jobs allow I'll try and get some more shuteye.

40M - Who rang 000 wanting answers? Don't know why they sent us but he had left his apartment by the time we arrived.
47M - Who wants to get to sleep but can't! (if the rest of the night is like this I'll go crazy myself). Abused everyone and left the hospital still abusing the universe.
53M - Left lower localised rib pain. The whole presentation changed and he sat up off the couch after I told him it wasn't his heart and it was safe to take some of his own over the counter pain killers. Stayed at home.
40F - Right lower rib pain, also not her heart but she told me that when we entered. A dry barking cough for 10/7 that is under treatment from her DR but she has pulled or pinched something and the pain has got uncontrollable (yep she's another of those who try to help themselves before they ring an Ambulance). Some nebulised saline to ease the cough stimulus (yes I am aware that there is no local protocol or clinical based evidence for this treatment but millions of Mothers for centuries must have known something) and some analgesia before transport for review of condition and re-assessment and pain management.
24F - Who had a cut on her thumb. I cleaned it and dressed it and while a pleasant young lass the gene pool was at the shallow end.
21M - Left sided pubic pain and swelling, I've never seen one but I'm guessing an Inguinal Hernia.
81M - Discharged to home.

In four hours I had to be up to sit for my first on-line Uni exam, luckily we got three hours down time between the last two jobs.

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

Taz

Colder Weather

I'm told the Ski Bunnies are getting thrilled with the developing cold weather but jumping in and out of a warm truck sure sucks.
It's warm because my partners like the heater.

59M - Travelling on the train and felt faint so gave himself a few puffs of GTN, Yep that fixed it, NOT
Pale and pasty on the platform we transported. Turns out he had a STEMI 3 mth ago and was given the GTN spray without instruction and concerning was although he was recumbent now and his colour had returned his BP was still shit after an hour, he was bradycardic around 44 but the 12 lead looked ok so he definately needed a hospital.
45F - Came down as chest pain but she was having an axiety episode and the 12 lead and the fact that I could talk her down to normal confirmed this for me. I couldn't keep her calm however and that's why we transported her for professional help (psych) and possible medication to assist.
84F - Abdo pain of an unclear nature.
44M - Alone with an unwitnessed seizure.
52M - IP who just needed a waiting room to sober up in.
68F - Hospital to Hospital transfer.

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

Taz

17 June 2012

A new week.

And a busy one it will be too.
Some industrial action to help secure the Industrial Landscape for Paramedics here.
My first actual examination for this semester or Uni in between night shifts because that's just the way it worked out, so onto the work,

29F - Presented at the Police Station twice with odd behaviour and while not a physical danger to herself or others there was concern for her dignity and virtue.
92M - Needed a CT after a fall at a Rehab Hospital.
89F - CVA event.
40M - Facial injuries after assault.
89F - Had a syncope at an Organ Recital, stuff room and felt better but went home.
57M - Knee and hip pain after a fall yesterday??? WTF
84M - SOB

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

Taz

Last night of first week.

71F - ?GI Haemorrhage although we didn't see any symptoms.
41M - Off his meds and very Paranoid.
85M - Crook legs and that's how we triaged him.
50M - I'll never understand why they shoot up when they're with a working girl, like I don't understand what it does to the sex? The Madam was doing chest compressions while the worker was doing mouth to mouth when we arrived and took over reversing the overdose.
16M - Drunk and really behaving bad, some people should not get pissed. Required Police to transport.

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

Taz

12 June 2012

I'm single tonight so I'm working with a level 2 and the next station away.

39M - NO PUFFER! Where have I heard that before? Yep it was him, same story, not distressed but there was a wheeze, it's raining Cats and Dogs so he didn't want to come. I better monitor this address to make sure we're not being suckered.
84M - Flown in from elsewhere for a pacemaker after falling over with complete heart block (too slow a rhythm to perfuse the body and stand upright).
52M - Chest pain, with multiple co-morbidity's I still didn't think it was cardiac but treated as such (aspirin and oxygen, no pain so I don't do GTN) and normal driving to hospital.
56F - An MS patient that I haven't seen in about five yrs, needed her legs straightened.
78F - Abdo pain, ? a bladder infection.
66M - Lung Cancer patient who was scared.
I have mentioned before that one of the greatest honours I receive is to be a sentinel for my patients. I have been the last person they have looked at, the last hand they held, their last human contact and I'm really a stranger but our uniform and job transport us past to be a guardian of their last moments because sometimes there is nothing more we can do but to hold them.
My man wasn't dying today, but he knows that is his future and soon, it scared him tonight. He's alone, few friends and no family. I sat on the chair opposite and we talked, about this and that.
About his meds and their effects on his sleep and appetite.
About euthanasia and palliative care.
About sports and end of life plans.
With the tube running back into a spare room to the oxygen supply like a thin green umbilical cord he walked me to the door when he was ready for me to go. A smile on his face and laughing as we shared jokes, we had told Comms twice that we were OK and in no danger, just talking with our patient.
I had nothing to give but my humanity and it made me feel good

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

Taz

New Roster.

Today is the start of a new nine week roster, I've taken a bit of a hit with the new roster with three shifts worked on the old one (day, day, night) one day off and the three more shifts (day, night, night) rather than carrying on with 4 on and 5 off as we do.
On the good side I have done this to help management with a hole and find myself working with two level two officers one on the 1st day and night and another of the 2nd day and night, so I know my partner for the whole roster.

67M - Renal pt for transport.
21F - FAS on way their way to an exam, crammed all night, took caffeine tablets and didn't have breakfast. Fine so you can have a syncope but don't make me carry you, your not dying.
21F - Small hospital to big hospital, nice young Miss who will forever look at high heel shoes differently after breaking her ankle last night in her Fav shoes.
37M - Lac to toe, dropped a glass table top on the floor and a piece cut his toe. Has now learnt that he doesn't do his own blood very well and that while there appears to be a lot of blood it does stop and clot in healthy persons. Put a clean dressing on it and left him to clean up.
87F - Hypertensive, 200 sys and a diastolic over 110 all the time, your coming with me to hospital.
39M - No puffer, asthmatic who while wasn't having an episode felt that a neb would see him through the night and so called. On welfare and knew that hospitals will supply a free puffer but didn't want to walk back in the shocking weather we've been having. OK my status as an emergency service is being abused with this job but asthma is a life threatening condition and if I can prevent an episode that's good but I ran lights and sirens to this. He was pleasant and thanked us saying he was getting some money tomorrow and would go buy a puffer from the chemist. Left at home.
82F - After hours Dr thought it was a TIA, looked more like 'your 82, it's foul weather today and you may have a bug', pt didn't want to go to hospital and as she was asymptomatic and the Hx had nothing to indicate a cerebral event and again I got the story of the expensive home visit after hours Dr spending less than ten minutes with patient and bumming them off to us and a hospital. We decided that she could stay at home in her own bed and rest and that either she or Hubby would ring us first if they felt anything amiss.
71M - With a shocking chest infection. It is the season for them,

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

Last Night of the roster.

25M - Drunk at the train station and in no fit state to be catching public transport.
48F - PV haemorrhage at a medical centre and while we were there for her,
65M - Confused, normally a high functioning individual who had insight to his confusion. Here on a holiday and asymptomatic of fever or other indicators.
34F - In custody and complaining of a shoulder # from position when cuffed. Not clever enough to remember to restrict movement while I'm in the room and asking her to remove her jacket so there was no reason to transport because this person was going to gaol (jail).
36M - Anxiety post MVA, being a little bit of a princess. NO injury at all.
36M - PFO and not a pleasent fellow either.
34F - Oh, forgot to tell me this one same patient in custody Now pregnant! C/o abdo pain, shit my hands are really tied I have to transport now because I can't rule out obstetric or GI.
Assist with extrication.
57F - Morning syncope, flu like symptoms yesterday so that would explain it. She didn't want to go to hospital so I prescribed fluffy slippers, feet up and lots of TLC.

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

Taz

11 June 2012

Last Week of the Roster.

The usual list of regular jobs,
54M - Partial Quad who needs some help but we rarely transport.
38F - Made some threats while police are executing a search warrant.
85F - Cardiac
39M - Can't remember what.
19F - Chest pain, not cardiac.
28M - Drug effected and tried to assault me, never landed a blow.
86F - Possible TIA.
Standby with another crew who also had a patient attempt to assault them. Again no injuries but lots of assistance from our friendly Cops.

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

Taz