Last night of the block.

And I'm feeling a little off my game.
I think one of the patients has passed on an infection.
My nose has a tingle and the throat is getting sore during the shift.

16F - Domestic argument that has seen her now make ill thought out comments about harming herself. I think she has made similar before as a paediatric but she's pregnant now and legally an adult, Social Service are also taking the child when it's born also.
83M - Unresolved epistaxis attended his local medical centre so we'll take him to bigger hospital.
20F - IP with a scalp lac.
24F - Anxiety chest pain.
29M - That everyone on scene thought was drunk but we analysed at hospital at only 0.035, but he was on a cruise boat? was he suffering from motion sickness?
40M - A winner this one. In the Police cells waiting for an appearance in front of the local magistrate later this morning. Starts off telling us about this chest infection he had three years ago and how it's come back tonight sitting in the cell and asked twice if he wanted to come to the hospital for a Dr to have a looked us square in the face and tells us all he wants is a certificate to give his lawyer to tell the Court that he shouldn't be locked up in a cell! Still waters don't run deep in that end of the gene pool!
89F - Took her own BP and got concerned as it kept going up each time she took it. Twenty minutes of sitting on her couch chatting about herself and family while holding her hand we fixed that.

Busy days off, I'm doing a shift swap for a workmate so she'll owe me a shift and presenting three traffic offenders courses. We will be going into town to a travel expo for Canada/US to get some info for our trip during my long service in 2014.


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

First night

65F - a quick inter hospital transfer.
22F - Fell yesterday and has found that 'weed' alone won't work for analgesia. I gave her some directions and left her some paracetamol after examination showed no skeletal injury.
??F - Running around in traffic Topless!, she'd gone by the time we arrived.
66M - Too many drinks with some mates and then a little uneven road and over he went, lucky he had such a large nose to break his fall.
20M - Seen by Police running along a rail bridge. They were wondering about his mental status. His mental status was PISSED and being a stupid boy. Left him in cuffs with them for his family to come and collect.
32M - Says he got puched in the face? Maybe it was a little swollen. Left him with Polie to make a statement.
69M - Complications with anti rejection drugs with a transplant pt. Hospital to hospital transfer.
23M - He's been standing on his feet all day at work and his back hurts. I stop myself here!
86F - Says she had a short episode of SOB


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

Second day

20F - Post ictal, left with family.
63F - One of the two drivers from a MVC, didn't want a bar of us.
20F - Who felt unwell while flying but better now on the ground.
10/12M - Floppy and with a yellow tinge, curious!
31M - Foot injury.
77F - SOB.
59M - Abnormal behaviour, high functioning businessman, required physical retraining to remove from the home and in the back of the vehicle. All obs were very normal apart from the behaviour and severe diaphoresis. As one of the Drs said a head full of aneurysms! His head was full of blood from the sub arachnoid haemorrhage.

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

First day.

36M - Mental health issues.
50F - Facial Injuries, minor post alleged assault.
75M - C/o an unspecified pain somewhere in his chest.
2M - Respiratory distress, was born at 29 weeks and winter months are always a problem for him.
87F - Oedema.
75M - Decreased alertness, ? CVA.

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

Taz

What I did with my days off?

Travelled home and jumped into bed for about an three hours attempted sleep before climbing into the passenger seat of the wife's car as she drives us in midday traffic out of the city to a rural location three and a half hours (190km) away to deliver one of my Traffic Offender Presentations at 6PM.

Stay over for the night before driving home arriving a little after midday but have to leave in 2 hours to drive 120km south to another country town for their 1st session of the Offenders course. There were only three people attending but unfortunately we know that more will be caught by the Police and sent by either their legal counsel or the Courts to attend in the future.

We drive home because I hadn't thought to look at accommodation and it's cold as hell down there anyway.

Today I have paperwork to complete, writing up my next roster, I have to have it in my diary I'm amazed by people who can just figure out whether they're working that day or not. Tax records, a survey for Paramedics Australasia that I need to read some thing else before hand, emails that need answering, hanging up some washing for the wife, washing my car after I have a look at an electrical issue with the light bar I hang from the bikes when they are on the bike rake (my reverse light came on and stayed on) it turned out to be a lose wire, easy.
Complete blogging and then read some more Uni stuff before the Tour broadcast starts.

So I'm off!


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

Taz

Night 2

95F - Discharged yesterday post treatment for pneumonia and it's flared up.
Take over a day shift crews patient, chest pain.
Leave my Partner at the hospital to go assist with a cardiac arrest that wasn't so I returned.
62M - Sudden headache, nausea, neck pain and a fast drop in GCS, appearing to be a STEMI. I already have ICP backup en route I need extra hands and some clinical direction because this is just falling apart in unexpected directions and the NESB of the pt and his friends along with social differences aren't helping. Aspiration and what appears to be really thick Pulmonary Oedema all the while with normal BP a brief episode of tachycardia after a loss of pulse and normal BGL and reactive pupils. The STEMI has resolved en route but I have transmitted the ECG and talked to the ED and calmer than I am the ICP Officer tells me he's not sure whats going on either. A massive Sub Arachnoid Haemorrhage that's what, nil trauma or warning. This was that 1/1000 headaches that was something, I'm not happy about my performance and am quiet and reflective for the rest of the shift and plan to delve into this job for my Uni study.
34M - Very drunk by admission and smell has fallen an unknown distance (there are stairs involved) full precautions and off we go and apart from the obvious injuries he's fine. You can't pick 'em.
??F - OD/Arrest who woke up as soon as I put my fingers to her throat. And then she proceeds to rip strips off her 'friends' 'cause all her shits gone!. We left about now.
Finished the night off with one of our renal pts who was in a good mood for a change.



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

Taz

Night 1

Started off the shift searching for someone who was behaving odd in the middle of the city. Of course we didn't find any single definable oddly behaving person.
91F - Elevated BP and with symptoms, vertigo and a headache with these I have decided to transport.
40M - IP and depressed. Asked his G/f to call. After listening to the brief Hx he has a lot of problems.
40M - With a non-descript muscular shoulder pain that he wanted checked out, at home not at the hospital. Highly unlikely cardiac in nature and he stayed at home.
??M - Drug effected in a toilet, naked and had scared the shit out of the hotel staff who were about to lock up and were checking the toilets when he started screaming. Unresponsive while I forced my way into the toilet, handed out his tablet, phone, keys, dressed him and then he woke up coming the Raw Prawn abusing me and refusing to accept responsibility of his actions.
24F x 2- Drunk and had been escorted out of a venue by security using wrist grips. They openly stated to me that they wanted to sue the security for breaking their wrists all the time fishing around in their purses for smokes and lighters and making phone calls without any difficulty with either hand. They stayed behind trying to get back in after I happily told them that Yes there was a cost to transport.
??M - #ankle. UTL


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

Taz

Day 2

Started the day as part of a convoy at the docks taking pts of a cruise ship.
There hadn't been any kind of accident or rough weather, these were just medical complaints from the ships hospital.
Then went looking for someone who kept calling up and c/o SOB but wouldn't stay there for us to arrive.UTL.
Then someone sleeping in the sun on some steps and who had been seen by a member of the public to have not moved for over ten minutes. The public had not approached him but rung us to come and cop a mouth full of abuse when I woke him up and continued to abuse as he walked off.
58M - Post Ictal and had no body to look after him so we had to offer transport which he accepted.
78M - Anxiety episode that was now giving some chest pain. Removed the issue and the pain left too.
75M - Fainted with an LOC confirmed by himself.
94F - From a little hospital to a big.
79M - Febrile with vomiting and diarrhoea.




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

Taz

Day 1

Went to pick up a dialysis pt but were called off for,
61M - Swollen ankle and it was as well as hot and it had been like this for three nights and neither he nor his wife had really slept. Again had not taken any simple over the counter pain relief!
83M - Discharge post treatment.
57F - Fall onto hip from a seated position. I gave the highest dose per body weight I have ever administered and the hospital wanted to give another 10mg during transfer to their bed but stopped when I informed them of my dosage.
I have started my second semester of Uni and only one module this time, it's a clinical reflection subject and my beliefs, thoughts and pharmacology reasoning for my analgesia doses is going to be one of my papers. I joke about being a bit of a 'Candyman' when it come to pain relief but I have been in real demonstrable orthopaedic pain and feel I have a good grasp on the pts pain but I'm willing to reflect and alter.
86F - Chest infection.
96F - Chest infection transfer from a big hospital to a little one for continued treatment.
89F - Feeling faint but called off for,
57M - with a acquired brain injury who is cared for by his 80+ Mum, had fallen over and needed assessment. We took him in for a few x-rays.
64F - SOB that her LMO believes is from a decrease in her haemoglobin.
91F - Her family who have placed her in a nursing home want us to take her from her bed and take her to the hospital because she's 'quiet' and 'not herself'. If they had thought about her needas and expectations and talked to her rather than at her they to would have discovered that she's bed ridden, tired and sick of being old.

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

Taz

And just a normal night.

Filled with the abnormal that is our work.

75F - Breathing problems, her name attracted fast track, a quick assessment in the ED and up to the respiratory ward.
22F - Anxiety episode, post natal depression. Family were on scene and it was just the numbness that they called us about, when that was explained we just had a quiet chat and left them to it.
10M - Had a vomit, been sick with a controlled fever and Mum just panicked a bit. They decided to transport when we told them Ambulance doesn't get you in quicker and that Paeds are usually quick anyway.
29M - Excellent laceration a third of the way through the fleshy base of the thumb from a wine bottle that refused to open. To top it of he fainted first with his blood and then nearly every time it was viewed by us or hospital staff.
44F - Hospital to Hospital transfer.
34M - Low speed MVC and while one of the drivers knew why hid shoulder was sore he wanted us to confirm that it wasn't going to drop off, which we did!
33M - Fell down some stairs and dislocated his ring finger.
31M - Off his meds and paranoid.

And that's this week, now time to do some training for our bike rides and figure out how to use my new Garmin 910XT GPS training watch.

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

Taz

Popped my partners Cherry!

Yep you heard me!

Get your minds out of the gutter you lot!

18 months in the job and had never, never ever done a cardiac arrest.
I kid you not, 12 months in a coastal resort town and then back to school and onto us and still hadn't got one until tonight. Look someone died, I'm sorry for their family and friends but no amount of practise or realistic manikin truly prepares you for the full on intensity of a real arrest and he got it. 24hr Hotel, public bar toilet, in the basement, patient behind a locked cubicle door, aspiration, flushing urinal, too narrow a scene gear stacked on gear, stepping over either the pt or another ambo, patrons still trying to use the facilities. VF coarse that was unresponsive to a complete drill with drugs and shocks and we ended up calling it just under an 50 minutes.
35M - Taxi driver, unrestrained in a medium MVC and hit the empty toll tag bracket on the windscreen and gashed open his skull about 7cm long.
45M - The other driver, uninjured, See seat belts do save you!
30F - After a fight with her B/f she needed attention and TLC and chucked a collapse in front of innocent bystanders. They called for an ambulance and that's were her night got worse. I turned up, with experience you know when it's being bunged on and with a little painful stimuli and a few choice words in her shell-like ear she decided that to leave the area quickly was most likely to save what she could of her dignity.
61M - Chronic Right shoulder pain requesting hospital.
45M - Atypical crushing lower chest pain without any obvious cause either traumatic, previous cardiac, infection or gastronomic. Treated cardiac as a priority and when that didn't decrease the pain and the serial 12 leads were clean went down the simple pain management with morphine.
27M - IP who took affront with the whole world about the bouncer who refused him entry but who couldn't accept that and kept at the bouncer who pushed him away and he tripped and gashed his face. I'm not saying the bouncer was innocent but he was telling me and everyone else that he was without blame and accepted no responsibility for his injury.


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

Taz

Weather doesn't stop the sick.

But it does make you thankful for the patient inside!

63F - Slipped on wet pavement and landed buttock first on a plastic planter. No shortening or rotation but lots of pain. I considered a pelvic # maybe but it may have also just been bad pain from muscular cause.
36M - A DD pt who had an explosive bowel motion in a public place and without being cruel had become a turtle and withdrawn into his shell and just lain down. Well that's what the staff saw, with the understanding that comes with our job I ignored the poo and talked to the little boy inside who was mortally embarrassed and got him out of there on the stretcher. Our little hospital in the middle of the city is being refurbished and the staff are kind of on an uneven keel at the moment so I continued my bond and washed him down and helped into some exchange clothing for his Mum to come and pick him up. Earned some really good brownie points with the nurses doing this.
80F - Sciatic pain.
4/12M - Appears to have a mild reaction to bananas, vomiting. Mum copped most of it not me.
99F - From a nursing home to the hospice, for the last time, always a moving job.
34M - Opiate OD who wanted transport, not common.
27M - Anxiety event.
Stand-by at a suspected building fire, our inspector released us before the Water Fairies had found anything.
21M - Who claims to have been vomiting for the the last five days. I couldn't figure out what his game was but he wasn't physically sick.

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

Taz

Raining on the East Coast of Australia.

And the wind feels like it's slipped up from the South Pole.
I'm not getting soft, the locals here still don't really know what cold is but at 4.45AM riding to work on the push bike there are bits of me that think they're freezing off.

88F - Slow to wake up at a nursing home so she must be stroking out? Was perky enough when we arrived but they still wanted to send her to a strange bright, noisy environment for testing. We don't look after our single elderly well do we.
40M - States he's from inter state just arrived and looking for emergency accommodation at this hostel and collapses in the foyer. Don't know what was going on, nothing obvious physically anyway.
39F - Post-op from a cholecystectomy 4/7 ago and in a bit of pain and vomiting. Warranty job back to the shop for her.
29M - A charming white boy trying to be a member of the hood, can't put a cap on straight, doesn't know how to put his pants on properly, talks with a mumbling speech impediment until he gets frustrated when you keep asking him to repeat his self (opps look now I've got it!). Got stabbed in the knee during a post drug binge psychotic episode by one of his alleged 'Homie's.
Odd behaviour by someone reclined on a park bench in a Mall, thankfully got called off.
70F - Sinus Tach without obvious stimulants, 140bpm for over an hour with us and then spontaneously resolved.
55F - Behaving strange in a shop, manic and disorganised for sure and seemingly unknown to any of the mental health units. Not a danger to herself at the moment or anyone else and your legally allowed to be like this in society so she can go.
52F - A skin graft coming adrift.
55F - Attending a week long conference who presented to the on site Medico's with chest pain. Clear 12 lead, does have a Hx of arrhythmia but none currently showing and with a careful Hx from the pt and confirmation from the staff, I'm going with a pleural cause.
Tx for further investigation but I got recognised by the staff as the writer of this blog and my trainee question guide book and touched up for some copies.
Hello Guys hope the rest of the conference went well and you got some more interesting jobs, I also hope you enjoy the book and find them useful but please don't copy them if others want them they can by purchased from The Paramedic Shop 


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

Taz

Did anyone notice,

THE TOUR HAS STARTED!!!

Sorry, that's shouting isn't it.
12 Australians,
Defending 2011 Tour Winner,
1st Australian Professional Cycling Team,
We've had both our commute bikes serviced (mine was due anyway)
I have not missed a moment and now I have to go back to work?

Which will be fine for the days shifts and on the nights I have the Skoda Tour Tracker app on my phone and the web site on my lap top.

And while talking about cycling there is a charity ride in Melbourne 16th of September that I'm attending and I encourage any other readers, paramedics or family members to come along on the day either to compete or support here's a Ride 4 Epilepsy.
$79.00 entry fee only and fundraising is a bonus.
You can enter as an individual or with a team (I've got a team, me and the wife but more are welcome)
You have a transponder on your bike and 6 hours to bust out as many laps as you can!

Because of the restrictions by my management I can't disclose the team name here but drop me a line at taztheambo@gmail.com if you interested and hope to see you there.

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

Taz

Australia's Most Trusted Profession, again!

For the 8th straight year Paramedics have been voted the Most Trusted Profession by the Australian public in the Reader's Digest annual poll.

It is very humblling to have this honour set upon us and I'm sure all Australin Paramedics thank our patients and their families for it.

Here is an article from the 2008 Reader's Digest after Paramedics got the Top Gong for the 4th year then about what makes us different.


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

Taz