See tonight's busier.

48M - Alleged assault.
Unconscious male, sitting upright in the middle of some steps when we arrived. Tired and resting.
58M - IP, depressed who has a Hx of sporting large knives on his person. None tonight thankfully,
52F - Feeling nauseous.
46F - Feeling anxious.
22F - Who wouldn't believe me that you're supposed to feel funny after smokin' weed and she wanted to go to the hospital to continue feeling funny!
34M - Who called us because someone slapped him in the face, we double checked yes slapped him.
65M - Discharge post CABg.

There was more work but that's all.

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

Taz

I thought it was quiet!

MVC - Without any patients.
Choking - But they then managed to swallow and cancelled us.
28M - Homeless and there is no hostel beds in the city so he just caught a train up the coast.
58F - Asthmatic who's anxious and SOB, I calmed her down and her breathing got better.
26F - Emotional and just having a good ol' fashion cry, nothing more serious than that but her sister overseas thought there was.
68M - Awoken from sleep with what he thought correctly was AF. He has had an episode about 20yrs ago but this one is not resolving and indeed it was still running around 140bpm hours later.
68F - Laryngeal spasm, she has a Hx for the same but this episode lasted longer and panicked her.

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

Taz

We are the Mental Health Bus!

63F - Lives in a hostel and was in a local facility for a few weeks suffering manic episodes and they've hit again. She claims to be taking her meds??
53M - Absconded yesterday from a facility and found by Police today for us to return.
68F - Found by Police living at the bottom of someones backyard? sounds like a fairytale but it isn't! Poor love she's homeless and suffers dementia, there are several journals with repetitive writings and drawings I don't know how long she has slipped through the cracks but hopefully we have caught her now.
26F - Known epileptic but an unwitnessed seizure in the bathroom and falling in the tub resulting in two facial injuries meant that I did push the point of transport before her GCS really improved too much.
18mthM - Croup, very good, thinking, common sense parents. We don't see enough of it.
81F - Gastro and as the carer for her husband needed the care of a hospital while a family member tried to cope with him. Pardon the pun but a shit awful way to spent your 81st birthday!
68F - Flu, fever, fainted this panicked the husband but with advice she stayed at home.
61F - Mechanical fall with a resulting swollen lip but she is on aspirin.

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

Taz

No time to rest at work.

20M - Concern for welfare after a long night drinking. 'Yes it will get better trust me!' And they think they're so tough and worldly.
72M - With increasing mobility issue and today the Misses can't get him out of bed. We talk about long term treatment options and home services and leave them to it as neither wish to come to hospital for this chronic problem.
73F - Social issues that don't require an ambulance.
Unknown - the address is a phone box, there's no-one there so call it UTL.
55M - Well known IP and threatening self harm as he does when he is!
Backup at the Casino for someone fallen down the escalator, cancelled.
Cardiac Arrest that turned out to be a mistaken call and not a medical incident at all.
45M - Spinning a very long and convoluted story that came to the same spot 'I need pain relief' We took him to the hospital and let them give him the bad news. You don't need any.
66M - Septic is a good bet.
89M - End stage CA and becoming acopic at home.


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

Taz

Did I say I had some down time?

I get the first day to sleep, then I have five hours to perform in a scenario for a Youth Road Trauma Expo before driving 2 hrs to give my Adult Traffic Offenders Intervention Program presentation and then drive home and sleep another day before driving 5 hrs to stay overnight before doing another presentation before driving back and then going to work the next day!

Yep I'll be well and rested.
And I wouldn't have it any other way.

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

Taz

Last shift for this block.

And I don't mind telling you I'm a little stuffed.
It takes a lot of energy to be bouncy and upbeat all the time, but I've done it and can now have a few day rest.
29M - Inter hospital transfer, one of three we'll do tonight.
31M - Abdo pain and again like last night I believe this guy, my guess, because we didn't go back to that hospital that night was a stomach ulcer.
41F - Claiming back pain. I've not seen her before but knew the story at a glance. A person who lives in a group home but with minimal supervision and is allowed to come and go as she wishes. She rides on trains to other cities and then claims some illness to get a bed for the night in hospital before returning home the next day. All this was confirmed by the after hours contact number she supplied. We directed her to catch the next train before we gave her to the Police for being a Public Nuisance (as directed by the carer's).
81F & 86F in a two for one hospital transfer.
48M - Homeless Man who looked crook.
2F - Has a fever (known to have had contact with other children who are sick) and had a little vomit. Advice given to Mum of caring for her at home and to ring back if anything changes.
37F - Admits to excessive drug use in the last 24 hours but thinks someone has spiked her with more.

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

Taz

I don't have a protocol for this.

The bane of all of us I suspect, the hang up job.
For the non ambo's, a call is made to the emergency number and maybe a few words are said or not and then it is hung up. We get sent to see if we are needed. the address details are only those of the phone as it is mostly a payphone (if a mobile the address of the owner is the best you get) and you arrive to search for a 'possible' patient.
O/a we are directed by some youths whom we asked if they had seem anyone behaving abnormal to a location around the corner and are confronted by several persons enjoying the contents of a brown paper bag and singing really really badly. Yep that's them, someone rang to complain about their singing!
We I don't have anything in by bag for that and so we left them to it.
5M - Has a toothache and a little vomit. We assessed and talked it over with Mum and they stayed behind.
57F - Laryngitis, self care at home.
43M - Anxiety.
48M - Abdo pain and very severe, one of those few that the experienced clinician recognises as a genuine case. Rigid with some deformity to his umbilical turned out to have been a strangulated hernia.
49M - Long fall unwitnessed with a closed head injury.
42M - Witnessed to collapse in a dance club and denied any drug use, yeah right. Fessed up later that there was Ketamine and pills on board. 

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

Taz

Third day shift.

And the work keep coming.

Start the day off with one of our Dialysis patients.
71F - Negative Ottawa exam but she would like an x-ray of her ankle.
30M - With a Hx of migraines panicking about a headache, it wasn't a sub-arachnoid bleed after all. 
56F - Nausea and diarrhoea, just wanted the symptoms gone and to stay at home. I gave her some anti emetics and advice but she called back six hours later.
Then we had to go back to collect my stethoscope from this job.
Attend a MVC that had no patients.
Take a 67F from the GP to a hospital for cellulitis in the arm because you get seen quicker by ambulance! That's what the GP told her.
Our local Cop Shop had someone who was in custody who wanted the methadone dose he had missed by being in custody. We got diverted to,
79F - Confused, lost in fact. With no obvious ID and not an English speaker we did some detective work and took a few leaps of faith and found she had been missing for 10hrs from her nursing home and was an Alzheimer pt, we returned her home.
43M - With ascites.
40M - Wanting some panadol.

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

Taz

Working five shifts this block.

Due to the roster that allowed me to travel home I have three day shifts and two nights.
That'll be interesting, keeping the energy high for five shifts.

20F - 18/40 gestation with severe pelvic pain.
63M - Assaulted, very minor facial abrasion.
Go to back up one of our motorcycle Paramedics but got diverted to,
86F - Unsteady and confused, LMO is thinking a UTI.
Run across the park at the back of that hospital to confirm a person dead for the Police.
4F - Febrile convulsion, Mum just wanted us to check her out and we left her in Mum's capable hands for some TLC.
Went to collect 2 from the same Men's Hostel and got diverted to,
51M - Who had fallen backwards and put a lacon his occipital region but more worryingly he had C5/6 disks removed last year and still has decreased mobility from that cord damage already.
Attended a local CopShop for someone who had taken only 4 Xanax but they cancelled us as we pulled up out the front so we went to,
50F - Painful feet.

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

Taz

Thank you.

For all the birthday wishes,
The extended break was fun and the home visit special.
But back to the real world now.

32F - Full blown and ready to pop her baby but hung on until we were at the hospital.
60M - An alcoholic with failing health.
37M - Fell on wet stairs and hurt his elbow and lower back.
58F - Migraine.
28M - Cut on his scalp from an assault.
21F - Syncope episode following what appears to be a case of food poisoning.
49M - Mental Health issue.


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

Taz

That's it for the block.

More polite drunks and a generally well behaved bunch of patients.

44M - IP at the train station with a split lip.
69M - Asthma and unresponsive to his owns meds.
22M - IP who has lost his mates, vomited up dinner and can't walk.
18F - IP, losther friends and vomited and has trouble walking.
22M - Emotional anxiety episode, calmed and left with friends.
22F - IP and in a toilet. B/f is with her and he can look after her.
22F - who had a G/f who spoke Tuff Love and told her to toughen up and go home with her rather than us.
23M - I can't read my note on him!
20F - IP and vomiting and her friends wouldn't care for her.

Well that's it I'm off to my home state to celebrate my birthday, until I'm back.

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

Taz

First night of the Weekend double.

I find that I'm always a little curious when we are sent to a new address.
On many levels firstly the access.
Is it street level, is there a ramp or just stairs?
Is there a lift or just many flights of stairs?
Can we get the stretcher in?
And so it was for the first job of the night.

78M - C/o SOB and so he was but then there was the ECG abnormalities was that the cause or COPD and his GSC was 15 but he couldn't keep eye contact or even seem to stay awake and his colour was off not appearing cyanosed but jaundice. We were  very close to the hospital and he needed them so we didn't do much on scene and unloaded him straight into a Resus Bay.
His Troponin levels were off the charts.
Liver function nearly nil, renal function failing (that explains some of the troponin levels), possible NSTEMI and COPD and hasn't seen a DR for the last 10 yrs but it all came to a head tonight.
62M - With Huntington's Disease found by the Police intoxicated in the CBD. We were able to safely take him home as his dystonia was normal really.
22F - Sprained ankle, explained the injury and management but she still thought hospital was a better option.
56M - A crew had already been to this pt and put a bandaid on the injury (over treatment I think) and he called back to ask about possible infection issues with our call taker who couldn't understand him so sent us there. He stayed at home we discussed issues with him and left it at that.
18M - Illicit Drug Stuffed, transported for his safety and a family member picked him up from hospital.
76M - Chest pain.
19M - Minor facial injury after an alleged assault.
22M - Minor facial injury after a different alleged assault.
40M - Poly Pharmacy OD, fluctuating GCS, aggressive verbally but no coordination to be a physical threat.


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

Taz

Day 2

Third last shift of the current roster for me and brisk, clear morning it is too!

42M - Fell from his horse while going over a jump. The fall was broken but the metal stand holding up the rail and then he continued to the ground. Got himself up and walked from the equestrian arena and then lay down winded. His only complaint was chest wall trauma. Good analgesia and off for some x-rays (fractured 2 and bruised his liver kept in overnight for obs).
77F - Syncope episode that was resolved, a little too many clothes on.
63F - Sorry for self with a cold. Elected to stay at home.
91M - Rapid AF, only this morning his last episode was 20 yrs ago. A retired GP who didn't introduce himself a Dr and was a very nice pt.
79F - Transport to the hospice for respite and pain management.
45M - Palpitations, he has suffered these previously and had them investigated (idiopathic) but there was something else about this one that has concerned him. ECG looked good in sinus but even the way he described the renching of the heart left me happy to transport.
66M - With mental health issues.

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

Taz

One more block before,

I slip away for a few extra days to celebrate my 50th, but until then I have madness and mayhem to get in amongst!

17F - Restrained front passenger and the seat belt did it's job and gave her a bruised sternum while saving her life. We were really just there to clear everyone involved.
22M - Found by some of our local plain clothes constabulary on their way for a early morning coffee sleeping on a ledge. I managed to wake him up an boy was he one drug fuc&ed up fella. He was still sleeping it off 10hrs later in hospital.
11M - Told Mum he had back pain, must be from the extra weight he puts on his fork cause he needs to loss some weight NOW! We had a chat to Mum and he went to school.
39F - Chest tightness with exercise SOB.
58M - Chest pain that was looking good for the cath lab but not good enough to go straight there with us.
44F - Feeling off but not having a seizure! Left her in the park in the sunshine.
99F - Sore leg and it was so we took her to hospital and loved every moment spent with her.
85M - Just about every artery around the heart is blocked. Do they graft or stent, sent her for more tests.
56M - Who wouldn't wake up and was only supposed to be pissed. He tolerated an oral airway and cannulation without a flinch so I gave him some naloxone and up he popped. He's blind which probably explains his lack of pupil constriction. Wouldn't cop to having taken gear!

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

Taz