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29 November 2012

One patient only not born in December.

Funny how those things stand out or like the pt's birthday is the same as yours!

44M - Friends were jumping straight to a stroke for a very localised paralysis but I'm going a very bad nerve pinch.
86F - Sounds like she had doubled up on her anti-hypertensives and with the expected reaction, fainted. Poor outcome as it was in the bathroom and apart from the significant hole in her scalp there was later found the occcipital # and a subarachnoid and subdural bleeding.
77M - Only one lung after CA saw it removed 11yrs ago and looks like a mild chest infection but for him that's worse.
84M - Possible bowel obstruction.
3F - Head butt with a set of open draws drew a little blood but enough to have Mummy calling us. All good smiley faces draw on her hands and left in Mums care.
93M - Wife says he's drowsy and wants him seen, never looked it all the time with us or when we say them several hrs later.
88F - Knee injury post mechanical fall and high care dementia pt who has reverted to her native tongue but no obvious injury transported for imaging.
40F With a rare angio-oedema condition not associated with anaphylaxis.
56F - MS sufferer who says in full and complete sentences that she has shortness of breath. Fully bed ridden, bariatric pt nearly by her girth, it's right on shift change and we're two sectors away from home and the local crew just got stood down after sign-on but when asked they are needed for cover as the sector is short staffed. We got the job done, it strained our bodies and minds and we knocked off three hours late.

That's the way of things some days.

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


So many jobs and we missed the Big One.

Well the big one for this week anyway.
A construction site had an incident and we were about a km away and got diverted onto something lame.
What we did get during the shift was;

37M - Post Ictal, recovered well not needing hospital.
28M - IVDU with an infected injection site on his hand that has got infected and is one of the nastiest looking cellulitic limbs I've seen in a long time. Transfer to the hand hospital for specialist treatment and he left shortly there after to find a hit.
Construction site fire&*^%$%*&^%$$$$
46F - Abdo pain but there are a host of mental health issues happening as well.
32M - Came home pissed and their relationship is rocky and he shot his mouth off (remembering what they think are throw away remarks are phrases that we use to transport for Mental Health assessment), anywho after a nice chat I was happy not to transport him and damn sure he'll think before shooting his trap off next time.
45M - Dislocated shoulder, called off that for,
93F - Who was tired, the husband has been ill for several days and she has been having little sleep, he's gone to hospital this morning and her careers wanted some one to confirm that she was just tired. Who hires these people?
90F - Dementia sufferer who had said she was unwell to her son but denied it to me. All other obs were really good so between us we decided to leave her at home.
47M - Transfer from a small hospital (more like a clinic really) to a large hospital with a presentation of chest pain now resolved post nitrates etc.
61M - Keeps taking his BP every 5 min and it's getting higher. Never did get an answer as to why he was taking it, denied any symptoms appears to have a morbid fixation about it. Of course it wasn't high when I took it after talking calmly for 15 minutes but there was no talking him out of transport.
45M - Transfer to a Detox facility.
Paediatric transfer, diverted.
Unknown problem, diverted.
20F - abdo pain and spontaneous bleeding 3/52 post a planned termination.

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


26 November 2012

Keeping the future safe.

So those that visit regularly know that I bleat on about a couple of driver re-education courses that I participate in. Well one is for adults who have done wrong and been caught while the other is run by Rotary and is directed at High School students in the year that they are going to either get their learners or provisional licenses.

An interesting aside to this was, several month ago at a rural township where I was presenting the adult session one of the participants asked a few extra questions about the course and any version suitable for schools. I told him what I knew and directed him to Rotary and our Media Dept.

This kind of community education isn't core business and is not well supported by the Service. It's not discouraged either and the value to community is acknowledged but not much. If you want to do it, do it on your own time and I do.

Anywho this gent is directed back to me asking if I'll consider coming back to the town (5hr drive inland) and present to the year 10 and 11 students at the local High School and while he doesn't have any school aged children his business will cover my expenses!

Ambowife and I went there a week or so ago now.
Three lessons per day approx 180 young adults in total.
Impromptu lessons with the Teachers in the staff room at breaks about drugs, alcohol, driving & behaviour.
A counselling session with three young ladies who had known someone in a recent fatal car crash and with whom I had touched a very raw nerve but they sort me out to sit down and discuss it and when we all left that room the boxes of tissues stayed behind and they seemed to walk a little straighter and smiled more.

I couldn't tell you if he has paid me, I haven't looked and don't care.
I've been paid in full by the way we and our message were received.

We hoping to go back next year.  

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


25 November 2012

Don't have a niffy title for this post.

77F - One of the nastiest skin tears I have ever seen the whole elbow basically.
62M - Yes he has a cardiac Hx but he is also a pest caller who has just returned to the area, Chest pain for the fourth transport in 24hrs.
??F - Seen by good Samaritan drunk in company of drunk males and holding her leg. Yes she was and they were also but her leg was not sore. We left them, all adults to party.
72M - Requesting Detox.
26M - British backpacker in Australia day one and already being carted to hospital pissed and making a public nuisance of himself.
50F - Heroin OD but not down enough to Narcan and to late to hope she'll walk it off so we had to Tx.
24M - Irish backpacker pissed, left by his mates and a tad angry about it. Tripped and scuffed his head.
88M - Increasing generalised mobility issues that he should of had resolved before discharging himself from hospital and then we wouldn't be carrying him out and back to hospital.

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


22 November 2012

A mixed lot

20M - Gastro like symptoms, a third party called and after some advice he opted to self manage at home.
45F - Sleeping in her BMW in between vomiting, I mean she was that pissed when we did get her to hospital she was incompetent to blow a reading on the breathalyser!
77M - Shoulder pain for thelast three days is keeping him awake.
24M - Febrile, he does have a significant Hx and has been trying to reduce the fever with medication administered correctly, but I can't explain why he or one of the three flatmates didn't drive to the hospital themselves in their flash cars.
22F - Crying, abnormal behaviour, really pissed and very annoying. 
80F - inside the Pub at 5AM preaching to the sinners at the bar, we convinced her to stop bothering the patrons and God together with a lift home.

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


21 November 2012

NOFing to write about.

It'll become clearer as you read.
86F - Fell at home, has missed a few days of her Parkinsons meds and a little unsteady. Left at home, uninjured and family told to ensure the meds are taken.
57F - Anxiety attack. Everything checked out fine and is so often the case just by our very presence she felt well enough to stay at work.
91F - Mechanical fall on a carpeted floor with instant pain, shortening and external rotation. We know what that means! Confirmed NOF later that shift.
33M - Dislocated shoulder.
75M - CVA with near total left paralysis attempting to shift from chair to bed unaided landed on hip and complained of pain. Because of the paralysis the staff wanted him x-rayed as he was not able to move anyway and had altered sensory response from that leg. It wasn't.
69F - To palliative care.
56F - Well known Pt for whom I have a soft spot (we have the same birthday [month and day]) increasing psych problems because of necessary prescribed drugs.
36F - Cyclist who saw the car door open and stacked it by herself without hitting the car.
25M - Told us to FUCK OFF. Drowsy post heroin but obviously not that drowsy.
??M - Seen sleeping on the ground by a passer-by who thought they might be dead and called us rather than talk to them. We were told to fuck off again.

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


18 November 2012

Two Police Jobs in the first hour,

That had us worried but the rest of the day proved satisfying.

??M x 3 for Decontamination post pepper spray, all refused.
23M - Severe anxiety that builds to a rage, came to have a talk to the Psych Team.
38F - Carers requesting an assessment of this chronic alcoholic but she doesn't want a bar (pardon the pun) of us.
48M - Abdo hernia complications.
8M - Collies #
51M - Fall from above 3m, major trauma criteria.
47M - Non traumatic back pain.
7M - stabbed himself, accidentally in the leg, it's going to need stitches too.

Gave back pain the full vial of Fentanyl 600mcg by IN.
# arm took some of the second vial I carry.
Hernia and Trauma fall took three vials of Morphine leaving me only two that I didn't need for the balance of the shift.

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


17 November 2012

Nothing special really

78M - Chest pain, his angina playing up.
95M - Discharged to N/h.
40F - Well know to all tried to cut her throat but it's not suicide rather self harm, she never cuts deep unless its accidental or she slipped.
34M - OD, heroin, Narc'd him. First day out after 4mths Rehab!!
72M - N/h thinks he has a #Hip. I doubt it, more likely a sore one from the fall but he has full motion but they want it x-rayed now at 3AM.
34M - Tourist with Gastro, has already been in our hospital and discharged two days ago but it's returned with a vengeance.
78M - Dialysis regular.

Look at that, started and finished with the same aged patient!

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


The Police took care of most of them!

Well most of the calls came from them anyway.

40F - Anxious post smoking Weed, Da! She was slowing down anyway by the time we arrived, no need for a hospital you can stay with them.
37M - IP who was refusing to give details, you don't need a hospital either, a nice cell will bring those details out and this end this silly game.
70M - Yep we'll take him Officer, an IP I don't recognise.
71M - Chest pain, got enough Hx but I am leaning towards GORD that he also has a Hx of.
30M - Skyped a friend overseas and complained about how he felt and they rang our emergency number from off-shore!!!!!! I got dispatched anyway and god love my dispatcher they called the 'alleged' patient who didn't know we had been called and he got better real quick and cancelled us.
47F - Fell off some killer heels 6hrs earlier plastered and is now sobering up. Has walked on it, I can't see much swelling, there was good ROM, but her tiara is crooked but she wanted to go to hospital.
39F - Alleged assault with fist to her face, not a fricking mark, you can stay her with them and complete your statement.

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


10 November 2012

It's not always better to be older,

We dream of it when we're young but getting just old is a drag to most.

67M - Regular dialysis.
38F - With a non traumatic back pain, we got called off for,
96F - With everything failing and hurting.
28M - Alcohol seizures.
92F - May of had a faint in the dining room chair at the home but otherwise well and fit when we examined, so she didn't want to go to hospital and we didn't want to take her so she stayed.
87F - Dementia pt who wanders and had a fall and suffered and small lac to her head and family wanted her seen.
81F - Lung disease with exacerbation of SOB.

And that was all we did for the day.

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


09 November 2012

Had to get one Psych job in.

But it took us until the last job of the day,

78M - Dialysis.
48F - Haematuria, called off for,
??M - Intoxicated and just lying on the footpath, got called off for,
52F - Airline staff member with some minor respiratory irritation.
71F - Peripheral Vascular Disease Hx and there is no blood in one of those feet when we arrived but en route we discovered that the occlusion was not total and with certain posture of the limb circulation would return.
60F - Minor posterior neck lacerations from a glass door shattering, very lucky lady. Nothing really that an A&E would do and she was totally capable of self management of the wounds.
49F - MS who just needed a hand.
??M - At a medical centre with what sounds like an inner ear complaint, we got called off for,
46F - C/o sciatic pain but also presenting as a septic pt.
47M - Wants to kill himself and lunges for a Police Officers weapon, twice. He is boozed up but there is more than the drink talking.

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


07 November 2012

More testing out the new bike.

From a ride with the Trouble and Strife.

Not too close, your not supposed to recognise me.

This site was used to junk old ships.

Her bike.

And mine.

That's her.

Look I think we found the African Queen, but where's Bogie?

Ah, my Queen photographing the African Queen.

Look at the sunshine, it got to 30C and we clocked up 65km in just under 4 hours.

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


06 November 2012

One year ago,

Ambowife and I had our last cigarette.
Never been tempted.
Never back slid.
Never faulted.

But not easy.

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


05 November 2012

And in complete contrast,

The next night was quiet and had seemed to have done to the dogs!

Another of those 'I think they're unconscious but I'm not going to stay with them' calls and once again the unconscious have risen and departed,,,, like are no longer with us,,,, you know BUGGERED OFF!
68F - Who it seems knows that loud noise and crowds seem to make her nauseous/vomit and faint (you jump straight to inner ear don't you) so WTF is she doing out on a harbour cruise at night with lots of drunk party goers??? The Capt had to make an emergency docking and off load her after which she got better.
37M - Dog attack, yep it was too. wounds to upper arm, abdo and both legs. A second victim that we didn't transport had a small chunk out of her lower leg. After spending time with the owner who was the alleged victim the dog should have its stomach pumped and be given an award, some people should not breed, be in relationships with normal people or own pets.
71M - Depressed, it's sad really, he has an acquired brain injury, (>50yrs) and every day is harder and more lonely than the last and he has lost direction. Not something we can help at 2 AM on a weekend. He wanted help and all we could do was complete a job sheet and leave a note for his carer's to make a Dr's appointment and try and get him out some more.
27M - Behavioural and drug effected.
24F - Would make Mummy and Daddy proud, got drunk and vomited, can walk and did up two flights of stairs and does a very graceful impersonation of a dying swan and needs to go to hospital and couldn't be told reason.

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


04 November 2012

Only two needed and deserved transport.

The others?

54F - Chronic alcoholic, currently intoxicated makes a comment about having a belly ache and a headache so then wants to go to hospital which as I have said before once they make that statement my hands are kind if tied. I give her some simple analgesia en route and she walks out of the waiting room. Why bother?
54F - Intoxicated in her motel room, this is what I read in-between the lines of their story. Had a meal across the road at the pub, had a few drinks and came back to the room. She's doing a little dance for him before they retire to the bedroom and slips and bangs her head on the coffee table. All innocent and it's just a scalp lac that is more embarrassing than dangerous.
21M - Birthday Boy won't remember tonight but before his mates take him home the pub security called us to give him the once over? Yep his pissed and they say he's taken a pill, he's had a chuck (normal) and they appear straight (not drug effected) and are stepping up to the plate to look after him, bloody good mates.
Your right boys take him away.
30M - Has taken usual meds that have an occasional side effect of a mild dystonic reaction of his eyes rolling up. Tonight it's lasting longer than before and becoming a little painful so he called us. I've got nothing so we transport. Having just left he rings his Mummy and she says come to my place because all they apparently do at hospital is give him some Valium and it stops. She lives in the next street, we drop him off because frankly he needs his Mummy more than us.
25M - Who security at the Pub where he was drinking, said was drunk (dah!) didn't want to wait so left. UTL
31F - If the equipment isn't yours DON'T TOUCH!

This image from the web is similar to her finger that got sliced by an oscillating fan she tried to move at a bar. It was a clean cut that took some of the bone too and was hanging on by just a strip on flesh.
25M - A multi-victim brawl on the street left this one with a # wrist, everyone else were just scraps and bruises
30M - Found in a back alley in the red light area refusing to give Police details of what happened. Again this is my take between the lines. Rather than pay for a short stay motel room (by the half hour) he wanders into the alley for a quick game of hide the sausage and gets robbed possibly by the prostitute judging by the relative minor nature of his injuries. He's fine just wants to get the hell out of here and forget the whole thing and make sure his girlfriend doesn't find out.
25M - Attention seeking self harmer who's playing games with the Cops and us, UTL.
45M - No officer he's not mental he's just pissed and angry and if he wants to sit but naked on the tiled bathroom floor of his hobo dive hotel and rant, I'm happy to leave him. In fact after I had shut the door and we were making our way door stairs I think I heard him go back to his room. See the audience had left.
25M - Yep officer this one is a Mental Health pt. Jayz (sorry if I got that wrong) the rapper leaves white minivans on the street with evil messages on them so the pt has to smash them up but Barack has told him that it's ok and he just wishes that Taylor Swift would understand that their relationship is over and they can only ever be friends and unless you get him onto these topics he is an intelligent high functioning individual. Scary how normal they can be. He was a violent threat to white minivans and possibly anyone he saw in them and I saw the destruction he had caused to the one up the road, that's why the cops were there in the first place.        

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


02 November 2012

Search your patients!

39F - Headache, tourist just in yesterday, not responsive to simple analgesia, transported to a little hospital close to the tour groups hotel. Transferred later to a big hospital for management for the aneurysm that had ruptured possibly due to the long haul flight.
93M - Fell while making his porridge. Didn't hurt himself and wanted a chat but we left him at home with the wife.
53F - Abdo pain.
57F - Fell down the front of a ladder giving herself a nasty lac anterior proximal tibia, fleshy spot on the top of the shin.
54F - Homicidal, yep that's not a typo!

From a GPs rooms after she became concerned by the pts conversation and had phoned the pts psychiatrist who agreed she should be scheduled and transported to hospital, she also informed the GP of the pts Hx of carrying knives. Pt told her she didn't have any on her,,, PATIENTS LIE! 1st rule of House.
When I asked her why she had it, quite calmly she told me to kill people, most likely former work mates, she was planning to go US Postal! Take care out there it can be very dangerous from the most unlikely places.
64F - Transfer hospital to hospital.
90M - Respiratory distress, his lungs are shot what more can I say, it's just a matter of time.
50M - Who stupidly took drugs and drove. The collision brought him to the attention of the Police and his decreased GCS got him tasked to us. While I can usually pick what they've taken I'm going to follow this one up because his cocktail wasn't clear. 

One last word on the safety issue people,
We are hyer-vigilant on the clear threats but the little 19F who had snorted half a pill and her friends couldn't handle so they called us and then she attacked and scratched my partners face wasn't seen as a threat to person. 
The seemingly normal 45F who has a long mental health Hx usually of self harm, who came to the Red Light area in which I do a lot of work armed with a 12" fillet knife hoping that someone dangerous here would kill her with it, looked and spoke like a suburban house wife.

Do you get my drift?

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