Merry Christmas

'Twas the night before Christmas, when all through my flat,
Not a creature was stirring and I was good with that,
The phone by my bed rang out in despair,
It read 'STJOHN' and I knew what news would be there…

Other members were nestled all snug in their beds,
While visions of disaster ran through my head,
I picked up the phone, and gosh I was right,
"I can't make the duty – just realised tonight!"
Upset that I was up so late in this slum,
I got out of bed to see who else could come,
Through my phone book I went in a flash,
Hoping to pull a favor from the IOU stash.

No matter which number the answer was 'No',
I began to wander to whom else I could go,
When, what to my wandering eyes should appear,
But a miniature Sprinter and eight prepared volunteers,
Complete with a driver, full uniform donned,
I knew in a moment it must be St John.

More rapid than eagles his coursers they came,
And he sel-called and shouted out each unit's name,
"Now 501! Now 502! 503 through 950!
Grab all your gear and please don't be thrifty!
We've posts to hold! Go out and walk tall!
Now dash away! Dash away! Dash away all!"
As dry leaves that before the wild hurricane fly,
They'd overcome any obstacle, with spirits held high,
So up to the main post the coursers they flew,
With a sprinter of gear, and our old St John too.

But I heard him exclaim, ere he drove out of sight,
"Merry Christmas to all members, and to Ops a good-night!"

Wishing you all the happiest, SAFEST holiday season... I'm heading away for the break so you'll likely next hear from me on Monday the 31st of December!

And now for something completely different...

Most of my posts are made on my laptop at work (still don't have internet at home - I've known I wouldn't be there for long so just never got around to getting it).

The thing is, that laptop boasts an impressive 17" LCD screen with no added extras...

I'm currently posting from my friends house. With a monitor that challenges all other beauties in the world.

Completely unrelated to the rest of the blog, but.. damn.

Who am I to judge?

Today one of my friends asked me about some of the work I do with St John, to which I gave the usual spiel about first aid. Then they asked me for some 'War stories', which, as I do in this blog I was only happy to share. This got me thinking about two things; firstly how EMS/Paramedics/EmergMed love to tell their stories, secondly about a comment my friend made.

One of the events I covered recently gave us some drug OD's, one of which was particularly worth telling and I'll be sure to throw it in here eventually. After telling how the patient treated us, my friend commented that it was perhaps best had we just left them alone - a form of Darwinian thinking that, truth be told I've heard before. My reply was simple; "I treat them as they come, be it a cut finger, a heart attack, their first OD or their tenth OD.", which my friend didn't seem to understand... After all, surely treating OD's all the time would wear you down - and that is what got me thinking.

I think in this job you have to understand something very important - no matter how much you educate and advertise, people are still going to get drunk, smoke and OD on pretty much anything. And for most of those cases you'll hear the same mantra- "I never thought it would happen to me."

We live in a society that speaks of 'added safety features', 'extended life' and those wonderful 'special enzymes to make your skin visibly younger'. Don't even get me started on those 'therapeutic biospheres'. Most people don't realise just how frail we are, how mortal our flesh truly is. Often it is later in life, when the body has felt the toll of youthful acts that people stop to think about what they have done - and often they try to warn the next generation of (alas) invincibles who naturally don't listen.

My job isn't about reprimanding them for their actions, it's about keeping them alive long enough so that they can reprimand themselves. Will I get sick of that? Hopefully not too soon.

That's not where I left it...

So today's post will be themed around things not being where they're supposed to be. Namely, body parts.

Recently I came across such a case and it occurred to me that I was not the person I once was. I discovered this when two people walking past the scene stopped and stared at disbelief before swearing with such voracity that even truckers would blush. It hit me then that witnessing dislocations, breaks and bleeding had no effect on me anymore - they were now clinical problems that had to be treated and solved.

The first such incident was a lateral dislocation of the patella (or knee cap to us) - luckily for the patient it had clicked back into place on its own, unfortunately it looked like he had a bit of damage to the tendons. That'll be a fair bit of physiotherapy.

Next came a double break - that's right, the radius and ulna bones of the left upper limb had been snapped clean in two leaving the arm to fling around like a rat on a stick. Manipulation, perhaps surgery and of course physiotherapy.

A dislocated and fractured ankle from a happy fence jumper comes next, the bones pulling on the skin until it was white... Luckily the foot still had blood supply, so just manipulation, surgery and physiotherapy.

Another ?fractured ankle, but a bit of an odd one. There was no swelling, but there was also no sensation at all. Couldn't bear weight or push/pull against my hand. I'm guessing x-rays, maybe ct scans, a few scratches on the head and something from there. And physiotherapy.

A MVC leaves a woman with a whopping bump on the noggin (and a pretty spider web on the windscreen). A fall onto hard ground leaves a shoulder dislocated but leaves the arm with blood supply (physio).

I sometimes wander if it's a good thing I'm becoming more and more detached from this - will I reach a point where nothing phases me? I'm not so sure if that would be a good thing, but at the same time I wouldn't want every case to stay with me. In some professions more than others, you shouldn't take work home with you. How will I work out? Time will tell, but currently I'm happy with my reactions. I still have the internal monologue of "that's so cool!" followed by "Can I get you some pain relief?", but I don't know how that would apply to some of the more serious accidents.

Moral of the story? Make sure you leave things where they belong - otherwise a man in a little blue jumpsuit might be grinning at how cool it looks. And you'd need physiotherapy.

Take long, deep breaths Part 2

A week since the original post and I'm only now doing the 'second half' to what I see as a two part saga.

The first half of the story centered around the attitude of different Paramedics in their approach to patient/carer/first aider interaction. This has a profound effect on the way the situation is seen by those involved, and while I will always aim to hit that second 'calm and friendly' version, there are times when even I as a first aider can see why and how the first 'sit down, shut up' attitude is taken.

From my experience (as limited as it is) in St John Ambulance, some people who are trained to do first aid take the 'Ambulance' part far too seriously. They think they're Paramedics just because their uniform reads Ambulance. This is far from good - they can get cocky, make mistakes or just generally be an all round jerk. It's for this reason above many others that I believe a portion of Paramedics dislike SJA, and I have to admit I don't blame them. I've seen people who have professed vast experience and intellect practically soil themselves when confronted with a real scenario or, as some patients/friends are prone to do, generally get in the way or use inappropriate terminology or treatments.

Fortunately for me, I only catch this once in a while - but I can imagine Paramedics would get it all the time. After a while (particularly if it's been a bad day) it would be easy to become frustrated with these types and find it easier to just do the job as you were trained. Sometimes a little attitude rubs off, though.

But imagine this also; you've just come from a child in RA who you've dropped into A&E knowing full well will never recover fully, even possibly not survive. Your next call is to a broken leg where a first aider is generally messing things up, using the wrong terms or possibly even doing everything right - it would be natural to be more disengaged and less sympathetic to that patient because you know they're really ok, and given a few weeks will be able to fall again when next they emerge from the pub drunk. Maybe they've just had a month of overnights, maybe they've just seen enough pointless spilled blood that week. It's about perspective.

Will this always be the case? Of course not. Some people are just jerks.

But it never hurts to think of both sides of the story.

Common sense (and why it isn't always common)

A good deal of what we do in first aid is common sense. Anybody can do it - most children, when asked what to do if they cut themselves would be able to tell you to put a band aid on it. There is one little catch, however, that has shown me time and time again why such a simple thing to treat can be changed into something a lot more complicated.

From the newest member to the most hardened veteran of first aid (sounds silly, I know), I've seen people freeze up at certain types of injuries. Some people don't like blood (again sounds silly but I've seen first aiders go pale at the sight of it), while others don't like screaming patients. I've done it too, but I'm trying more and more to stop it. Sometimes your brain needs a few moments to collect itself when confronted with a particular sight, and it's something that you need to condition yourself out of in order to become better at this. Some injuries require immediate attention, so you won't be given those moments, and it's a trend I'm noticing going through the Paramedic literature that an important part of the job is getting around that initial mental hurdle to get back to that common sense.

But this raises another point - Paramedics condition themselves to adrenalin, as the job puts the body into a stressful state for frequent, long periods of time. This is a two edged sword; it allows the Paramedic to work in stressful situations to accomplish that which may not ordinarily be accomplished, but it can also lead to chronic fatigue and a depletion of mental resources. It can burn you out. A good Paramedic will be able to find that balance, the sweet spot between exhaustion and exhilaration that leaves them in the right frame of mind for the job. I've heard it's not easy, and not everyone can do it despite their best efforts. It can hit you straight away, or slowly wear you down after years on the job.

Will I be able to find this spot? I hope so, but I guess you'll only ever find out through a trial of fire. All else fails, I like to think I'll still be able to use my common sense.

Super happy fun time update

And so I have a fair bit of news for this post! An update both of what's happening with the Ambulance Service of New South Wales (which is who I'm hoping to do the Traineeship with) as well as some happenings with St John.

Firstly, apologies but I'll have to delay the 'other side of the story' as promised in Friday's post - rest assured that's what Wednesday will cover.

Secondly, and much more excitingly, I received a call from ASNSW Friday (shortly after making that post) telling me that I was successful in the previous round of Aptitude Testing and that they would like me to come in again. Not only that, but they were keen to fast track me, so I will be sitting the next two rounds (Full interview and driving test) on the one day being January 10th. This was very good news for me - the fact that I had been contacted only 1 week since doing the tests implies that I had performed well, as they tell you to expect a call after three weeks when the ranking is completed. On top of that, a friend of mine (who happens to have just landed a job with MAS, but who had also applied at ASNSW has told me that they pretty much tell you after those two rounds if you're in or not - so I may very well be able to tell you that afternoon if I've entered the first real step into my new life. My friend has also offered to run through some of the questions to expect and other general pointers - greatly appreciated!

The other news is in regard to St John Ambulance, who recently purchased and decked out a new Mercedes Sprinter with the new design splashes. I was fortunate enough to have been allocated the vehicle (ok, so I begged) for a duty last night (Carols by Candlelight), given it was a well populated area it doubled as brilliant advertising for the organisation (photo above - who could that handsome devil be? - More photos coming as soon as they hit my inbox!). At the end of the night when they were calling out the thanks, St John got a mention and so we did the compulsory lights flashing which got a laugh from the crowd. A quiet night casualty wise (the way we like it) but still a rather enjoyable night!

With Daft Punk coming up with St John this Thursday, I'm sure I'll have plenty of stories to keep me blogging for a bit longer ;)

Take long, deep breaths...

I'm posting Saturday's post today, because I know tomorrow is going to be a nightmare of activity for me. An early post? I'm shocked too.

The idea for this post came to me after reading Baby Medic's post 'Real Strength', which I think is compulsory reading for anyone in the field. What I want to talk about today is the aura you seem to get when working in an emergency setting.

There is a long running joke in St John Ambulance about the 'Paramedic Strut'. Basically, whenever a Paramedic walks into one of our posts following a 'Code 6' (call for Ambulance), they tend to strut in with the flag billowing in the background while they calmly ask "So..." *pause for effect* "What seems to be the problem here?". Naturally, the girls (or guys, should the Paramedic be female) swoon and the patient will miraculously recover at their touch - once more the world is safe.

What this joke refers to is the sense of authority that is immediately identifiable in a Paramedic. I tend to summarise this into two categories, and this is where Baby Medic's post comes into play.

The first type of Paramedic will come into the room and ignore us (St Johnno's) completely. They will do their obs, perhaps ask a question or two to the person in command and then get irritated when said person isn't familiar with one of the terms or methodologies the Paramedic is referring to. They assert their authority through a sense of aggression and condescension. While I'm the first to admit we are only First Aid (more on this later), it is this first type of Paramedic who leaves a bad taste in your mouth long after the ambulance has left. They use every technical term to talk about the situation and the patient is often too scared or feeling too incompetent to actually ask what is wrong with them.

The second type of Paramedic walks into the room, says hello to everyone and with a calm grace takes in the situation. They take obs, also asking the Johnno's around questions and explaining any terms/methodologies in a conversational and respectful way. They talk to and reassure the patient, explaining in simple terms what the problem is and why going to hospital would be the best idea - but reminding them it's their choice. It's this calm and respectful stance that I've come to admire about certain Paramedics.

Of course a single Paramedic may have a combination of both attributes, and this may also change from day to day - the job is demanding, tiring and often frustrating. But at the same time, the attitude rubs off, so even if you're feeling frustrated it's important to keep that calm.

Before any Paramedics flood my inbox (not very likely... but still) with emails, I'll be making another post on Monday with the other side of this story from what I can gather. Then please email me if I've left anything out.

Blogging about Blogs

I've come to appreciate blogs as more than just a spleen venting pit of the internet - they're a chance to tell the world your story.

First let me say thank you for taking the time to read my vented spleen, and also to let you know some of the spleens I enjoy reading - mostly of people who've traveled down roads similar to the one I hope to travel.

Basically, they have better stories right now ;)

Baby Medic - http://babymedic.blogspot.com
Inept Pike Fishing - http://ineptpikefishing.blogspot.com
Trainee Paramedic - http://traineeparamedic.wordpress.com
Other People's Emergencies - http://urbanparamedic.blogspot.com
PurplePlus - http://kingmagic.wordpress.com
Street Watch - http://medicscribe.blogspot.com
The Paramedic's Diary - http://paramedicsdiary.blogspot.com
Policeman's Blog - http://coppersblog.blogspot.com
The Thin Blue Line - http://thethinblueline.blogspot.com

If you've enjoyed some of my stories, try theirs...
Just make sure you come back!

Dance the night away

It was a duty like any other, only it happened to be a youth dance competition... At first I thought it may have been the annual Oompa-Loompa reunion given the amount of orange skin and wigs.

After several hours of boredom a young boy (around 14) 'hopped in' complaining of an ankle injury after a stumble when leaving the stage. I had a quick look by lifting up his pant leg and then fled to the opposite side of the room calling on anything holy to protect me (of course, this didn't really happen...) as I noticed his ankle was around three times the size it should have been. After taking a few more obs I followed the nifty little RICE mnemonic for soft tissue injuries and was recommending the joys of a trip to the local hospital to get an X-ray to be on the safe side. This was not to be...

The mother of the boy refused to leave, saying the child still had one more round - the Grand Final to compete in. I looked at his ankle. It looked back at me, whimpering. I looked at the boy, who seemed determined to keep his mother happy despite the risk of further (major) damage to his already damaged ankle. As the boy was under 18, his guardian had right to deny treatment.

I hadn't removed his shoe, given it was holding in the swelling somewhat and the parent had already said they wanted him to be able to dance. If the shoe came off, the swelling would immediately spread down into the foot and any hope of getting a shoe on again (and thus his ability to compete) would be lost. I was so tempted to take that poor boys shoe off... But alas, I had not the right.

This places us in a tricky situation. I had fully informed the mother of the potential harm she was doing her son, but still she refused. After a bit more talking we came to an agreement (which I still hated) - she took her son from the First Aid room back to the event, covering his ankle with his pants (thankfully loose fitting). Nobody was allowed to know he had been there (not that we give out any details on our patients) and, if we pretended nothing was amiss she would 'allow' us stand side of stage if he collapses. How caring of her.

This is where the story gets strange (I know). The boy goes on to dance. The boy wins the championship. Nobody notices his ankle, three times the normal size, and he walks off stage as if nothing were wrong. That boy must have been in tremendous pain - and as he walked to his mother out of sight of the crowd you could see his limp and unshed tears.

He may have won this championship, but I shudder to think the damage he may have done to himself or - more to the point - the damage his mother had 'allowed' him to be exposed to. I hope he's still out there dancing (he was good), but I'm hoping more that he was allowed to heal before his next competition.

Some people just shouldn't be 'allowed' to have kids.

Regarding my mental abilities...

Ok, so as promised this post will be a run down of the Aptitude/Psychometric testing - and an explanation of the last two post titles.

To start off, I was sent to the Ambulance Service Education Center, where we packed in like sardines to sit the tests. And boy, did they last a while...

The first round was language, where we were given a paragraph from which we were expected to be able to extract certain information which we could apply to a given question. Fairly straight forward, fairly easy. There were a few questions where I was very happy for my prior medical knowledge, but overall it was based on common sense. There was one question which stuck on my mind regarding heat stroke, where they give you a bit of background then talk about a patient you arrive at who was jogging but now found on the ground covered in sweat. Asked if you think the patient had heat stroke, most people put no - the patient was sweating, which stops in heat stroke. Luckily I put maybe (more information needed), much to the chagrin of the others at lunch break, because he had been jogging, so may have been sweating from that prior to cessation of sweating due to heat stroke. One to me :)

Next came Mathematics skills, which is where I feel I excelled. I've always been pretty good at maths, given this was still at a fairly simple and I've successfully completed a university mechanical biophysics course - so hopefully I was fine.

Map reading I may have made a boo-boo on... I only realised today I may have gone the wrong way down a one way street, but only for 10m so I should be ok... We had 2 minutes to work out how to get from one side of the city to another! And Sydney is renowned for its one way streets...

Word association came next with logic/pattern recognition - the inner geek was actually enjoying this section! I've since looked up the tests on the 'net and got all of this section correct - go me! (PS: I need to get out more)

Now it was around this time that the real pain started - the previous tests told them how smart we were. The next test was the Aptitude part - a long test provided by the Dept of Forensic Psychology. This was the meat and potatoes of the test, because you could be the smartest person alive but if this test said you didn't have the right attitude, you would not progress. I have to point out a few questions that took my interest;
Select the answer that you identify with best:
a) I avoid responsibilities and work whenever possible
b) I like to criticize my bosses behind their back

ARGH! What's the right answer?! I chose b, simply because I don't think avoiding responsibility helps you - but there were many questions like this that made you stumble a little. Then they would re-ask certain questions in slightly different ways to see if you're consistent (or at least a consistent liar ;P).

True or False:
I believe I may secretly have unusual mental abilities which I cannot talk about in case people don't believe me.
Related:
I hear voices in my mind

Does anyone actually put 'True' to these? If so, I hope I never end up transporting them...

Overall the Aptitude section was the hardest. There is no real way to cheat it because they talk to you about your answers in the interview (next round), so they'll catch anything you've 'made up'. And it asks some fairly personal questions too, again which you'll have to be candid about if you're serious about going for the position... I decided to be honest about everything - even some of the things I was afraid they might not like - because I feel that they'll understand a) I'm only human and b) sometimes life throws curve balls, and they're important lessons we can learn and evolve from.

I find out in three weeks how I went (or at least when my interview is if I'm through to the next round) - you'll know as soon as I know.

Until then, 'normal' posts for a while ;)

I believe I may secretly have unusual mental abilities...

AND IT'S DONE! The latest round is over...

As predicted, I'm a geek - blogging from an internet cafe in beautiful Sydney. I'll rant a little about Sydney today and the test details will come on Saturday.

So Sydney is a nice place, the weather is beautiful (although not as rainy as I would perhaps like...) and the people are... well, everywhere. Someone else has commented and I agree totally that Sydney is like the rush of Melbourne combined with the feeling of the Gold Coast. There's people everywhere doing everything, which is actually pretty cool - but there are of course a few downsides to all this...

Firstly, can everyone from Sydney please just slow down when driving? You're all insane. All of you. Bus, don't cut off the car I'm in please - you're bigger than our car but that doesn't mean you instantly have right of way. And for some reason they decided to print the speed limits on the road, as opposed to on signs lining the street... An interesting move, given everyone drives so damn close together (despite whatever speed they may be traveling at) that you never get to actually see it.

Also, cabbies here are pretty cool - I've had four dealings with them and three were quite positive. The first guy added extra money to the charge without telling me then didn't give me a receipt (I decided not to say anything, it was only a few dollars and I justed wanted to get back onto safe ground), but the next guy yelled directions across from another car to us when we got lost (a friend was driving) then indicated when we needed to turn off by driving in front of us and pseudo-indicating. Legend. The next one took me on a rather neat short cut that saved me $5 and finally another took me back where I needed to be despite not having a proper address... I just described the place and he knew it.

Accommodation is pretty expensive and I'm getting a little nervous about how I will afford living here, but I'm sure I'll work that out as I go along. The Ambulance HQ is located in a pretty good spot that's easy to get to, so I can live pretty much anywhere (ie, the cheaper outskirts of the city) which is lucky.

Well my time is running out so I'll finish up here - more details on Saturday!

T-minus 24 hours and counting

I'll post today because I think tomorrow might be too busy - but tomorrow I'll be flying to Sydney for the next round of Paramedics Intake Testing - Psychometric Analysis/Aptitude Testing to be held on Thursday.

The thing is long. One of my Paramedic friends jokingly put it; "If you FINISH the test... you pretty much get a job, because its long as f**k!!"

I think the aim is to see who has the stamina required to sit in a truck for hours on end by making us sit at a desk for countless hours asking questions that assess our ideas of right and wrong. I've been pre-warned not to circle 'Yes' to 'Do you hear voices?'. Thanks. I'll be sure to post what it was like as soon as I get back (or sooner, depending on how geeky I want to be in Sydney) on Saturday after I'm done testing, checking out accommodation and catching up with family who live there.

So here goes nothing... Wish me luck!

One reason why I'm happy I'm leaving research right now...

It's 10pm. Apart from two hours off since dinner, I've been here since 8am.

I'm currently sitting here, waiting for a phone call. Our Liquid Nitrogen tank which we use to cryogenically store cell lines, biological samples and other less stable compounds has run out of liquid nitrogen. This means it's slowly approaching room temperature, which if it does means we lose thousands of dollars worth of samples, not to mention the countless hours (read: months if not years) of time taken not only to prepare those samples or their experiments, but to perform various analysis and calibrations required for each sample batch we receive in order to be able to standardise our experiments.

I've already called the emergency contact for such emergencies, who told me there basically wasn't much he could do. The other contact's phone is off. My lab heads phone is off. So I'm waiting for engineering to call back, but again I doubt there is much they can do.

Worse comes to worse I'll spend the rest of the night transferring samples from the big tank (oh, it's big) to several of the -80 freezers (which is warmer than liquid nitrogen, so may still impact on samples) unless I manage to get access to the upstairs liquid nitrogen tank. Best case scenario I'm told the tank will hold temperature till morning when a new tank of LN2 is supposed to arrive.


Either way, I don't see myself getting home (in particular to bed) for at least another few hours, and I have to be in again at 8am. I guess I could look at this as training for the long hours of Paramedicine, but truth be told even they'd sympathise with a (I don't want to count) hour day.

What is wrong with you?

Sometimes we get cases that we just know are wasting our time.

It might be that you can still move the fingers you just 'dislocated', that the throwing up has nothing to do with the eight bottles of beer you just finished and must be due to internal bleeding (despite the lack of blood) and your obvious soberness. It might even be that you've just 'fainted'.

It's a funny thing, fainting. You see, we have these little things called oropharyngeal airways, which for unconscious patients just slide right in. Fits like a glove (providing of course you use the right size oropharyngeal airway). Unless of course you are (and of course you are not) faking - in which case you will gag and cough up the airway the second it's in - a natural and almost invariably an irrepressible response. Oh, we know what's going on now - but we have to play along with your little game because there's not much else we can do. This seems to be a popular activity for teeny-boppers when that young boy comes out on stage wearing almost more make up than said 'boppers...

But then there's the other cases, where the patient is just plain stupid. They profess that they wish to become a neurosurgeon (despite a distinct hate of all and any education establishments) so that they can perform brain surgery on themselves. I'm not making this up, I've had someone tell me this. And then there was a youth with severe stomach cramps after a two week binge on junk food and alcohol...

While the last two examples had patients who were there for genuine reasons (the first was there for reasons other than brain surgery), you still feel like your wasting your time - that Darwin determined long ago they should be left to nature. Of course we still treat them like any other patient who comes for help - but its these patients who treat that little bit faster so as to get them out the door, away so they cannot accost your ear drums with their taint. You feel that little stupor that comes with not using your brain for an extended period of time after dealing with these patients, and I at least get a little angry (but of course don't show it!) at their sheer ignorance of what the world is really like.

I like to think I treat all patients equally, but even I must admit I get on better and do that little bit extra for the patients you think are really worth treating - worth our time.

Keep the tip

Over the weekend a bunch of high school friends and I got together again for the first time in a long time. It was great to see everyone, but I had to travel quite a distance back out there as I've done a bit of moving since graduating. Unfortunately, only half of the people we were expecting turned up, and from them only half the people could really stick around for the full time - however one of the people leaving was leaving for work a few restaurants down from where we were.

So we tagged along :D

It was a great night of catching up, with plans to get the full gang together again soon (damn pikers ;P). At the second restaurant for the night we grabbed some dessert and were entertainingly served by our friend (who, after a few jokes from the gang I'm scared we almost got fired - sorry!).

So where does this blog come into all of this? As we went to pay for the dessert, my friend tells me (rather sheepishly) that one of the kitchen staff had an 'accident' in the kitchen. With a knife. And their fingertip. Well, an ex-fingertip.

Kitchen staff are notorious for these kinds of injuries, so I thought they'd probably know what to do, but offered to have a look at it anyway - which was kindly accepted. On my way in I PPE'd up from my belt pouch much to the amusement of my friends. The injury was fairly minor, she had taken the tip of her finger off but had left little skin remaining - they had found the tip from the floor but the likelihood of re-attachment was low given the size. The main concern was the bleeding, as she kept removing the paper towel they had over the finger to 'show everyone'. This has the lovely effect of removing any clots that may have formed to stop the bleeding, the end result making the wound appear much worse than it is and increasing the time taken for a proper clot to form.

After asking for one more show so I could assess, I got a knuckle bandaid and used the non-adhesive dressing over the tip and told her to keep pressure on it, put some wrapped up ice around the finger to reduce blood flow, told her to keep the hand elevated and do not use the hand - at all. She would have to go to A&E; best case to do a proper clean and cover, worst case to get a skin graft to cover the tip to let it heal properly. She had taken a fair chunk off the tip... After a bit of chit chat they worked out it was best to get a private car to the hospital and so I left them be to return to my friends.

One thing my friends and kitchen staff commented on was the gloves. They asked if I always carried them (to which the answer was yes) and why (to which the answer is you never know when you'll need them). A pair of gloves are a wondrous thing to have on your person at all times - they make great ice bags, let you pick up undesirables and other assorted fun items and, occasionally, can be used for first aid. For this reason and others I always carry my belt pouch regardless of where I'm going and I'm finding time and time again how valuable the little bugger is. $15 is a small investment for piece of mind.

I'll have to remember to check how the finger went and what A&E did, depending if they mind or not I'll throw the update in here. I think the hardest part of this job was resisting the urge to make the plethora of rather poor jokes that were running through my head at the time - although I am afraid to say one or two snuck out.

Read the post title one more time - and let that sigh/giggle out ;)

Look after yourself (aka almonds)

It was nine o'clock on a Saturday, the regular crowd shuffles in. There was a young man brought in to me, with the stench of tonic and gin... Ok, well it was actually more of a beer smell and from memory it was a Tuesday, but let's call it artistic license.

At first he refused treatment but said he wanted water and a sit down, he was dehydrated. This is far too common at concerts like the one we were at, as we were situated right next to the stage and provided one of the best places to watch the show from. Perks of the job on quiet nights. This had all happened while I was at another post and the crew there were happy to just let him be for a bit.

After a while I moved to this post to help even out the crew numbers around the event and I was introduced to this lovely fellow with a 'I'm all right, f*** off.' I asked the intercepting crew member why he was there, as I'm a firm believer that despite our rather well placed post the spot should be reserved for casualties, and while I'm happy to have people sit down for a few minutes and get re-hydrated, the last thing I want is for the post to become a perch for the lazy and unscrupulous.

I returned to the gentleman who, for the record, was pleased to make my acquaintance again which is when I decided to inform him he would have to move on if he was 'f***ing alright', to which he suddenly remembered some wounds he had. Thinking he was just stalling (the concert was quickly nearing its end) I asked him to tell me about his wounds when a rather interesting story ensued.

He had been motorcycle riding in Country A before deciding to get even closer to the countryside by coming off the bike at high speed and spraying himself along the roadside. He had been taken to a local hospital and his wounds (which were fairly minor given the accident) were stitched, dressed and he was sent on his way. He returned back to Australia a week later and, being bored one night decided to remove his stitches with his hands and a pair of kitchen scissors. He also redressed his wounds which he thought at the time 'looked like s***'. A shining star of Australian upper class culture, this boy. I was tempted to ask if they smelled of almonds...

After a little negotiation I convinced him to let me have a quick look at his wounds, as two days had passed since his self-redressing and I was beginning to suspect they had become infected. As he removed the covering over his elbows and legs, I realised how right I was - every wound was in various stages of infection. None were what I would consider life threatening, but they would certainly require a hefty dose of antibiotics. With his new found consent, I cleaned and redressed the wounds in sterile non-stick dressings and tried to convince him to see his GP in the morning (he had already refused going to A&E), even writing up an OB11 (one of our casualty report forms) that he could take with his doctor.

Now I knew that the doctor wouldn't care less about the OB11 and that it was obvious what needed to be done, but I like to hope if nothing else it would serve as a reminder to the man to at least see his GP. He was under the influence and I wasn't too certain how much of the night he would remember, so an official looking piece of paper with 'Ambulance' written on would hopefully leave an impression on him.

The thing I didn't understand about this casualty was that he must have been in pain from the infection, even after recognising the wounds weren't quite happy it took two days and a person to tell him to leave a first aid post before he did anything about it. He wasn't about to lose his legs just yet, but infection is a serious problem that can cause major complications if left untreated. The common thought of 'If I ignore it it will get better' just isn't going to cut it in this situation, and you tend to look decidedly less macho when the doctor tells you of his plans to amputate.

At the end of the day, the only person who is really going to look after you is yourself. So make sure you take responsibility for yourself - otherwise you might be getting a visit from our friends in the shiny vans with lights on top.

The Helper

While I'm doing the little rant at patients, I thought there was someone else worth a mention.

The Helper.

I'm not talking about First Aid, or a Doctor or Nurse (or Paramedic!) who is there helping out - I'm talking about the friend(s)/family of the patient who do nothing but get in the way, distract you from treating and generally make a nuisance of themselves. While I'll admit they can play a vital role in maintaining the support of the patient, more often than not they end up doing the exact opposite. Here's a few stories of what I've encountered so far.

I was at a local event and, for reasons I won't go into, had to move a patient via stretcher. I had another member there but the patient was quite rotund (patient to stretcher ratio of about 1.6). Luckily we had security nearby but, as I thought at the time, luckier still a member of the public had stepped forward, informed us he was a doctor and would lend a hand for the move.

I thought our doctor was a little clumsy with the stretcher, but didn't think too much of it given St John are known to use some older models (read: discounted) and it was most likely a while since he had used one anyway if he was a GP. After getting our patient to a First Aid post and a handover completed, I thanked our friend and chatted a bit (you might notice we tend to do this a lot). I asked where our Doctor worked, to which he replied Hospital A. I followed the usual routine of asking his specialty to which he replies 'Oh, I'm not that kind of Doctor. I'm an epidemiologist.' Our Doctor was not in fact a medical doctor and actually knew almost nothing about treating patients. He was a numbers doctor. I know the patient just needed to be transported, but boy did I let him have it... I haven't been quick to trust the 'help' from the public since, regardless of what they say they do.

The next case comes from a concert where a young man sustained a minor injury but needed observations at a post just to be on the safe side. We moved him over and a friend of the patient tagged along. Along the way I continued to ask our patient questions, to which the friend kept answering. Things like 'Where does it hurt', 'On a scale of 1 to 10' and 'Did you notice anything when you fell?' were all answered initially by the friend until I cut them off and asked the patient to answer. To make things worse, the friend decided to continually spice things up by attempting to use anatomical terms and medical abbreviations which were either completely wrong, mispronounced or physically impossible. I'm yet to find the clavicle in someone's knee - but I haven't given up yet.

Moral of this story? We understand that you're trying to help - but when we ask the patient a question, we'd like the patient - and unless they're unconscious or have omitted a major detail only the patient to answer.

The last story I'll mention goes back to one of my very early duties where a young girl and her mother were brought into First Aid, where we quickly discovered the mother spoke not a single word of English and relied on her daughter to translate. It was obvious the daughter was used to this arrangement and for a 12 year old was very mature about the entire thing. While the actual problem was rather minor but a little embarrassing, I was sure I could have it sorted out in no time. That was, at least, until the rest of the family arrived.

Around 12 of them poured into the very small post and were yelling at each other in order to try to gain the most attention. I think that's what happened at least, because none of them spoke English except for our aforementioned 12 year old. After trying myself to get their attention (which they politely ignored) I turned to the girl to find out at least what on earth they were arguing about. After much hand waving and more than a little pushing back out of the room, I got the girl to tell them to wait outside unless something was also wrong with them or unless they had something very important to tell me - but that other than that they would have to leave us alone for a few minutes. As predicted, the actual problem was solved very quickly and they were both out the door before the rest of the family could storm the room once more.

The final moral of today is this - even if you're not answering for the patient, sometimes just being there and being noisy is enough to cause us problems. We understand you're concerned for your friend or family member, but please let us do our job in some kind of peace.


Going back to my biochemistry roots;
If you're not part of the solution, you're part of the precipitate. (Credit)

Letter to Mr. Johnathon Walker

Firstly, this post isn't late - the world is just spinning a little faster than usual at the moment... This also means two posts will be released on the same day, because although I started this post on time, finishing only occurred on Wednesday when I got enough time to do so and start the next post ;)

Dear Mr. Johnathon Walker (an Open Letter to those who drink),

Firstly, let me wish you health and happiness in your travels, for I know last we met you were short on such luck. I was the fortunate soul whom your limbs were entrusted to while your mind decided to go for a bit of a wander. Unfortunately, you left behind your stomach and we were thus treated to a fireworks display. Relax, we've all been in this situation (myself included), and it's something most of us will grow out of.

I wish to make a few requests for the next time we meet, so that our fun times may continue in this little cycle of ours, and so that next time my washing will be made all the easier.

Firstly, I am not a tall guy - 5'7". I am also not the most muscular person in the world. For these reasons, I would most appreciate it that if you decide to become unconscious or, for whatever reason, are unable to walk even with assistance - please do so on the ground floor of whatever establishment we may be inside. Better still, do so outside, next to the car park (NEXT to, not ON or IN) while wearing warm clothes if it's cold and the brighter (and more reflective) the better. Not too long back you decided to make your resting place in the basement with only one entry (a damn narrow and steep flight of stairs) and given your girth I'm sure you appreciated the effort I was forced to make in your extrication. My back was fine after some rest, thank you for inquiring.

Secondly, please try to be conscious enough for me to be able to ask some simple questions and for you to understand and provide some simple answers. You don't need to tell me you're not (or are, in some cases) an alcoholic, as we have already established this prior to our arrival. Honest. Another thing I would appreciate in these early stages is that, should I require to, I may need to inflict a little bit of pain to rouse you. Please don't swing at me, because nine times out of ten my co-ordination is slightly better than yours and it makes you look slightly silly. That other one time... Wait until we get to the 'Finally' paragraph.

If you feel the urge to undertake the act of emesis, please do so in the bags provided. This may come as some shock, but my shoes are not in fact emesis bags. Nor are my overalls. For the love of all things holy, if I'm in my black and whites, these are certainly not to be utilised. Once you have completed your act, just hold onto the bag unless it's full. I'm sure it'll come in handy before too long.

Emesis bags are not to be thrown at me should you decide you no longer would appreciate my assistance. A simple thank you and nod of the head would suffice.

Finally, we may very well become good friends, repeating our adventures on a regular basis. For this reason, be nice to me (and ask your friends to do the same!) - for although I will do what I need to do to make your health improve, your comfort might just be slightly increased if I know you're an ok person.

Wishing you well in this drinking season of (insert any time of year here),

KT

Trauma Junkie

Since writing this blog, a few friends have called me something which, while not necessarily inaccurate, I don't find too appealing.

Trauma Junkie.

In a sense, they are right. I like getting the 'big cases' where my hands get wet. I like being tested, forced to think on my toes and, I'll admit, the adrenalin rush is certainly an interesting experience.

Don't get me wrong - I never wish for someone to get in trouble, in fact in a perfect world my future career would be redundant and I'd be more than happy with that - it's just that this isn't a perfect world, and accidents do happen. So does stupidity, hate, greed, lust (and all those other enjoyable sins we hear so much about). I've become a bit of a junkie in the sense that I want to experience things so I can learn from them, observe and help when things go wrong. I want to be there for the 'big cases' so that if, and I hope this doesn't happen, I'm on my own in this situation without the support of a team or partner, I will be able to keep my cool.

Something of a recurring mantra on this blog - I want to be better. If that makes me a trauma junkie, so be it - as long as everyone goes home to a full family tonight, I'll be more than happy to stick with that title.

DIB

The first time I thought to myself that I was becoming better at this was a rather interesting day. I was at (yet another) St John duty at an all ages concert with a crew from another division - one I hadn't worked with before and was made up of mostly cadets. This is always an interesting situation to be in, because you're never really sure what level the others are at until they're put to the test in front of you.

Who should decide to pay a visit except the Commissioner of St John Ambulance (the relevance of this shall appear in a later post).

He was having a chat with the one of the other members (I usually try and stay out of a lot of the 'politics' of the organisation) when the event radio squeals for us to head to the first floor for 'an elderly man in trouble'. I love the non-descripts.

I grabbed a basic kit, defib and threw (by which I mean of course under Occupational Health and Safety requirements, passed in a slow and safe manner) O2 to one of the cadets, not too sure of what we'd need. I called for one of them to follow me, but somehow had two when I got there.

Luckily for us, our 'elderly man in trouble' was not critical, but he was having difficulty breathing. After doing basic obs it was clear all was not well and I called through the radio to get an Ambulance in. We administered oxygen and got a wheelchair to get him down to the First Aid post where we'd organised to meet the Paramedics.

He had forgotten to take his blood pressure medication and had a very rapid, strong and slightly irregular pulse, which was (and still currently is - although I'm working on it ;) ) beyond my capabilities to treat.

I had chatted to him until the ambulance arrived, given the circumstances I did most of the talking - it helps give a touch of normalcy to the situation and also takes the focus off the symptoms, slows the pulse. He was a rather interesting old chap, I'm always amazed by the lives of those I come into contact with...

It was a simple transfer, after ten minutes the Paramedics had come and gone (and somewhere amongst all the fun the Commissioner had vanished), but I was amused to hear the two other members talking in the hallway outside the post...

"That was freaky..."
"Yeah, never had anything that serious before. The other guy was ok though, I couldn't stop shaking!"

I wasn't sure how to take it at first, I was of course feeling undeserved complimented and a little abashed - I was only doing what I was trained to do, after all. They came in later and, given they were still a little rattled, I gave a debrief and we talked through the scenario.

This was my first real taste of teaching first aid, because it turned out the other two there didn't even know how to administer oxygen. We spent the rest of the duty going through scenarios and equipment - everyone rather enjoying themselves with no other call outs.

I left that duty with a sense that I had accomplished something, not just with the patient, but with the other members - and it felt good. For the first time I felt I had achieved something beyond what I originally thought I could do, and it was around this time I seriously thought about becoming a Paramedic. I like to take my time with decisions though, unless someone's bleeding.

The other thing it made me think about was just how limited my treatments were as First Aid - both in knowledge and resources. After this case I did a lot of reading on blood pressure medications and furthered my knowledge of oxygen therapy - sometimes being in a university gives you access to some fantastic references, even if you're a molecular biologist not enrolled in the Paramedics course ;)

How little I've learned...

The thing I have to keep telling myself lately is that I don't even know if I'm in the traineeship yet. For all the posts, the experiences, the aspirations and hopes - I have to remind myself that I'm still in my infancy. That I'll end up getting into Paramedics somehow is obvious to me - I'm too damn stubborn. The question is how long will it take me?

So there's a few things I want to say to various people, those things you'll find below.

To NSW Ambulance Service;
I am what you're looking for. I am hard working, good with people, a quick learner and have a passion for doing more of what I've experienced so far in First Aid. I have a medical background, holding BBioMedSc(Hons) with experience in cancer and viral medical research. I am self-reliant but still love working in teams, efficient and (with what I've experienced so far) able to keep a cool head in potentially bad situations. Give me a chance, and I will not let you (or those who trust in me) down.

But I am young, and while I think I have experienced some things, I know they are nothing to what a Paramedic can experience on a daily basis. I am willing to learn, and for that I need you to teach. More than anything else, I need to remember that no matter how qualified I am (with my current degree, while I'm in training and long after I finish) I will always need to keep learning. I have long loved to learn, having spent most of my life in educational institutions, but the real learning starts when you let me into your vehicles.

To any crew I (hopefully) will work with;
Be patient, for although I may be eager I know I am only human and will make mistakes. Let me know when I'm doing things wrong, but more importantly don't be afraid to also let me know when I'm doing things right. Guide me until you think I'm ready.

I will try to keep my patients happy and safe, I will introduce myself to them by name and make sure I listen to what they have to say. I will treat everyone with respect, even though I may not always be treated the same. That is life, and a lesson I've learned somewhat already but will continue to learn. I will treat them as best I can, explaining everything I do and why. No matter how much smarter, better trained or higher in the social hierarchy I think I may be compared to those I assist , at the end of the day we are public servants, and they are the public - my humility can help my patient just as much as gauze and saline (but that doesn't mean I have to respect every drunk ;P).

I will do what I can, but I know I can't save everybody. I will accept that when it happens, and although it's easy to write now I'll need your help when it happens (even though I may be too proud to ask). Make me good at what I do, but always remind me to become better.



Making the decision to follow this path was one of the hardest decisions I've ever had to make - but since making it I haven't had a second thought. Where I was afraid of beginning my education again, I have found a fascination for reading EMS text books, reports, stories and blogs. Where I was scared of changing the direction of my life, I've found an inner peace and sense of 'rightness' I haven't felt in years.

The more I've learned in life, the more I realise how little I've learned and how much more there is out there to know. An old friend of mine once told me that was the first step to wisdom, but that the path was long and easily lost. While he left us several years back, I'm sure that if I could ask him today what he though, he'd tell me to follow my heart.

I only ask the Ambulance Service of New South Wales to give me a shot and see what I am capable of. Teach me, train me - and no matter how good I may become, always remind me just how little I've learned.

Panic Attack

Three of us were at a local St John Ambulance duty, while the event had a purpose it was basically another get-people-together-and-get-them-drunk night. It was a night like many others, we basically sat around and chatted amongst ourselves while everyone else became about as stable as a half demolished tower of Jenga.

Fun for all.

One thing that I didn't like about this venue was the positioning of the rest rooms - they were outside the hall, down a corridor and tucked away into a back corner. Usually this wouldn't bother me, but given the heavy drinking the toilets were something we wanted to check on a regular basis. Luckily there were two females on duty with me, so we've divide up the toilet checks where I'd go check male, they'd go check female - much more convenient than vice-versa.

At one point they went off to check the bathrooms and hadn't been back for some time. Figuring they got a job but not hearing a sitrep on the radio, I stuck around and made sure everyone else was playing nice. Down the corridor comes a howling scream and it's at this point I decided I might pay a little visit to see exactly what was happening.

The two females I was on duty with had discovered a girl in a full-blown panic attack. Trying to get her out of the bathroom to somewhere a little better ventilated, they had tried to take her outside - only to have her hit critical when coming down the corridor. I brought over some O2 and we got her ventilated and were reassuring her when I get a tap on the shoulder from security - they were complaining that we were blocking off the toilets.

This really gets to me, when people can see we're in the middle of something, but insist on bothering us for something quite trivial. This girl just needed a few minutes of privacy, so we had stopped people coming down the corridor to the bathrooms. Now, far be it from me to think that maybe, just maybe, people could hold their bladder another few minutes - but to have security demand we move a patient unnecessarily for the convenience of a few drunks makes me just plain angry.

After a little bit of 'verbal altercation' we had them open up a large room and we moved the poor girl still screaming into the room until she calmed to a full recovery. In the end she was more embarrassed than anything, which is quite common in these situations, but I think the stupidity of security didn't help the situation.

This duty taught me two things;
1) While most event security are fantastic and helpful, you do get those on a power trip. Stand your ground, because sometimes you will be the only one defending the patient - and no matter what else may be happening they come first
2) I hate screamers. Put me with a gasping or unconscious patient and I'll work my magic - but when they're high-pitched screaming into my ear it hits me like I'm stuck inside a ringing church bell

I've decided my post on Monday will be a rant on everything I've learned by knowing how little I've learned... Confused? Wait till Monday ;)

Supervisors

So I've just come from my PhD Supervisor's office - I told her (and my Co-Supervisor) last night about my plans to defer the PhD and take up Paramedics. I was nervous about how they would take it, after all, they had invested a lot of time, effort and money to get me this far and here I was telling them I wanted out.

Fortunately, they both took it very well! I was amazed and humbled that they genuinely thought I should do what I felt was best for me, they had noticed my attention wasn't always on the project and thought a year off to pursue whatever I wanted might be in my best interest. This way, I could defer the PhD for a year, start the Paramedics intake (hopefully!) and after a year decide if I want to continue with Paramedics or return to the PhD.

I had felt guilty that it had taken me so long to tell them - a part of me was scared of their reaction, but the main reason really was that I wanted to be sure this was what I wanted, and I wasn't risking my PhD on a half understood dream of being a Paramedic. It was after treating a serious case late at night that I realised without a doubt this was what I wanted, and why the next day I called both supervisors in for 'a chat'.

Don't be afraid to follow your dreams - but just make sure it's a dream you really want to follow.

Thinking

Well, I've been doing a lot of thinking lately. It's something I quite enjoy doing, and has driven me to where I am today. That and a good deal of coffee.

Why do I want to become a Paramedic? Why do I feel the urge to go through Paramedic blogs, read books on the subject (biographies, stories and textbooks) - why is it when I got a PDA the first thing I do is load eMedic? More to the point, what's made me decide to leave science and medical research to follow this dream?

I've always had a fascination with medicine. From an early age I wanted to be a forensic scientist, it was only after discovering how boring a job that can be that I decided to go into medical research. Working with St John changed a lot in my life - for the first time I was working with live patients, the effects of my work became clear almost instantly and, I hope, I am not too shabby at it. While many would argue (and probably correctly) that medical research is indeed a far more valuable thing to persue, I can't help but be attracted to the more instant, single (hopefully, although triage can be rewarding too) patient treatments that I perform myself...

It's not a question of which do I enjoy more, because each career has its ups and downs - it's a question of which do I, personally, feel more rewarded by performing. Greedy, perhaps, but it's a hands down win to Paramedics.

Schedule

So I've decided to set in stone a schedule to keep me posting here - as Jeff Atwood puts it, 'posting in obscurity' until I 'suck less'. I've been reading his blog for months now and am constantly amazed by the things he pulls out.

Anyway, back to this blog... The last post was a bit of a downer, so I thought I'd make sure the next one ended on a more positive note. That doesn't mean for every bad story there is a good one - only a few people call an Ambulance just to see the pretty lights.

This story is the favorite of Allen's, my CO in St John.

I was in the First Aid post at Vodafone Arena, another boring shift where not much was happening. Suddenly, a woman pops her head in the door and asks for aspirin. A little bell went off in my head - nobody asks for aspirin. Paracetamol, yes, but never aspirin. Flags went up in my mind and I ran through the standard routine;
'Is it for you?'
'No.'
'Who's it for?'
'My mother-in-law.'
'Why do you ask for aspirin in particular?'
'She's having some chest pain and I thought it would help.' She's right - if it's cardiac chest pain aspirin can help break up any clots that might be contributing to chest pain. But if that's the case, it's time to take a little trip to hospital. I give her the spiel about how technically we're handing over medication, so we have to be with and talking to the patient, but that I was more than happy to follow her back to wherever her mother-in-law was.

And off we went. On the way we made idle chatter, how long the pain had lasted, how was the weather, that sort of thing... Apparently the woman was a cardiac nurse, that was why she knew to ask for aspirin. We reach the mother-in-law, and after one look I'm at her side taking observations while requesting for a wheelchair and oxygen to be brought over along with an ambulance - her pulse was erratic and she was not looking good. Aspirin was not going to fix this. Wheeling her back to the FA post I was able to talk to her a bit more and get a more accurate history - double bypass, on blood pressure meds but had forgotten to take them today (the number of times I've heard that... but that's a rant on it's own for another day).

One last thing; she was allergic to aspirin.

It amazes me that a cardiac nurse had not noticed the condition she was in, and was ready to give her medication that quite possibly could have killed her - suffice to say she was very embarrassed and more than a little scared. We had an ambulance come in and drive them both off to hospital, not before confirming on a 6 lead ECG things weren't right in the ticker department. All things considered she would have made a full recovery after getting back on her meds, so this post teaches us three things;
1) Never trust the friends or family, no matter how well they 'know' the patient,
2) Don't forget to take important, life saving medication and
3) Even Cardiac Nurses can hope to be better at what they do ;)

Be safe.

My first loss

I'm on holiday at the moment so have a little more time to post than usual ;)

I was on duty at a music festival with St John Ambulance about a year after joining, working on a response crew with another member from my division. He was a Paramedics student, so I felt pretty happy working with him, because I knew I could learn from him and have him guide me through any uncertain situations.

As happens at these types of events, we were called to a non-breathing male, no other details. It took us longer than we liked to get through the crowd, and even then longer to clear enough people away from the boy to begin our work. He was unconscious, non-breathing, had a strong and rapid pulse but was unresponsive to sternal rub - most likely a GHB overdose. My partner (praise be to) noticed I was a little slow to respond, I hadn't experienced this before, and quickly put me back in the right frame of mind - get the O2 ready while he did artificial respiration with a BVM, monitor vitals until help arrives. We had an ambulance on the way, but he had no improvement - he had been in RA for around 6-7 minutes before we were on scene and his likelihood of survival was minimal. At the very best, he would have permanent brain damage. As the paramedics arrived I had begun to get the details from the girlfriend as to what had happened and was filling in the OB12 (St John Patient Record Form) for the handover. We got him on a stretcher and into an ambulance.

Afterwards I remember my partner checking if I was alright after my first real big case, and we talked about it. We talked about his probable outcome, what we did and should have done - neither of us had been wearing gloves, a point which I think he was surprised I had picked up on when he first asked if we did anything wrong. I think he was happy with how I had been, and for some reason that made me feel good. I wanted to earn his respect, this made me feel like I was on the right track (although far from the final step). It was a great experience in terms of what emergency care is really about, I can honestly say I haven't been slow to respond since. It originally made me angry that a young male, my age, could do this to himself and everyone around him.

In the end I realised it was just the way life is sometimes, and it's why, once again, I wanted to be better at this.

My first test

There was a sporting event at Monash University, I was on duty as a First Aider with St John Ambulance. I'd experienced a few minor injuries at local football events (a few knocks and bumps, no ASC or LOC though) and thought I was pretty good at this First Aid thing.

There were a few of us there that day, so when a few people were called over to see an injured girl at first we thought nothing of it - two people headed off with a standard kit and walked over. A second later a call came through on the radio with a panicked voice saying that something wasn't right and they wanted assistance. I hurried over (walking still, but purposeful walking) with an O2 tank, when I got there she was lying down and turning blue. I quickly called for the attending FA's to get her into the recovery position while I set up the oxygen and called through the radio for an Ambulance. She was conscious and alert, but had trouble answering questions - pulse rapid and weak, resp low and shallow. I carried out other obs and reassured her until the Ambulance arrived and got her into the vehicle.

My hands had been a little shaky but sure of themselves. Everyone was a little shaken up though, for all of us it was our first 'serious case'. For some reason I felt like I was in charge of the situation, even though some of the people there had been in St John for longer... I started a debrief for the members after the Ambulance had left and congratulated them on a job well done. I talked them through what happened, what was done, what should have been done (but still affirming them) and things to remember for next time.

After a while it was time for me to go, only then did my hands really tremble and I felt my share of the scare. Nobody saw it, but I had been terrified. At one point she had looked at me and said "I'm scared.", to which I could only say "You'll be right, you're doing great - just keep taking deep breaths." and hope I wasn't lying. I never found out if she was ok, I'm positive she was but there's always that feeling of 'what if'. But from that case I learned two things - what I was doing had very serious ramifications, and I wanted to be better at it.

Almost a year and a half later I had become head of Operations and Training for the division, we were having a meeting when a member said to me "You know, I've never seen you freak out, you're always in control." I think back to the first real test, to every test I've had since then. Each time I'm scared, but each time it gets that little bit easier, more refined and autonomous. I reply the only thing I can think, the only thing that makes sense -

"Oh, I freak out," I laugh. "the important thing is to do it after the patient is safe."

St John Ambulance

It was 2 o'clock in the afternoon, I was in the laboratory at Monash University Dept of Biochemistry and Molecular Biology during my Honours year. The phone rings, and by chance I am the first to answer it (communal phone used by around 9 people). It was my girlfriend, in the offices of the Biomedical Society three floors below me.

She sounds scared, and after a few seconds I work out what's happening - a friend of ours is in the office with her having a seizure. He's diabetic and is known to sometimes lapse in his management, and she's not too sure what to do. She calls the University Clinic and gets a doctor on the way, while I head downstairs to see if he's ok before I run to the pharmacy to get some jelly beans.

Luckily, by the time I got back the seizure had ceased and the doctor had arrived, but it gave everyone there a bit of a shake up. It was the second time in a short period of time my girlfriend had seen a friend go into seizure, and she decided it was time to learn something about how to help.

St John Ambulance offers free Senior First Aid courses to those who volunteer 60 hours service at major public events, so Monday night the next week my girlfriend and I meander into the meeting place for St John Monash University Division and take a pen, sign up sheets and lastly a seat.

The next round

I've put in my applications for the Ambulance Service of New South Wales as a Trainee Paramedic. I'm nervous, but at the same time very excited.

A few days back I got a reply telling me I was into the next round - aptitude testing. I'm flying up to Sydney on the 29th of November for it, but I'm already impatient and wanting to take the test today! Oh well, with a bit over a month to wait, I'll be showing I'm good with patience (get it, patients? I'm so sorry).

I've managed to score a week off work, following certain information that rendered my brain somewhat fried. Time desperately needed for my personal sanity but also to get myself organised for this venture.

Over the next few days expect some posts in here about why I've decided to go down this road - it wasn't an easy choice to make. I'm going to talk about the experiences that got me into emergency medical work and the experiences that made me decide to take it up full time. Some happy, some sad stories - but they're stories as I remember them and the way they've shaped my life since.

Sleep tight.

Introduction

Let's start off.

Hello, I'm Kane - and I'm going to become a Paramedic. Well, that's the plan, at least. I'm 22 years old and currently live in Melbourne, Australia. At 21 I graduated with a degree in Biomedical Science from Monash University, then again at 22 with Honours in Biochemistry and Molecular Biology. I'm currently undertaking a PhD in Virology and Protein Interaction, however, one year into it I've realised science isn't quite for me.

It's not the work - in fact I love medical research. It's just not somewhere I see myself right now, although down the line I feel I'll return.

Rather than give up on science all together, I've chosen to take time off, taking up another passion of mine - working with people. I do a lot of volunteer work for St John Ambulance and love it - I came to the realisation that Paramedics may be far more suited to me than science, although I'm reluctant to rule it completely out of the life plan. This decision has not come lightly - it was something I have been thinking about for quite a considerable amount of time, and has required many aspects of my life to change.

So here it is - this blog will document my trials and tribulations of my journey from a PhD candidate to a Paramedic, and hopefully beyond.

I hope you enjoy it.