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.