Tumbleweed begone!

Yes, it's been quiet here lately - not because anything is wrong, just because I've started my on roads and I'm flat out (and completely buggered). Good news is I have a lot of new stories to tell, I'll be sure to type them all up when I get some time off over the weekend and schedule them as usual.

'Till then, have a sneak peak at what happens when you get three ambo's stuck in one of the few comfortable waiting rooms while a Pt gets ready to be transported... ;)

I love this job...

Cool little things...

One of the cool things about my course right now is that I'm backwards diagnosing some of my old patients...

Boy with big floppy ankle? Oh - he had a Potts fracture! Lovely old lady with Angina? Unresponsive to her sublingual spray and duration of pain makes that a possible AMI (and makes me very happy I called the ambulance!). Carpal spasm? Hypoventilation due to drug use!

You get the point...

Looking back on most of the patients I don't think I'd have done anything differently back then... which is a good thing I think... Doing it now, I'd do a lot more - but only because now I have that extra training, knowledge and resources I'd be more confident in my treatments. There were times when I wished I could administer advanced pain relief, confidently read an ECG or even just move the patient in some circumstances - none of which I was legally allowed to do with St John.

I guess my point today is this; from here on in I'll get to do all of the cool little things that make big differences in patient comfort and outcome...


Until of course I go up the next training scale and look back again!

Bigger than a band-aid

One thing I remember happening in St John a few times was that you would get 'senior' members who flat out refused to do anything but the 'big' cases. I'm not sure if I've blogged on this before, so if I have - bugger - if not, great. Because it's something that keeps popping up in my Paramedics training at the moment...

The thing that got me with the people in St John (and I don't doubt you'd find these in every emergency medical/first aid service) who were of the 'big stuff only' mindset was that they were missing the two biggest points to do with pre-hospital care; looking after people's health and looking after people. I was extremely pleased to see that one of the steps in Protocol 1 (the very first Protocol!) in our protocol book is 'REASSURANCE'.

The people who only seek the 'big' cases (BC's for short from here on!) miss out on the real work of any good ambo - looking after people, regardless of if anything is actually wrong or not. The big test is usually if someone comes into a first aid post looking for a band-aid. Our BC's scoff at the thought of applying a mere band-aid, such is their skill and prowess that they must hold themselves in reserve in anticipation of that big fish. In my opinion, it is the humble, friendly member who puts the band-aid on the persons (usually smelly) feet, has a chat with them and walks them out the door when they're ready that is really doing the good work. Because they're fulfilling both neccessary steps of being a good medic.

Unfortunately I've seen a BC in action at an OD, the patient was transfered to an ambulance at said BC walked off grinning at what a good job they'd done. Right past the girlfriend crying because she didn't know if she was going to see her boyfriend alive again (which in that case she definitely would, although perhaps a second trip to hospital would follow his initial release thanks to said girlfriend's 'welcome home'). I remember the look on her face - desperate and vulnerable, terrified and lost. Fortunately a nurse got to her and directed her to another vehicle headed to the hospital, they had a chat before she went off and I don't doubt for a second it did her the world of good. The patients on our run sheets and cas forms aren't the only people we treat. A smile, a slight touch of reassurance, a kind word are often worth more than the most expensive equipment you can pack into an ambulance.

I know that, as often happens, I will grow tired of doing the little things. I won't want to put the band-aid on the foot, I won't want to do the simple little procedures. I like to think I'd do it anyway with a smile, or hand it to a probie (be nice to probies! please?) who needs these experiences - but not because I feel I'm above it.

They drill into us here that we are public servants in all senses - we will politely oblige the lovely old lady who has fallen over in her thirty roomed mansion. We will also politely oblige the homeless man who has passed out in a pool of filth.

I hope that no matter how much training or experience I get, I will never - for an instant - think I am bigger than a band-aid.

Heavy lifting

This is a retrospective message out to the ~150kg man who briefly passed out on the basement level of an event. Myself and a guard had to carry him up a narrow flight of stairs in a collapsible wheelchair (I still don't know how we got him to fit on there...), of course I had a little trip and hurt myself for a brief time.

Still thinking of you, and looking forward to repeating the experience with your brothers and sisters out there in the world...

- Peace out.

Toilet humour

One funny thing about working major events is the number of calls that lead you - one way or another - into the toilets.

Now, aside from the obvious joke that the toilet is where you'll find disgusting shit - a call into the porcelain shrines usually provides a few chuckles or at the very least a grin or two. That is of course providing you don't actually have to touch anything, and your sense of smell is tolerable of such places. But it seems that the drunk in particular have a unique affection for these places, and I'm never quite sure if it's the constant need to void the bladder after a few too many beers or the fact that somehow - somehow - they know there's nothing we love more than trying to lift a 130kg man from a pool of his own vomit, urine and... other surprises in a confined and crowded space.

Nine times out of ten you're there for a drunk who has either decided the small benches inside some toilet blocks would provide a better resting site than anywhere else outside, but there's always that other one time that keeps you on your toes and reminds you that this can be an unpleasant place to work.

Treating the drunks is usually easy - make sure there isn't some underlying medical problem, help them outside and watch them go on their way (and by that we mean anywhere but here).
Most of the time they just want to be left alone to go sleep off their little adventure, but sometimes they insist of vomiting on you, despite all efforts to convince them that it isn't in their - or your - best interest.

But every once in a while someone comes along to make your life hard. Maybe they've passed out inside a cubicle (a personal favorite, as there's usually no easy way to get into these urine-soaked domaciles without a high chance of getting yourself 'contaminated' - thankfully this has only happened to me once so far), passing out on the floor or (and I've only heard of this happening once) passing out while standing up at the urinals. Fun. I know this is something I'm only going to see more of now in the service, and it's something I'm dreading even before it's really begun.

For all the perks of this job, sometimes you have to put up with a little toilet humour.

Where's the marshmellows?

Driving along one sunny afternoon in the trusty St John vehicle, my partner and I noticed a strange sight before us; a burning vehicle.

Sensing that something was off with this sight, we decided to pull over and check what was going on. Luckily the good folk from MFB were already on scene and doing their thing - but interesting was the fact that we were the only medical team there... The vehicle was very much aflame and there seemed to be some kind of high-temperature fire happening underneath the vehicle, because even after half an hour of absolutely soaking the underside of the vehicle in water and chemicals the vehicle was still merrily burning away.

And did I mention we were the only medical crew there?

We had done the compulsory 'Hi, what's happening?' with MFB, checked out the 'occupants' of the vehicle who were fine and had no smoke inhalation and spent the rest of the time sitting on the side of the road hoping it didn't all go pear shaped.

Fortunately for everyone involved, it didn't, and before long we were able to go again on our merry way. MAS had been held up at a major event for the day and so in the end we, who just happening to be driving past, were all that was available. MFB were very grateful for us stopping I think, and although we all knew fairly quickly we weren't needed, there was always that 'just in case' that made us stick around.

After all, cars and fuel tanks have known to possess a volatile relationship...


All in all a lazy job but with some pretty neat visuals to go along with it - I was happy nobody was hurt, sad that two nice people who had only recently come to Australia had lost their car and wishing that I had brought some marshmellows.

All in a days work ;)

Future in doubt!

Well today we had a test. It went.

More important than the assessment of my intellectual capacity however is the patient confidentiality and privacy session we had after it... At the end of the session I asked about the policy on blogging - something I had raised several times with other trainers only to be told I should bring it up in this session. The overall picture was they didn't want it.

Tom Reynolds, a Paramedic who also blogs on the side, provided a lot of inspiration to me and was a large factor in my decision to start this blog. A fair while ago he posted on this exact issue, and this is something I'm currently using (along with a few other bits and pieces of information) to appeal this decision.

Essentially at the moment I can blog about my thoughts and views on certain topics providing they are exactly that, and I distance myself and my opinions from any service of an ambulatory nature. I am not to discuss anything to do with any patient work I may or may not have/will come across until this issue is decided.

Rest assured even if this decision is made going against my views, this blog will continue. I will still have my little vent in here about the general life, but no 'work related' issues will be brought up. I will continue to discuss medical issues and may even be able to slip in an 'example of a hypothetical situation' from time to time providing I have distanced my thoughts and views from the service.

Frustrated? Me too - but I'd rather be working towards a solution to this than hitting my head against a brick wall, so expect the next post Saturday as usual!