Friday, July 31, 2009

Virtual meets Real

Strolling down the ED this afternoon, and my partner and I exchange a few words with a doc who's been out in ED all day. I've been told that he's a good doc and an ace in his speciality - toxicology. I could learn something from him, methinks.

He starts talking about some new blog out there, some student ambo called 'the elmbulance'. He recently found it, and if we know who he is.

Hmm. Do I identify myself? It will come out over time, and hey - we both have one thing in common!

me: "sandnsurf by any chance?"

doc: "yep."

me: "your standing in front of the blogger you were asking about. flobach."

We had a quick chat about e-learning, blogging, websites and resources; and I thought to myself: How cool is that. My first virtual acquaintance turn real life experience. Sweet.

I was going to link his website in a future post anyway, but here it is:

twitter: Sandnsurf

Check the site out. it is amazing (beware, it's not fluffy, light stuff. Get yer grey cells switched on, pronto).

Thursday, July 30, 2009

Back again...

Backt to Uni after 14 great weeks off, back to work tomorrow after a productive (OzAmbos!) 4 days off. Back to pilates later. All Good.


Back to do the Bugger.

Wednesday, July 29, 2009

New Site: OzAmbos

Well, I've been contemplating, working, procrastinating, avoiding, and generally letting my thoughts go free. And have come up with a new site I would like to introduce to everyone:


The Focus is:
  • To bring Aussie Ambos and emergency workers together
  • To provide information to the general public about the services in Australia
  • To provide Student Paramedics with some good (online) resources
  • To provide tutoring paramedics with some good (online) resources
This is no closed project, I'm open to suggestions, contributions, criticism etc. If you have an ambulance/emergency blog, particularly if you Australian, please let me know. As far as I know there are only four of us out there at the moment...pretty poor in comparison to the loads of UK and US blogs.

There's even a discussion group for some interactive talk available.

Pre hospital care has always been a personal interest of mine, together with new technology. Combining the two, and being a student Ambulance Officer myself, this is the best way to express my passion out to the world, and hopefully get others involved and informed.

OzAmbos is still in it's infancy, I hope to let it grow over time. Please let me know what you reckon.


Tuesday, July 28, 2009

Damn abbreviations...

Nightshift Shiteshift.

Another night in the van. I didn't sleep too well during the day, and didn't get much sleep the night before - I was feeling a little hazy. We do a few calls. We clear from hospital after a job, and I start to write the date in the case sheet, ready for the next call; I put it in as if it were past midnight. I glance at my watch: 10pm. Bugger me. It feels like 3am.

An hour later later we get called to a patient, the screen reads: "HYPO, ALTERED CONS STATE".

I'm attending, and I mentally prepare for the job. Hypotension a.k.a. low blood pressure can lead to altered conscious states. Not enough blood in the brain, not enough oxygen, nutrients, sugar etc, it makes you go a bit funny. Could be anything.

We whizz along, emergency lights allowing us to treat red lights as give way signs, allowing us to swap the shown speed limit to a speed we're comfortable with. We arrive at the house, we pour out of the truck, grab our gear. In the hallway of the house sits our patient, husband holding her sitting upright. She is unresponsive.

I go blank.

Husband starts talking about insulin, diabetes, no food. In a smooth move PTSD colleague kicks in and takes over, grabbing the blood sugar testing kit, and hints me on grabbing the Glucagon. I clue in that this call has something to do with diabetes, not enough sugar in our patients blood. I desperately try to yank the picture of our screen in the van in to my memory. Why didn't it tell me the patient has a problem with her diabetes? Did I not read that bit? Curse you calltaker, you robbed me of my preparation. This is getting my brain tied up in knots. Not good.

After a couple of minutes, we get out patient sorted, we take her to hospital for observation as she is feeling pretty nauseous.

After we deliver the patient, do the handover to the triage nurse, clean and restock the ambulance, I take a good look at our van screen, and read again: "HYPO, ALTERED CONS STATE".

Oh, that probably stands for Hypoglycaemia, not Hypotension.

A lesson lived is a lesson learnt. Don't think I'll get that muddled up again.

Saturday, July 25, 2009

It ain't too good to be true

Some folks are just a bunch of whingers. Sure, some more than others, and we're allowed to have a whinge ever now and then - but some people just ought to shut up and get a reality check.

This post is directed at noone in particular, and is more of an explanation of myself than anything else. I'll try and keep it short and sweet.

Generally, if you can read this, you have at least one functioning eye, the cognitive capacity to digest this information, you have internet access, you have food, and you are still alive.

Bloody Brilliant.

For many a reflective times I have quietly thought to myself: You know, I'm a lucky bugger. Pushing the materialistic aspect aside, things have worked out for me, and even the moments that I kinda screwed up turned out all right, even if it did take a couple of hours/days/weeks (or years, if you are talking about the torture of having to go to school :).

But it all worked out for the better. And there were heaps of positives.
Why? Because I saw the positive sides. Best example was when I broke up with a now ex girlfriend of mine on a Friday, I was pretty down. Then I thought to myself: Hey, that means I have the whole weekend to myself with my mates. Excellent!

I didn't get in to the Ambulance service the first two times I applied. Annoying, but I picked up my game, focussed so damn intensely on reaching that goal, and BANG, here I am writing these lines as an ambo.

As a student ambo, I failed my first subject. A bit of a wake up call, I re-did it the unit, fast tracked it (only had to do half of it), and ended up best in my year.

And so on and so forth. I could have given up trying to be an ambo. I could have wanted to get back with that girl. I could have.....but I didn't.

So, focus on the good stuff. Shit happens, as they say, but excrement has great value for plants as fertiliser. They just grab the goodies and make the best out of it.
A matter of perspective, just look for the positives, here's a good post from The EMT Spot.

As for me:

"I am one of these strange individuals that every work place has. You know the one I mean… the one who loves his job, the one who stays positive about everything even when things seem to been all going a bit pear shaped."

And if you think I'm the only nutter that thinks like this, read the intro from medic999.
So good, I shamelessly copied it. Reading his description, I could identify myself in a jiffy.
So why re-write something if the point has already been stated precisely?

I've been "published", look at me!

My knowledge would be nowhere near as high as it is now without the many influences and information sources I have.

One of them is right here: The MedicCast. Go check it out.


And this is an email I sent in a couple of weeks ago, I hope you guys might be able to get something out of it:


I used to think podcasts was some kind on new, wanky type of stuff for those seriously cool type of people.
Well, now I seem to be one of those people, and love it. Have a browse, have a listen, have a bit of patience and learn something.

Tuesday, July 21, 2009

Confidentiality killed the cat

I just spent the last half hour typing up a blog post about confidentiality, and constructing a framework for my future blogposts based upon and in accordance to my organisations Media Liaison Guidelines.

Until I read the header: INTERNAL DOCUMENT ONLY.

Frustration just set in.

But surely you see the irony: I would get the sack from this job not because I disclosed confidential patient details, but because of publishing an internal document how to avoid just such mishaps.

Off to bed now, gotta sleep over this one.

Monday, July 20, 2009

It's a Given

Inspired by Tazambo, and in relation to my earlier post, here is a list of standard service issued personal equipment, Head to Toe:

  • Baseball Cap
  • Akubra Style hat (Nobody wears it, impractical, but I have been challenged to wear it for a set of four!)
  • Safety Glasses, both clear and tinted (with a band so you can hang 'em round yer neck)
  • 6 Shirts, long or short sleeved
  • a jumper
  • a bomber jacket (warm and cuddly, but doesn't look very ambulancy)
  • a hi-vis rain jacket (with removable insulation)
  • a belt and buckle
  • a MagLite belt holder
  • 3 pairs of pants (no cargo, dress style pants unfortunately)
  • 4 pairs of socks, thick or thin (100% cotton)
  • Boots or shoes.
Personal Equipment:
  • MagLite (I believe a 3 D-Cell big one)
  • Mini MagLite (2 AA cutie torch)
  • Bulbs and batteries if they need replacing
  • Pens en masse

All in all, nothing to complain about. It's good stuff we get, the MagLites are awesome (both big and small), and if we need anything spare, we'll get it (although I have been told it may take a while...)

The only thing I would like to see introduced are some cargo pants. Two additional pockets would be excellent.

Sunday, July 19, 2009

Overheard on the train

Moron #1: I did a runner from the cops the other night, but he fucking caught me, man

Moron #2: Shit, man, what happened?

M1: Yeah, well it was like, I was driving back with the fucking work truck..

M2: Oh that fucking pile of shit.

M1: Yeah, and the cops were behind me, and fucking pulled me over. Well, I didn't stop, cos I don't have a license, and floored it, and the cops were still there, and the bloody ute was sooo fucking sloooow man, so I had to pull over.

M2: Shit dude, what the fuck?

M1: Yeah, fuck man, the cop asked me why I didn't pull over right at the beginning, and I said I don't have a license.


M1: So the cop comes back and looks at me, and says I have a license. I forgot, fuck man, I got my license two days ago.
I've been driving since I was twelve, man, and never been pulled over.

Saturday, July 18, 2009


How boring can patient assessment be? How boring can assessing the pain score be? Here's my trick:

"Sir, in how much pain are you on a scale from 0 to 10? 0 being no pain, and 10 being the worst pain you've ever experienced, like a long weekend in Adelaide".

Friday, July 17, 2009


It must be mentioned that my new current partner has some weird form of Post Traumatic Stress Disorder (PTSD) going on.

Driving along back to the depot all of a sudden he starts screaming OHMYGAWDWE'REALLGONNADIE, and then turns to me to explain it's all got to do with such "awful traumatic experiences" he's seen as a medic.

I cracked up laughing. And knew instantly I would have a few wicked weeks ahead of me.

Thursday, July 9, 2009

on me

Inspired by this post on Random Acts of Reality I will share with the world what I carry with me on the ambulance and in my uniform.
This will also be a good reference if one day I look back on this blog post and reminisce "cor blimey, that was me as a junior ambo just starting out, what a whacko :-) "

Starting from top to bottom:

  • Cap: to be worn if it is a) sunny or b) my hair is pointing every which way and it just won't listen to it's master (me)
  • White T-shirt: for those chilly nights (and winter days), worn under my
  • Shirt: meticulously ironed, you could slice bread with the crease on the sleeves
  • Left shirt pocket: contains two pens (how often do you give someone a pen...and then you're stuck with nothing) and patient detail forms - for relatives on scene to fill out addresses, phone numbers, medical history etc. Also my namebadge is attached.
  • Right shirt pocket has my penlight (to check pupils for reaction and maybe nystagmus). I've also got a little drug wheel with our current drugs and doses. Then a little booklet with extra info (mass casualty help, burns rule of nines, drug indication and contraindications, paedoayric tips and apgar). Plus a little notebook.
  • Jumper, to be worn if cold, has a pocket on the sleeve for one to two pens and maybe a penlight.
  • Further down the line we've got my bellybutton, which always has a bit of fluff in it, just in case you need a bit of padding, or a pillow for you dear insect friend.
  • Moving right along, my belt has a 3 compartment pouch, which houses a pair of trauma shears (excellent for cutting clothes and bandages). Next to it a mini maglight, a permanent marker and a whiteboard marker (writing things on the windscreen, like stock to be replaced in van, obscenities on other crews trucks...) and two pairs or disposable gloves.
  • Right hip has a maglite belt loop for the big long maglight. Normally though I just clip the van keys to it (even if we are attending that day we have a set of van keys on us). Around that is a roll of micropore tape, always comes in handy.
  • My right trouser pocket stays empty, my fingers are usually housed there when I am pretending to look cool. Actually, the van mobile phone lives there. And the van keys hang there - I hate dangling keys, it gives off the impression of "look at me I'm important".
  • left trouser pocket is the rubbish bin, I hate to leave my scene untidy.
  • left bum pocket houses my personal phone and my iPod touch (with an offline Wikipedia database - very handy!)
  • right bum pocket has my wallet and my home keys, which are kept in place via a lanyard that loops around my belt.

Unfortunately we don't have cargo pants. Two extra pockets would be awesome, I'd rather have my bum pockets clear.

All this seems a lot, but I use it. Gotta be prepared.

In a next post I'll write what else I carry with me in the van.

What do you carry on you during work? Even if you don't work on an ambulance - I'd be thrilled to know!

Tuesday, July 7, 2009

Polished boots and ankles.

Random tidbits that need writing down:

a) check patients ankles if they have a cardiac history - swelling may indicate right heart failure - CCF and peripheral oedema.

b) query DVT (deep vein thrombosis)? Always auscultate (check lung sounds) in case they end up with a PE (pulmonary embolism - clot in lungs).

c) set fire to your boot polishing wax. It will become runny and yummy and spread easily over your boots for that extra shine :-)

More to come soon, need to catch up on some sleep now. I was away for the weekend too, so forgive the lack of postings, I have a life to attempt to live...

Thursday, July 2, 2009

CO2 retainers

Just learnt from a colleague how to check if an emphysema patient is a CO2 retainer or not:
Get them to hold their arms out straight in front of them, and their palms away from them (like they are pushing a wall away or stopping traffic). If they are having rhythmic spasms, pulling their hands back a bit, it is a sign that they are retainers. If they are to weak to hold their arms out you can support them for the patient.

Apparently this is also a sign for people with a certain liver disease. Pre hospital no big deal, one patient would most likely be complaining of shortness of breath, the other of abdo pain.

Unfortunately I do not know much more, but I will have to look this up, really quite interesting (we just had a patient presenting with a positive result to this test/experiment).