Monday, August 3, 2009

ramping nights #1

Ramping is a massive problem here in Australia. For those of you lucky enough not to know what I am on about: Ramping is the act of the hospital not accepting patients in to the Emergency Department due to overcrowding - the ambulance is 'ramped'. This means that the patient is still in care of the ambulance crew, at hospital, until a bed is free.
The main problem is that that ambulance is now off the road, not able to respond to emergency calls, so other crews have to fill in the void. Other crews then have to leave 'their patch' unattended to answer priority calls. On my second day shift just gone we responded to a chest pain call 21 km away, lights and sirens, because all the other crews were ramped at hospital.
We need more hospital beds. Patients are spending too much time in the ED.

Anyway - back to my night shifts. Sunday night, I got called out to the following jobs:

  • 15 min Priority 1 drive to a ?unconscious patient in restaurant. On arrival the manager of the place tells us he asked the patient to wake up, and he did not respond, so our patient must be deeply unconscious. You guessed it, our patient woke up with a good sternal rub. I called him a cab, but he walked off, as the waiting took too long - not before he asked us if we had a pack of cards on us, so he could show us some card tricks :-)
  • Off we then went to take over from day crew that were ramped at hospital and wanted to go home after 2 hours of overtime. They had been ramped for 2 1/2 hours, we were there another hour...
  • Transfer from one hospital to another, back in to our local area.
  • Then an interesting call to a poisoning in a nursing home. Good ol' Mavis (yep, you're right, not her real name) reached for the toothpaste and instead grabbed the sorbolene hand moistener. Upon realizing her mistake, she went to drink a glass of water, which happened to have (don't ask me how) a tablespoon of salt in it. Staff called the poisons information centre, who told them the mix could be potentially dangerous - enter ambulance crew. Mavis was deaf as a doorknob, but a lovely old gal, so we had a good chat (at screaming decibels) en route to hospital.
  • Early morning Acute Pulmonary Oedema (APO). An interesting call, upon arrival we could hear the tell tale bubbling, so we knew we had to shift up a gear. Hospital was four minutes away, and BiPAP saved the day!
  • A psych transfer to end the night.