Wednesday, August 5, 2009

ramping nights #2

We brought our first patient back to hospital, and upon nearing the Ambulance Bays at ED, all we saw was a sea of green. The picture does not do the situation justice, we were in fact the ninth (!) ambulance pulling up at hospital - I couldn't capture all the vans in the parking lot. Four or five vans is usually a high number...but nine? All hospitals were ramping at that stage, and I guesstimated that roughly half of the services ambulances were tied up at hospital and not ready for emergency calls. Even one of the admin staff asked me what was going on, as she had been told by patients "I called an ambulance, but it never came, so I came to hospital myself". To put the record straight, in such cases it must have been a low priority case - if you want an ambulance, you will get an just need to wait long enough. I might post later about priorities, apparent time wasters etc...

Anyway, we stayed in our local area last night for a change, and did the following jobs:
  • Person with chest pain in car, pulled up on side of the road. It was dark, and we had our emergency lights on to (hopefully) protect us from traffic hitting us. I was treating the patient in the back of the van with my partner, when I notice an additional set of blue and red flashing lights outside. I peek through the window, and see a police car pulling up. Cop gets out, I open the door, and all is well. They saw us and just wanted to check up if we needed a hand. I'm still touched - Thank you guys!
  • Abdo pain with violent vomiting, inducing haematemesis (vomiting blood). Poor fellow.
  • Transfer from public to private hospital. Fellow was a nurse of 35 years, very pleasant chap.
  • Fall or collapse, wife found him on floor. No injuries, but underlying medical conditions meant we took him in to hospital just in case.
  • Early morning Acute Pulmonary Oedema. Ramping and APO both nights...I am sensing a theme!
  • Last call was an interesting one too. Call to a middle aged male, complaining of sudden onset of dizziness and nausea. Now, for a layperson, they would go back to bed and either a) wait for the world to end, or b) for things to get better. What? Our patient says their anti emetic (against nausea) medication didn't work? Where did you get that stuff from? Oh, you're a doctor. Aha. You have too much medical background knowledge, and you now believe you are suffering from a posterior MI (heart attack, back side of the heart).
Poor fellow. Getting carted off to a hospital where some colleagues probably know you and who will now treat you...what a feeling. Deep inside you probably know that you got up too fast out of bed, but these symptoms could also be cardiac related...damn you, medical education!

I sympathise with that, last year I had chest pains and went to the doctor. It was worse on inspiration, a twelve lead ECG was done and no abnormalities detected, and it went away the next day - a muscle strain (I had done some heavy lifting). But the background knowledge I had from uni was just getting to me, so I had to get myself checked out. Better safe than sorry!

OK, enough rambling now, it's 0255hrs and I'm wide awake but in a haze. Shouldn't have slept as much after coming home from nightshift. Damn shift work, has it's ups and downs....