Tuesday, October 12, 2010

Beyond the back yard

Recently, I've had a thought or two in regards to the interface of ambulance staff and hospital staff, i.e. handing a patient over. Once particular point that I wanted sorted out was what the hospital based staff wanted to hear from us, so I could adjust my practices accordingly.

Well, it's not that easy. To part quote Dirty Harry: "Opinions are like assholes, everyone has one". Some want this done, some want that information included, but most are just happy with whatever you give them.

So I went on a little hunt, and grabbed a hospital "Emergency Chest Pain Assessment Pathway" form. It's an A4 leaflet (four pages) with all triage, assessment, history, medications and you name it conveniently written down in one form. Everything the hospital does assesses when they are presented with a patient complaining of chest pain.

I'm not sure where I stand i regards to copyright etc so I won't publish it, but here is the complete document how WA Health  ACS Models of Care in pdf. extensive, but good to have a browse if you happen to work in Western Australia (and yes, they recommend 12 lead ECGs for the ambulance service...surprise surprise!)

So, the next time you are at your local Emergency Department, pop down to to the paperwork section, ask some staff about it and see if you can find some info to learn off. I'm going to sit down for a couple of minutes and do just that :-)

Sunday, October 10, 2010

Pocket Rockets

Since we recently got new uniforms, I thought it would be a good time to have a look at what we carry with us and on us during our shift.
This is not a new idea I must point out, check out these two older posts for the full history

Oh, and this is my contribution to The Handover, October 2010

- ~ -

My uniform, in its basic setup (no vest or jacket, no additional pouches) has 9 or 10 pockets (depending if I am wearing the jumpsuit or the two-piece).

Here is what I carry with me on a daily basis:

On arms: ball point pens: pens are awesome. You can write with them, you can reset calculators with them, you can use them for self defence if you're desperate. I usually carry in order to have a spare or two (a. hand to a relative t fill out some patient details whilst we are treating, b. in case they don't return it and I need a pen on my next job, and c. if my colleague forgets his…)
And a pupil light.

breast pockets: stay empty as of yet, I have found nothing to put in them. During the shift they get used to temporarily store stuff (med vials, patient details…all whilst moving the patient around so they don't get lost).

Waist/thigh pockets (you know, the ones you stick your hands in when its cold)
left: is the rubbish pocket. All on scene rubbish (as long as its clean and not sharp, e.g. plastic packaging) gets stuffed in that pocket, for disposal later at hospital or the depot. I don't like to leave the patient with rubbish if possible. All sharps go in the sharps bin, all dirty or wet things (alcowipes etc) go directly to a bin where possible)

right: If I come across coins for some reason or another, they go in here. I generally hate coins, and never start a day with them in my pocket.

cargo pockets
left: all my personal stuff: phone, wallet, house keys (and car keys if I happen to have driven to work that day). I am not trusting enough to leave them at the depot (although others blatantly leave their 1500$ laptop lying around…). Plus, you never know when you need them.

Right: Ambulance related stuff: Patient detail forms (hand to relatives to get some information), drugs protocol reminder card (adult and paeds dosages), what does this drug do card (the mini analogue version of Epocrates really), and a little green booklet with a few other ambulance related things).

In addition, I have my medium sized pouch clipped to my belt on the left, with 2-3 pairs of gloves, trauma shears, mini mag light, won-baker pain scale (only used twice in 18 months….should remember I have it there. When i used it it was really handy though).
Plus a permanent black marker (you never know, plus there was space left) and a whiteboard marker (write little notes on the window of your ambulance, e.g. a list of items to restock).

On my right belt side I have a mag light hoop thingy that will hold a 3 cell mag light (service issue). I always have a set of ambulance keys hooked to them, that then hang in my pocket (I can't stand hanging them from belt loops, they hang to high and rattle around, and make you look like and absolute try hard prick).

Anything else? I carry a few items in my kit bag, but nothing out of the ordinary (hi viz vest, cap with clip on LED lights, something to read in case we get ramped, spare pens).

What do you carry on you when at work?

The Handover - Wearing is Caring!

Here I am, trying to become more regular...you know, more fibre in your diet and...erm, I mean more bog blog posting...

So I've teamed up with the wonderful troupe down at The Handover for this months Handover...

*insert drumroll*


Tell us what you wear to work; your uniform, your gadgets, even trusty friends like Simon the Sturgeon (a colleagues stuffed fish who always rides on the dashboard).
Or Geoffrey.

So - write up a post, or start a blog if you need to (with blogger.com, wordpress.com or any other popular blogging platform) and send me the link of your post to me:

flobach at gmail dot com

Deadline is 30th of October, so get cracking and writing!

Here's my post, something to get started on (but by no means a guideline - get creative, people!).

Cheers in advance for you contributions, and a big hooray for the blokes who started and continue to look after the handover!

Saturday, October 9, 2010

Wear art thou?

Back in the day...

Recently, our ambulance service treated us all to a uniform update.

The old uniforms had been around for over ten years, and were outdated in terms of style, functionality and visibility (that would mean that they were stylish and functional at one stage...no comment on that).

So we went from a 'dress' uniform (no, not wearing dresses) with dark green pleated pants and light mint green (horrible) pressed shirts to a more tactical style uniform - much better!

The benefits in my humble opinion
  • the dark green/teal does not show up stains (although it does attract white hospital linen fluff)
  • the uniform represents our workplace environment (less office, more outdoor)
  • the breast pockets velcro open, no more fiddling with unbuttoning them and having everything fall out when bending over
  • no more epaulettes, rank on breast patch and on back patch. No more stuff getting caught on your shoulders, no more fiddling them on new shirts; also makes for a cleaner look.
  • name (left) and rank (right) on little velcro patches, no more stab wounds from those bloody name badges
  • pen pouches on sleeves
  • Cargo pants - big pockets with velcro for stowing heaps of stuff and accessing it easily.
  • Reflective stripes on pants, reflective piping throughout uniform, relfective rank patch on back, reflective name and rank patch on front.
  • much more rugged (it seems) material, with mesh underarms and mesh flap on back (great in 40+ degree Perth summers)
  • Overall fit is much better, and looks nicer on staff (the old stuff was baggy where it shouldn't have been, and tight where it was inappropriate).

Oh, and the best? We get Jumpsuits….yeah baby! Love 'em!

What are your uniforms like? Have you recently changed or are you going to change?
Interested to hear about your rants, raves, preferences and improvements!