tag:blogger.com,1999:blog-2993914689654053562024-02-21T13:34:31.439+08:00flobach republicflobach has got your back!flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comBlogger135125tag:blogger.com,1999:blog-299391468965405356.post-77469573646551047682011-01-28T11:06:00.000+08:002013-04-17T15:35:15.039+08:00Moved!Hello dear reader,<br />
The Republic has moved. You can now follow everything on<br />
<br />
<a href="http://flobach.com/">http://flobach.com</a><br />
<br />
Not only have I moved, but I have also joined the <a href="http://emsblogs.com/">EMS Blogs</a> Network.<br />
No change really, apart from a different theme, yours truly trying to keep you up to date with some of my thoughts, but being amongst some other great writers out there (here are the other networked blogs: <a href="http://emsblogs.com/blogs/">http://emsblogs.com/blogs/</a>)flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-55372572235808134872011-01-04T14:41:00.001+08:002011-01-04T14:41:45.381+08:00Making friends is easy<span class="Apple-style-span" style="font-family: Helvetica;">We take over from the night crew, who tell us that one of them had struck lucky with a dimensionally challenged and visually challenging member of the nursing home staff.</span><br />
<span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: Helvetica;">A little something like this:</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><br />
<blockquote>Staff: You might need this (hands over <a href="http://www.hssproducts.co.uk/acatalog/Absorbeze_Sick_Bags__Emesis_Bag__Urine_Bags.html">emesis bag</a>) </blockquote><blockquote>Ambo: Why? We have plenty in the truck! </blockquote><blockquote>Staff: No, I really think you need this. I'm sure it's about the right size condom for you! *winks*</blockquote>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-20459992477953992502010-12-27T15:07:00.000+08:002010-12-27T15:07:53.920+08:00Merry fornicating Christmas to you tooIn my books, if I invite anybody over to my place, be it for friends for drink or some poor sods who have to work over christmas in order to help you with your oh-so-bad-back pain, please do not criticise their attire, especially since the latter group generally has no say in to their choice of cloth.<br />
<br />
Envisage following scene:<br />
<br />
(enter big person who has just got up from the toilet, walked through the bathroom door and is standing in front of us):<br />
<br />
<blockquote>pain Pain PAIN! I can't walk, I can's sit, I can't even get up when I'm on the toilet. My back hurts. Really bad. Horribly bad. Do something. And what are you wearing? Is that your new uniform? It's <i>horrible</i>!</blockquote>(enter the aghast, hollow and echoing mind of the flobach)<br />
<blockquote>...horrible...orrible...rrible...rible...ible...ble...le..e...</blockquote>(enter the face.etc. motor control bit of the flobachbrain)<br />
<blockquote>Right everyone, we need to pull up the sides of those lips, scrunch those eyes a little to get a professional and positive scenario going on here! C'mon muscles, get to it! And tell that voicebox to get some lame joke happening, pronto!</blockquote>Sounds like everything went smooth? Yes, everything except for the trip to hospital.<br />
I may have aimed for every gutter and pothole until we got there.<br />
<br />
Oops.<br />
<br />
(and read <a href="http://ambulancedriverfiles.com/2010/12/everybodys-got-a-diagnosis/">this</a> if you already haven't)flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-3365982228830960012010-12-15T14:12:00.000+08:002010-12-15T14:12:59.122+08:00The living dead<div class="separator" style="clear: both; text-align: center;"><a href="http://www.royalbritannia.hu/art_3_elemei/image005.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://www.royalbritannia.hu/art_3_elemei/image005.jpg" width="272" /></a></div><div class="separator" style="clear: both; text-align: center;"><span class="Apple-style-span" style="font-size: xx-small;"><b><span class="Apple-style-span" style="color: #444444;">(via: <a href="http://www.royalbritannia.hu/art_3.htm"><span class="Apple-style-span" style="color: #444444;">http://www.royalbritannia.hu/art_3.htm</span></a>)</span></b></span></div><br />
<br />
Reading <a href="http://justmejustmyblog.blogspot.com/2010/11/how-often-does-this-happen.html">this</a> which was inspired by <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJ8S-klbdg8LtHLIzvJ1Ff-fdn6Ii-Ks4xhn2T2TPo_gt-5BACCAEzEsZkf1IsnGk3LbVQgo5f6pK83c3totAOaT6PGEd0EN9S1Vq0fpzvRfE2Ht5SGP16MgSXn-z1IwJBfNfF2aA8sFBf/s1600/Untitled-1.jpg">this</a> made me write this post.<br />
<br />
Enough confusion.<br />
<br />
Years ago, when I was doing my mandatory civil service (Germany still has conscription, and instead of going to the army I opted for the cushy way) I was a simple disabled taxi driver: driving taxis for the disabled mind you, not being disabled myself or driving a taxi that was disabled (although some of the vans were on there best way to scrap metal heaven).<br />
<br />
Happily cruising through my day the next job was a simple home pick up to take an elderly gentleman to his dialysis appointment. He didn't look happy. In fact, he looked a bit like a bulldog - no facial hair, saggy cheeks, rounded head. Wheelchair bound, he looked at me with hollowed eyes, grumpy, sad.<br />
<br />
Of course I walked in with a cheery "How are you going this morning?!", which was met by a nonchalant grunt (told you, bulldog). In the lift down to the ground floor, I tried to make conversation, blah, blah, but it ended abruptly when he answered my question of what is going on.<br />
<br />
<br />
"I just want to die."<br />
<br />
<br />
"Hmm" I thought to myself. No response came to mind. No response would ever come to my mind. How do you deal with someone who has no family around, who is stuck to a chair on wheels, who lives a confined life in a crumbling shell (body), but who's senses (mind) are still sharp, if somewhat depressed?<br />
<br />
He was the first of a few patients, both then and in my current job that I have come across that have expressed their will to die. Many others I assume would have expressed this wish to me as well, if they had not been in a situation of severe dementia, unable to speak, doubly incontinent and bed ridden.<br />
<br />
For the first group, I recently met up with our ambulance chaplain, and brought up just that point, and how I always feel so helpless and speechless. He did acknowledge the difficulty of talking about such an issue, and recommend I should try using a little reverse engineering: Get them to share memories of their 'good old days', when they had friends & family a plenty around them. This should hopefully cheer them up if done properly, plus it may breathe new life in to trying to establish new relationships and overall enjoy life a little.<br />
<br />
As for the second group, I reckon a little reverse engineering would be appropriate to: Instead of life saving interventions, some life ending interventions would be the most humane thing society could do for these poor souls.<br />
<br />
Thoughts?flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-41844548790003721642010-12-12T10:03:00.000+08:002010-12-12T10:03:32.175+08:00Registered IncompetenceWe got hammered last night, job after job after job.<br />
<br />
Great when some nursing home colleagues are happy to assist you with your patient, stating that "she normally isn't like this", and that her medications aren't working, and everything is going downhill, and she needs hospital, patient is really breathing fast and blah blah blah. I would like to share the following conversation snippet between me and the RN:<br />
<blockquote>Me: So, this patient is usually <a href="http://en.wikipedia.org/wiki/Glasgow_Coma_Scale">GCS</a> 14, then?</blockquote><blockquote>RN: What? Huh? *scuffle* Hospital! Worsening!</blockquote><blockquote>Me: Beverly, your resident, does she normally present with GCS 14?</blockquote><blockquote>RN: What? Huh? What's GSC?</blockquote>At this stage my colleague had to leave the room, and I heard heard versus wall banging from outside. I popped our confused, anxious, dazed and hyperventilating patient on our stretcher, wheeled her out in to safety, and magically she calmed down, had nothing majorly wrong with her, and was quite pleasant, if somewhat confused...as it said in the nursing notes.<br />
<br />
And to think she is in charge of peoples mums and dads out there...horrible.<br />
<blockquote> </blockquote><blockquote> </blockquote>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-14556915330903238062010-12-11T13:25:00.000+08:002010-12-11T13:25:23.561+08:00The December Handover would like your inputWell, since I've gotten in to this Handover thingamajig, we'd better keep it rolling!<br />
<br />
Pop by to <a href="http://justmejustmyblog.blogspot.com/2010/12/december-handover-holiday-cheer.html">Just my Blog</a> and submit your chrissie stories!flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-37069413522342009982010-12-08T10:24:00.000+08:002010-12-08T10:24:49.551+08:00AdvertisementMy service recently aired a TV advertisement as part of a <a href="http://www.stjohnchangelives.com.au/">big recruitment push</a>:<br />
<br />
<object height="385" width="640"><param name="movie" value="http://www.youtube.com/v/n4q_EW71rIE?fs=1&hl=en_US"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/n4q_EW71rIE?fs=1&hl=en_US" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="640" height="385"></embed></object><br />
<br />
Naturally, it has caused some discussion. First time I watched it, I was left hanging. Wow, it's really short...too short. Was that it? Is that all we do, put blankets around people? What about all the sexy skills we have, sticking things in to people, driving on the wrong side of the road, checking peoples ECGs. That would attract a few more people.<br />
I believe the producers/writers/company wanted to epitomize what being a paramedic essentially is: someone who cares for the sick or injured. And offering someone understanding and a warm blanket after a rollover on a major road s just that. Probably not the approach I would have taken, but it does boil it down to the essentials.<br />
<br />
But the clip wasn't intended for me, it was intended for members of the public who are (or should become) interested in joining the profession. Hope it hits the spot, we need more staff!<br />
<br />
I won't comment on vehicle placement, how crowded the scene is etc etc...it's a promo video and it it supposed to look like an accident, the public wouldn't have a clue about tactics (then again, it would have been nice to incorporate such realism in to the video)<br />
<br />
<div style="text-align: center;">- ~ -</div><br />
That may have sounded negative, it wasn't entirely. Just not what I had expected. So...let us have a look what other services have done to promote themselves<br />
<br />
From <a href="http://maps.google.com.au/maps?client=safari&q=milano&oe=UTF-8&ie=UTF8&hl=en&hq=&hnear=Milan,+Lombardy,+Italy&t=h&z=11">Milano, Italy</a> comes <a href="http://www.areu.lombardia.it/">AREU</a>, the local ambulance service.<br />
<br />
<object height="385" width="640"><param name="movie" value="http://www.youtube.com/v/JkJhlM2jIeI?fs=1&hl=en_US"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/JkJhlM2jIeI?fs=1&hl=en_US" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="640" height="385"></embed></object><br />
<br />
I quite like this one, more action packed. Then again, this may recruit the wrong type of people (maybe the first clip is more likely to appeal to and recruit caring people?). This one is also a little more realistic, with the ambos grabbing all their gear, scuffling up the stairs and checking a response for the patient, and actually medically treating the patient (you can't cure everything with reassurance, you know). And Kudos to the kid who called <a href="http://en.wikipedia.org/wiki/Emergency_telephone_number#Europe">118</a> (ambulance emergency number in Italy), and despite not understanding Italian, you can hear the dispatcher congratulating the kid at the end of the clip with a clear "Bravissimo!". Thumbs up.<br />
<br />
<br />
Denver EMS:<br />
<br />
<object height="385" width="640"><param name="movie" value="http://www.youtube.com/v/uv8qhkNXLuM?fs=1&hl=en_US"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/uv8qhkNXLuM?fs=1&hl=en_US" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="640" height="385"></embed></object><br />
<br />
Denver EMS took a different approach again. A mini series, no visual action, but stories told. What it is like to be a paramedic. What to expect. The guts, the glory, the ups, the downs.<br />
I really like them. And I dig the music, too.<br />
<br />
The others clips:<br />
<a href="http://www.youtube.com/watch?v=v3exPHrUqSQ">Commercial #2</a><br />
<a href="http://www.youtube.com/watch?v=d4U7h1Wnn2Y">Commercial #3</a><br />
<a href="http://www.youtube.com/watch?v=Z2oGVyofC8k">Commercial #4</a><br />
<a href="http://www.youtube.com/watch?v=kp1eYx1dFSg">Commercial #5</a><br />
<a href="http://www.youtube.com/watch?v=MfMJyFOosBg">Commercial #6</a><br />
<a href="http://www.youtube.com/watch?v=_YlyGclHp2c">Commercial #7</a><br />
<br />
<div style="text-align: center;">- ~ -</div><div style="text-align: center;"><br />
</div><div style="text-align: left;">So, there we have it. Three recruitment video from three different continents with three different takes. What is your favourite, what service would you want to work for after viewing these ads?</div><br />
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</div><div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">Please comment in the comment section below!</div><div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><br />
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And a final laugh! Found this whilst browsing for vids...hehe: <a href="http://www.youtube.com/watch?v=CNZtpTc8eH8">http://www.youtube.com/watch?v=CNZtpTc8eH8</a>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-35424008940756034802010-12-06T15:39:00.001+08:002010-12-06T15:39:29.505+08:00The Handover, #21Burnout.<br />
<br />
I had a recent rant (see my earlier post), and so have a few other bloggers out there.<br />
<br />
<a href="http://rescuemonkey.wordpress.com/2010/12/03/burnout/">Go see for yourself</a> what everyone has contributed!<br />
<br />
And take a break every now and again.flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-79407549074236331332010-11-23T19:44:00.000+08:002010-11-23T19:44:42.635+08:00Just one lookJust one look is all it takes, they say, for an experienced paramedic to realise if the patient is "big sick" or only "little sick", if the patient is time critical or a time waster.<br />
<br />
Just one look is all it takes for a jaded, cynical & no fun to work with paramedic to annoy the fuck out of me. Sorry for the harsh language, but it <i>really </i>annoys me when people look at the job description, and consistently fob it off as the patient being a time waster.<br />
<br />
I don't f&^%ing care, I'll see for myself. We all know that dispatch information is unreliable. And occasionally, the patient who has had constipation for three days and is complaining of a little tummy pain failed to mention the chest pains he is having - bang, there's your 'genuine' patient. But even then that burnt out paramedic will not accept that as a wake up call, more of a 'oh, happened to be a real patient for a change, meh'.<br />
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FFS, be enthusiastic about the whole thing. And I'm not talking about girly screams and wishing every patient be involved in major trauma and having massive myocardial infarctions. Just take things serious enough, have some fun, a get some satisfaction and excitement out of it.<br />
<br />
I am absolutely over with this awesome job being treated as more daily boring stuff, more everyday boredom, more drab, everybody is there to get me down.<br />
<br />
Get out of that horrible cycle, splash some cold water on to your face, slap yourself hard, get back to the days to when you were excited everytime you got a call, no matter what it was.<br />
<br />
This job, this life is about enjoying yourself as much it is as helping others enjoy their lives as much as possible.<br />
<br />
Do it together. And if you want to go down, get out. Don't pull me with you.<br />
<br />
Coz I'm here to have a party.flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-17739444573743282342010-11-18T16:14:00.001+08:002010-11-19T14:17:28.460+08:00The October Handover - Wearing is Caring!<div class="separator" style="clear: both; text-align: center;"><a href="http://thehandover.wordpress.com/"><img border="0" src="http://tacticalpants.com/blog/wp-content/uploads/2010/06/The-Handover-Logo.jpg" /></a></div><br />
<br />
Another month has passed by on planet earth - which means it is time for another edition (number 20!) of "<a href="http://thehandover.wordpress.com/">The Handover</a>"!<br />
<br />
This time we wanted to find out what everyone wears whilst they're on the job...uniforms, gadgets, the lot. Thanks for all who contributed!<br />
<br />
We'll start off nice and casual with EMS Chick, who has the liberty of wearing what she wishes at work. Well, suspenders would be taking it too far I believe, but read for yourself:<br />
<a href="http://emschick9.blogspot.com/2010/10/pockets-but-i-have-rookies.html">http://emschick9.blogspot.com/2010/10/pockets-but-i-have-rookies.html</a><br />
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Cruising along the volunteer highway, let's have a look at how to save for a hot tub. I believe this is ancient ninja technique: a) remove spare change from pockets in order to be able to move stealth-like towards your opponent, and b) wear a ballistic vest for an extra super mario life. Is EMS really that dangerous up there?<br />
<a href="http://justmejustmyblog.blogspot.com/2010/10/pockets-jingling.html">http://justmejustmyblog.blogspot.com/2010/10/pockets-jingling.html</a><br />
<br />
Jonathan B takes variety to a new level...from uniform over evening dress to...boy scout uniform? Hell, that's <i>way</i> cooler than I'll ever get to dress up when going on calls. Honestly, I would<i> </i>pay to see that. Kinda kinky too ;-)<br />
<a href="http://jonemtp.blogspot.com/2010/10/things-i-carry.html">http://jonemtp.blogspot.com/2010/10/things-i-carry.html</a><br />
<br />
Follow the accessory maturation process of a EMT-P (P for Primate this time), over at Life of a Transport Monkey. Like the evolution, keeping it down to the minimum as you realise you don't need everything. Going through that process myself (no offence to those who carry more though!).<br />
<a href="http://transportjockey.wordpress.com/2010/10/21/are-those-shears-in-your-pocket-my-handover-post/">http://transportjockey.com/2010/10/21/are-those-shears-in-your-pocket-my-handover-post/</a><br />
<br />
The Ditch Doctor takes it to an even leaner level. And I have to quote his three main items: "education, clinical knowledge & experience". Well said, Jonathan.<br />
<a href="http://futureditchdoctor.com/2010/10/20/my-handover-submission-wearing-is-caring/">http://futureditchdoctor.com/2010/10/20/my-handover-submission-wearing-is-caring/</a><br />
<br />
Firing it up again, Ronnie swings us a 180, and explains why he does like to carry equipment on his person.<br />
<a href="http://gatesofintegrity.blogspot.com/2010/01/on-duty.html">http://gatesofintegrity.blogspot.com/2010/01/on-duty.html</a><br />
<br />
James Chadbourne, a.k.a. mack505 shares great ways how to fight the obesity pandemic that is currently flooding the western world: Empty your pockets!<br />
<a href="http://notesfrommosquitohill.com/2010/02/im-not-overweight-im-overequipped.html">http://notesfrommosquitohill.com/2010/02/im-not-overweight-im-overequipped.html</a><br />
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Last but not least, InsomniacMedic takes an entirely different approach on the subject. I really like the post, and can't sum it up nicely, so please just have a read yourself. And don't forget that we are all human at the end of the day.<br />
<a href="http://insomniacmedic.blogspot.com/2010/06/suit-of-armour.html">http://insomniacmedic.blogspot.com/2010/06/suit-of-armour.html</a><br />
<br />
<div style="text-align: center;">- ~ -</div><br />
And so to answer Transport Monkeys question: I don't carry shears in my pants pocket. I'm happy to see you guys and gals contributing here.<br />
<br />
Sorry for the long wait. I'd nearly finished typing up version 1 when the interwebz went kerbonkers on me, and lost everything in the ether. Exams came and went, and finally I sit myself down now in between night shifts to re-wrte everything. So many apologies if this read a little twisted/warped. Purely (un)intentional.flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-6308833584196814832010-11-11T20:36:00.000+08:002010-11-11T20:36:55.842+08:00A dream.<div class="separator" style="clear: both; text-align: center;"><a href="http://img32.imageshack.us/img32/2364/adsztyg.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://img32.imageshack.us/img32/2364/adsztyg.jpg" /></a></div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: x-small;"><a href="http://www.minimalfreaks.com/marc-houle-licking-skin/"><span class="Apple-style-span" style="color: #666666;">http://www.minimalfreaks.com/marc-houle-licking-skin/</span></a></span></div><div><br />
</div>Second night shift.<div><br />
</div><div>We finally head back to the depot in the deep, dark hours of the night. Pfffffftttt, I let myself fall on to the recliner, my dead weight heavily pushing out all the air previously trapped under the faux leather covers. Click click crunch, up goes the footrest. Squeeaaak, down goes the backrest. The chair, although rickety, comfily mould to my tired body, and soon I drift off to...</div><div><br />
</div><div>...the back of the ambulance. I am sitting in the attendance seat, an elderly gentleman on the stretcher beside me. Full treatment is on the way, hooked up to the ECG, IV's running, SpO2 probe on. He is topless, his skin is a pale, mottled, sickly colour. An 'Eau de Old' fills the air, wafting from his pores, his vaguely active sweat glands covering his skin in slippery moisture. </div><div><br />
</div><div>All of a sudden his arm is in front of my face. Is he angry? Is he attacking me? What is wrong?</div><div><br />
</div><div>I open my mouth, lick his arm, and then half-heartedly bite it as it accidentally (or incidentally?) moves towards me. Salty sweat and weeks of neglected personal hygiene mix on my taste buds to an utterly indescribable taste that immediately makes me dash to the back door of the van where our cleaning equipment is kept. I grab some <a href="http://www.afcgroup.com.au/products/cleaning-products/isopropyl-alcohol-wipes-swabs-sprays">Isowipes</a> and hastily wipe my mouth out, the salty-stale taste making way for an overpowering disinfectantly, alcoholic clean taste. In order to completely get rid of all yukkybugs I douse my tongue, gums and teeth with alcohol based hand cleaner, images running through my head similar to Mr. Bean covering his tongue in out of date oysters (<a href="http://www.youtube.com/watch?v=W3TqbuxYP8Q">video from minute 2:38</a>).</div><div><br />
</div><div>Yet the images of flaky, pale skin and the musty taste persist. My body twists and turns, my stomach cramps up in disgust, and...three hours later the alarm goes off for another job.</div><div><br />
</div><div>What a strange dream indeed.</div>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-14849805838139741992010-11-10T08:23:00.000+08:002010-11-10T08:23:44.427+08:00DuetIt is 0630hrs in the Emergency Department. We have been working without rest since 1800hrs the previous day. No acute emergency work, just steady, chronic malaise of the population.<br />
<br />
Right now, we are standing next to a deaf old dear in the corridor who we will take home to a nursing home. An agency nurse (AN) sees us (US) standing there and starts asking questions:<br />
<br />
<blockquote>AN: Are you guys the day or the night crew?</blockquote><blockquote>US (grunting, in unison): night.</blockquote><blockquote>AN: You do long shift hours. 12 hour nights?</blockquote><blockquote>US (grunting, in unison): fourteen.</blockquote><blockquote>AN: Wow, you guys must be tired then!</blockquote><blockquote>US (grunting, in unison): yes.</blockquote><blockquote>AN: How long are your day shifts?</blockquote><blockquote>US (grunting, in unison): ten</blockquote><br />
AN left us alone after that. In retrospect I did like that my partner (on overtime, never met him before) and I responded so well together (pun intended).flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-13691665343467789272010-10-12T13:38:00.000+08:002010-10-12T13:38:00.590+08:00Beyond the back yardRecently, 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.<br />
<br />
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.<br />
<br />
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.<br />
<br />
I'm not sure where I stand i regards to copyright etc so I won't publish it, but <a href="http://www.healthnetworks.health.wa.gov.au/modelsofcare/docs/Acute_Coronary_Syndromes_Model_of_Care.pdf">here</a> 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!)<br />
<br />
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 :-)flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-77774894291179966922010-10-10T11:48:00.000+08:002010-10-10T11:48:07.708+08:00Pocket RocketsSince 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.<br />
This is not a new idea I must point out, check out these <a href="http://flobachrepublic.blogspot.com/2009/07/on-me.html">two</a> <a href="http://flobachrepublic.blogspot.com/2009/07/its-given.html">older</a> posts for the full history<br />
<br />
Oh, and this is my contribution to <a href="http://flobachrepublic.blogspot.com/2010/10/handover-wearing-is-caring.html">The Handover, October 2010</a><br />
<br />
<div style="text-align: center;">- ~ -</div><br />
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).<br />
<br />
Here is what I carry with me on a daily basis:<br />
<br />
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…)<br />
And a pupil light.<br />
<br />
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).<br />
<br />
Waist/thigh pockets (you know, the ones you stick your hands in when its cold)<br />
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)<br />
<br />
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.<br />
<br />
cargo pockets<br />
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.<br />
<br />
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).<br />
<br />
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).<br />
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).<br />
<br />
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).<br />
<br />
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).<br />
<br />
<br />
What do you carry on you when at work?flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-51817548347732310952010-10-10T10:00:00.004+08:002010-10-20T08:29:17.374+08:00The Handover - Wearing is Caring!Here I am, trying to become more regular...you know, more fibre in your diet and...erm, I mean more <s>bog</s> blog posting...<br />
<br />
So I've teamed up with the wonderful troupe down at <a href="http://thehandover.wordpress.com/">The Handover</a> for this months Handover...<br />
<br />
*insert drumroll*<br />
<br />
<blockquote><span class="Apple-style-span" style="font-size: x-large;">"WEARING IS CARING"</span></blockquote><br />
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).<br />
Or <a href="http://outbackambo.blogspot.com/2009/06/my-role-model.html">Geoffrey</a>.<br />
<br />
<br />
<br />
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:<br />
<br />
<b>flobach at gmail dot com</b><br />
<br />
Deadline is <b>30th of October, </b>so get cracking and writing!<br />
<br />
<a href="http://flobachrepublic.blogspot.com/2010/10/pocket-rockets.html">Here's my post</a>, something to get started on (but by no means a guideline - get creative, people!).<br />
<br />
Cheers in advance for you contributions, and a big hooray for the blokes who started and continue to look after the handover!flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-42683999396016024252010-10-09T12:00:00.001+08:002010-10-09T12:12:16.980+08:00Wear art thou?<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Back in the day...</span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0WjG1w5m1ti2jcFOM9dcRJVkU5KpQNTBRT9a9LIaI-_55WYksuKNy5_5Hr99TeBdluqx8ntisP15uQztv25ucj_j8ehruY7wsuXpB4EkQshU1wKD5w9nFNYT2LFXEZ5CJnxpxPWhorXwV/s1600/IMG_4395_2.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="260" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0WjG1w5m1ti2jcFOM9dcRJVkU5KpQNTBRT9a9LIaI-_55WYksuKNy5_5Hr99TeBdluqx8ntisP15uQztv25ucj_j8ehruY7wsuXpB4EkQshU1wKD5w9nFNYT2LFXEZ5CJnxpxPWhorXwV/s320/IMG_4395_2.JPG" width="320" /></a></div><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><div style="font-family: Arial; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Recently, our ambulance service treated us all to a uniform update.</span></div><div><br />
</div></span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">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).</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">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!</span><br />
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</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">The benefits in my humble opinion</span><br />
<ul><li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">the dark green/teal does not show up stains (although it does attract white hospital linen fluff)</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">the uniform represents our workplace environment (less office, more outdoor)</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">the breast pockets velcro open, no more fiddling with unbuttoning them and having everything fall out when bending over</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">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.</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">name (left) and rank (right) on little velcro patches, no more stab wounds from those bloody name badges</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">pen pouches on sleeves</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Cargo pants - big pockets with velcro for stowing heaps of stuff and accessing it easily.</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Reflective stripes on pants, reflective piping throughout uniform, relfective rank patch on back, reflective name and rank patch on front.</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">much more rugged (it seems) material, with mesh underarms and mesh flap on back (great in 40+ degree Perth summers)</span></li>
<li><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">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).</span></li>
</ul><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Oh, and the best? We get Jumpsuits….yeah baby! Love 'em!</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">What are your uniforms like? Have you recently changed or are you going to change?</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Interested to hear about your rants, raves, preferences and improvements!</span>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-22408779782841913022010-09-16T16:06:00.001+08:002010-09-16T16:07:25.179+08:00Scholarship for the ACAP Conference<span class="Apple-style-span" style="font-family: Helvetica;"><span style="font-family: Calibri, sans-serif; font-size: x-small;"></span></span><br />
<span style="font-family: Calibri, sans-serif; font-size: x-small;"></span><br />
<span style="font-family: Calibri, sans-serif; font-size: x-small;"><div><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">A little something that may encourage you to come over to sunny Perth for next months <a href="http://conference.acap.org.au/">conference</a>! </span></span></div><div><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span></span></div><div></div><blockquote><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Applications are now open for financial ACAP WA members to apply for the 2010 Kevin Milton Smith Scholarship to attend the 2010 ACAP Conference at the Sheraton Hotel Perth.</span></span></blockquote><blockquote><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">As the 2010 ACAP Conference is held in Perth, 10 scholarships will be awarded which will cover the Conference Registration fee, the Welcome reception and Clinical Simulation or Triage Workshop.</span></span></blockquote><blockquote><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Please direct all 2010 Scholarship queries to </span></span><a href="mailto:Blaise.Rego@wa.ambulance.net.au"><span class="Apple-style-span" style="color: black;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Blaise.Rego@wa.ambulance.net.au</span></span></span></a><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"> </span></span></blockquote><blockquote><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"> </span></span></blockquote><blockquote><table border="1" style="border-bottom-style: solid; border-bottom-width: 1px; border-collapse: collapse; border-color: initial; border-left-style: solid; border-left-width: 1px; border-right-style: solid; border-right-width: 1px; border-top-style: solid; border-top-width: 1px; margin-left: -5pt; width: 587px;"><col width="127"></col><col width="460"></col><tbody>
<tr><td rowspan="4"><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><img src="cid:0707df93-fbca-4813-8081-11d7cf270317" /></span></span></td><td><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Australian College of Ambulance Professionals</span></span><br />
<div><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">WA Branch Inc</span></span></div></td></tr>
<tr><td><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">E: </span></span><a href="mailto:secretary@wa.acap.org.au"><span class="Apple-style-span" style="color: black;"><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">secretary@wa.acap.org.au</span></span></span></a></td></tr>
<tr><td><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">A: PO Box 335 Belmont WA 6753 </span></span></td></tr>
<tr height="6"><td><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">W: </span></span><a href="http://www.acap.org.au/"><span class="Apple-style-span" style="color: black;"><span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 0px; -webkit-border-vertical-spacing: 0px; border-collapse: separate;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">www.acap.org.au</span></span></span></a></td></tr>
</tbody></table></blockquote></span><br />
<div><br />
</div>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-50788610513714583042010-09-15T15:35:00.000+08:002010-09-15T15:36:58.929+08:00Automatic RecognitionWe are at a nursing home, Patient bundled up on stretcher, heading off down the corridor.<p>A visitor sees us going past, and exclaims: "that's my mother!"<p>We stop, said visitor has a closer look, and realizes that no, our patient is not her mother. <p>"I thought she looked like my mum, she had white hair!"<p>A rare occasion in a nursing home...flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-80187120392871363552010-09-10T09:11:00.000+08:002013-04-17T15:36:04.505+08:00You Define, We Whine...<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
Well, I felt like it was time for a rhyme. Or as a colleague put it:</div>
<blockquote>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
I'm a poet</div>
</blockquote>
<blockquote>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
and I don't even know it</div>
</blockquote>
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- ~ - Finish Interlude - ~ -</div>
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<span class="Apple-style-span" style="font-family: Helvetica;">Taking my <a href="http://flobachrepublic.blogspot.com/2010/08/alternatives.html">last</a> <a href="http://flobachrepublic.blogspot.com/2010/09/alternatives-pt-ii.html">few</a> posts further, here's my take on <a href="http://theemtspot.com/2010/08/15/patients-define-their-emergencies-part-2/">Steve Whiteheads comment</a> (from the ever great <a href="http://theemtspot.com/">EMT Spot</a>):</span></div>
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<br /></div>
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<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
Quote #1:</div>
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<blockquote>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
I think the idea that people call 911 out of ignorance is a flawed analysis. People call 911 inappropriately for two reasons. </div>
</blockquote>
<blockquote>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<span class="Apple-style-span" style="font-family: Helvetica;">1.) They have reached the end of their problem solving capability and need help. They don’t care if they are misusing the system. They care about getting help because they don’t know what to do. In their mind, that is an emergency.</span> </div>
</blockquote>
<blockquote>
<div style="margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px;">
<span class="Apple-style-span" style="font-family: Helvetica;">2.) They are purposefully abusing the system for personal gain. Whether it is for controlled medications, in-home health care, a ride to somewhere closer to the hospital, attention, a warm bed or food, they want something that we provide and they don’t care if they have to game the system to get it.</span></div>
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I believe there is a group in between, 1.5 so to say: People who undeniably need help. They need advice. They need <i>someone, but not us.</i> They just don't know that yet.</div>
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Our Comms/Control/Dispatch should control and filter these calls out, and divert them to appropriate resources (paramedic practitioner, hospital at home, telephone advice, GP, psych services, talking clock.)</div>
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And as pointed out on my last post, it would help for all health professionals to work together, know what to expect from each other, and know how to use the other agencies resources appropriately. A great step forward for paramedicine would be to be recognised as a profession (registration in Australia, hint hint.)</div>
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Notice something about both of these types of people. They both have a basic understanding of the 911 system. Educating them further on the appropriate use of 911 will not prevent their next call. Even if you could stop them from calling, their problems are so common that their will almost certainly be a new person to call tomorrow instead of them. And the process begins again.</div>
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As I stated above, education for caller type 1.5 will help. You can do your bit, it won't change the world, but we gotta work on it together. Sure the big changes have to occur on a management level, but we're the road warriors actually talking face to face to the people.</div>
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So in a way, we're all asking for the same thing: More options, or tools as Steve calls them. The bottom line remains: Our current model of 'send an ambulance out for everything and treat at ED/ER/A+E' is outdated (and too costly).</div>
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Apart from those minor points I don't agree with, a brilliant (I really mean brilliant) post by Steve.</div>
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I just wish more of our breed would adopt such attitudes.</div>
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flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-61900399395582605502010-09-08T12:10:00.002+08:002010-09-08T12:13:39.765+08:00Something for the locals...<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><a href="http://www.acap.org.au/">ACAP</a> and <a href="http://www.rph.wa.gov.au/">Royal Perth Hospital</a> are teaming up together again for this years </span><br />
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</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><span class="Apple-style-span" style="font-size: x-large;">Western Australian Trauma Symposium </span></span><br />
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<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">on the </span><br />
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<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><span class="Apple-style-span" style="font-size: x-large;">6th of November 2010.</span></span><br />
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<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b></b></span><span class="Apple-style-span" style="line-height: 18px;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Registrations</span></span><span class="Apple-style-span" style="line-height: 18px;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"> are open now, earlybird closes on 30th September.</span></span><br />
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<div style="line-height: 18px; margin-bottom: 15px; margin-top: 0px;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Dr Tony Smith, the Medical Director for St John Ambulance New Zealand, will be the keynote speaker.</span></div><div style="line-height: 18px; margin-bottom: 15px; margin-top: 0px;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Topics include Prehospital, Military and Rural Trauma Management, the aftermath of Disaster Management and Issues pertaining to Trauma Training</span></div><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">For more info go to the ACAP website:</span><br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><a href="http://www.acap.org.au/news/wa/wa-state-trauma-symposium/">http://www.acap.org.au/news/wa/wa-state-trauma-symposium/</a></span>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-4059441448732180592010-09-06T10:00:00.001+08:002010-09-06T10:00:00.651+08:00Alternatives, pt II<span class="Apple-style-span" style="font-family: Helvetica;">Something I didn't consider in my <a href="http://flobachrepublic.blogspot.com/2010/08/alternatives.html">previous post</a> was the incompetence and lack of knowledge / laziness of other health professionals.</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><span class="Apple-style-span" style="font-family: Helvetica;">We picked up a bloke the other day who had been seen by his GP for an ongoing chest infection. The prescribed drugs weren't kicking in, so a couple of days and a few more visits later our patient is sent home again with no new treatment.</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><span class="Apple-style-span" style="font-family: Helvetica;">The patient calls the surgery again, stating the not improving condition, and wants to make another appointment.</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
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</span><span class="Apple-style-span" style="font-family: Helvetica;">The reply from the other end of the phone line? Call an ambulance, and go to hospital.</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><span class="Apple-style-span" style="font-family: Helvetica;"><br />
</span><span class="Apple-style-span" style="font-family: Helvetica;">After all, we still are DFAs.</span>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-11911200016695277842010-09-05T09:26:00.000+08:002010-09-05T09:26:59.039+08:00Someone loves me!Thanks to the people over at <a href="http://www.medical-assistant.net/">Medical Assistent.net</a> for featuring this blog in their <a href="http://www.medical-assistant.net/ems-blogs">top 50 EMS blogs</a>.<br />
Looks like a bit of a generic site design wise, but hey, some random number generator picked me, so I feel good :-)<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://www.medical-assistant.net/organization_files/945/ems-blogs.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.medical-assistant.net/organization_files/945/ems-blogs.gif" /></a></div>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-56870335163701219012010-09-04T18:06:00.001+08:002010-09-04T18:06:21.554+08:00ServiceI recently ordered a sandwich at a cafe. Nothing fancy, but the waiter was friendly. <br>Halfway through my meal, some of the staff slowly started packing together the outside furniture. The waiter must have realized that I (unintentionally) was speeding up with eating, and reassured that there was no hurry, and I should take my time. <p>The best part came when I asked what time they close: "it doesn't matter. You take your time."<p>What a brilliant answer. I will be going back there. They all seemed really happy when I complimented them on their great service too. <p>Goes to show, you can learn a lesson from anybody.flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-1895993993049333382010-08-12T11:49:00.002+08:002010-08-12T11:58:00.766+08:00Alternatives<span class="Apple-style-span"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">To all us paramedic types: Who hasn't arrived at a patient to find out their call was not appropriate for the ambulance service? Thought so!</span></span><br />
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</span> </span><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Two things I would like to discuss:<br />
</span> <b><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">One</span></b><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">: Alternatives. In the area where I work there aren't too many. A lot of GP clinics don't take new patients, the standard of treatment can be very average. At night time, getting hold of a GP is even trickier, heading towards impossible. Out of hospital services (hospital at home, nurse practitioners) are just in their infancy and not widely spread. Paramedic practitioners do not exist, and judging by the current environment it may be quite some time until they do arrive (if at all).<br />
Point being: a lot of the times people don't know where to turn to, so they just call an ambulance. You might be their only choice.<br />
</span> <b><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Two</span></b><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">: Due to the above, it has become a mindset to call an ambulance. Not only for transport, but for advice on the current situation. Unfortunately, not much of our training is directed towards advice, neither are our guidelines. (You come? Hop on! You stay? Sign here!)</span> <br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">BUT - This is the very situation where we have the chance to change things and show the public that we a professionals, and not mere transport monkeys.</span> <br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">That 13year old girl with 'DIB/SOB' (difficulty in breathing, shortness of breath) due to a massive asthma attack who gets a lights and sirens response? Yep, on arrival she has a cold, nothing more, but thats part of the job. Sure, her mum may have exaggerated over the phone to get us there quicker, she also may have unintentionally said all the right keywords (AMPDS or not). Either way both of them should be told (not told off) when to dial 000/112/999/911, and when not. The next time they don't call you at 3am for a manflu you may not know it, but you or a colleague will be thankful for one call less that night...</span> <br />
<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">I know there is no easy fix. There will always be people who will call an ambulance for the most minor of ailments, no matter how much you </span><s><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">hit them on the head with a sledgehammer</span></s><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"> educate them. On the other side of the fence, people will still continue to ignore chest pains and refuse ambulance transport although their need is more than genuine. We can't do much about these extremes...but for all cases in between, it's not only up to the system to educate people how to use the service correctly, it's up to us. We are part of the system, after all!</span><br />
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So, what can we do? We should familiarise ourselves with alternative healthcare pathways, pass on this information to patients who may potentially benefit from such and encourage them to use them - appropriately. Talk to the staff at your local hospital what they might know, and find out what they tell people who self present to ED. Browse the net, especially the government websites (aged & disability care), additionally any private healthcare providers who may work closely with the government to provide a service.</span><br />
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<div style="text-align: center;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">- ~ -</span></div><div style="text-align: center;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br />
</span> </div><div style="text-align: left;"><span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">Feedback please! Let me know how you deal with such situations, what alternative pathways you have, and any improvements (both ambulance and hospital) that have been implemented in your area.</span><br />
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<span class="Apple-style-span" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">P.S.: Thanks to Ross Hendry (twitter: <a href="http://twitter.com/ross71521">@ross71521</a>) for pointing out that <a href="http://twitter.com/thehappymedic">The Happy Medic</a> wrote a similarly themed blog post recently: <a href="http://bit.ly/cwHIUc">http://bit.ly/cwHIUc</a></span></div></div>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.comtag:blogger.com,1999:blog-299391468965405356.post-63210531956435769332010-07-29T10:49:00.003+08:002010-07-29T13:49:11.775+08:00My FolderMy Folder.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLQb99280pRYvEWDlrWkLdj3RPJ3GpbMiQk10iMz2Q5HyhXAE7JQsP_5hQt31LpRIK9ic1Chm2ImXAwhKB7-SfEqwbt02pSfoiM0IYqYKebECkVIJ83dydCpI3cXRSQ6rFVR3RrXy6klB3/s1600/Photo+on+2010-07-29+at+10.30.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLQb99280pRYvEWDlrWkLdj3RPJ3GpbMiQk10iMz2Q5HyhXAE7JQsP_5hQt31LpRIK9ic1Chm2ImXAwhKB7-SfEqwbt02pSfoiM0IYqYKebECkVIJ83dydCpI3cXRSQ6rFVR3RrXy6klB3/s320/Photo+on+2010-07-29+at+10.30.jpg" /></a></div><br />
Comes with me to every job, gets to know all my patient details, get flung around in the back of the van, falls on the floor, spills its contents around, only to be picked up by an angry owner (me) and getting shoved back together in one place. It's predecessor was green (funky!), but sadly died a slow death of maltreatment. Everyday office folders aren't made for everyday ambulance abuse I guess.<br />
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Anyway, point to be made is the content. Have a look at the inside sleeve, that's my main reminder of what I want to write on my Patient Care Record form, on the other side is a quick trauma assessment sheet.<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRee5TkD0olExqN1Po7ConJTmEe3U6LXT8e-vWxXKBLHQsmXZACrJ4O929q8Hk5NRsfJG3TdEU7M8Ma24O6_KOC39VGPw36adCVDSALwX_NoruQO7igw9EJ0gy5c6bJ6X_TmztlQDfNaoQ/s1600/Photo+on+2010-07-29+at+10.31.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRee5TkD0olExqN1Po7ConJTmEe3U6LXT8e-vWxXKBLHQsmXZACrJ4O929q8Hk5NRsfJG3TdEU7M8Ma24O6_KOC39VGPw36adCVDSALwX_NoruQO7igw9EJ0gy5c6bJ6X_TmztlQDfNaoQ/s320/Photo+on+2010-07-29+at+10.31.jpg" /></a></div><div class="separator" style="clear: both; text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: left;">This is the Main Page:</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixQOYp-lhINf0CagpunNQ7LK8ASL_siL5SY0qrpcHcF2uCytmN3ROA4gdQJw5VTNh1dv7gKAANsdoD4Cyxt3Zo_WFzJTqXfR6ampvNBe_dWYAGed0XWIb6ALvXeTDPn-_YIXMbYkvSDocw/s1600/00+-+Main+Page.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixQOYp-lhINf0CagpunNQ7LK8ASL_siL5SY0qrpcHcF2uCytmN3ROA4gdQJw5VTNh1dv7gKAANsdoD4Cyxt3Zo_WFzJTqXfR6ampvNBe_dWYAGed0XWIb6ALvXeTDPn-_YIXMbYkvSDocw/s320/00+-+Main+Page.jpg" /></a></div><br />
<div class="separator" style="clear: both; text-align: left;">Crafted and finetuned after 15 months of experience (with hopefully many more years to come!), continually added information as experience expands, this is the heart and sole of my paperwork. Generally the procedure consists of doing a job, documenting as much as possible and needed, handing over at hospital, remembering questions that I had no answer for (I once forgot to check for a tonguebite and incontinence in a seizure patient). These improvements make their way on to the sheet, which eventually make their way in to my brain, sheet more of a backup plan for doozy days or 3am jobs. Only recently (3-4 weeks ago) did I add the OPQRST to my repertoire, which has made Chest Pain and Abdo Pain calls much easier, asking the right questions and getting the documentation right the first time.</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: left;">To keep posts short (yep Taz, this is for you :), I'll divide my folder explanation up in to two posts.</div><div class="separator" style="clear: both; text-align: left;"><br />
</div><div class="separator" style="clear: both; text-align: left;">What do you guys carry around in your folder? Any tips/tricks/hints I could add?</div><div class="separator" style="clear: both; text-align: left;">Feel free to use my template (please don't forget to credit me). I can send you a PDF/word/pages version of the document if you like, just let me know in the comments (can only upload pics to blogger).</div>flobachhttp://www.blogger.com/profile/07877806978467752904noreply@blogger.com