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 :-)

Run from the Fun!

Imagine yourself wafted away in to the depths of medieval times, 1485 to be precise.

Prince Edmund: They're coming! Run for the hills! 

Baldrick: No, my lord! They're coming from the hills! 

Prince Edmund: Run away from the hills! Run away from the hills! If you see the hills, go the other way! 

- ~ -

Now come back to September 2009, if you wish. It is a Friday night, and poor old diddums here wants some funky action happening in da van (no, not that kind of action, I'm at work, silly).


Priority ones are being sent out to crews north of us, a dime a dozen, and we are on a low priority job. Then again, the familiar silencer, a long beeeeep, gets sent through the radio, telling the crews that a high priority job has just come in, but has not yet been assigned. "This is us, I can feel it" I tell my crewmate...I sense that he is also on the edge of his seat, hoping to get a more exiting job. This job has the potential, I know it.


BINGO!


It's us, we're closest. We light the night with our darkness piercing strobes and oscillating rotators, and part the traffic with the deafening screech of our siren. The engine roars as my crewmate, who is driving tonight, accelerates with full throttle. Water is everywhere, it's pouring from the heavens above, it's below us, our tyres splashing left and right whilst we crash through huge puddles. 


But hold on, this job is a relatively standard one. Chest pain, although our patient is only in her late 30's. Better than a transfer, and you just never know.


The radio comes to life again. There has been an accident on the freeway, a crew is sent out on a one. Hmm, methinks, I wouldn't mind doing something like that. Then another crash on the freeway, another crew is sent out to investigate. Hmm, methinks again. I want to do freeway prangs. One of those jobs turns out to be big, read about it here. And I get stuck travelling the other direction to a relatively 'standard' job. Enter Blackadder from above. Ah well, the patient had genuine chest pain (cardiac or not I do not know), I did my bit, patient felt better en route, and I managed to insert a few bad jokes on the way, so I kept myself amused as well :-)


The other jobs were nothing out of the ordinary, they were:

• Mental health transfer. Patient was quiet, and the nurse was also a cycling enthusiast, great talking to him.
• Regular caller. I had been there before. Patient always claims problems with his heart, and depending on the experience and insight of the calltaker it is either prioritised as chest pain, getting a lights and sirens approach, or as a low priority. This time it was a low priority, so we could finish our dinner. En route I joked to my paramedic that my ECG might even still be hanging on his wall - I printed one off roughly four months ago and stuck it on the wall for other crews to see. And indeed, it was still hanging there. Together with another five print outs. So I added to the collection, patient refused transport, and off we went.
• Some job, got stood down for next job
• Chest pain, read above
• Post assault, brothers fighting. More emotional...well more alcohol than anything else really. Left in care of dad.
• 0430 in the morning, we drive for 17 minutes to a woman who has severe back pain and cannot get out of bed. Why she wanted to get out of bed at such an ungodly hour eluded me. I shall never find out, because we got stood down and so we headed back in to the depot for some more well needed sleep.

That was my third night shift in a row; I swapped shifts with a fellow student colleague of mine. Right now I am awake, going allright - I have reached the stage of "stuff it, who needs sleep anyway". The previous nights were absolutely crackers, no sleep whatsoever, so last night came as a welcome change.

And if you are reading this MP, thanks for the shift swap, I think you owe me one...or at least four hours of working!