limb-o

Saturday night, and I am geared up for a big night. I want a big night. I need a big night. No tough jobs to sink my teeth in to means no experience for me. Throw it at me, give me the big stuff while I'm keen and enthusiastic.  Please.

Pretty Please?

Nothing too exciting again, but I can tick the burns bit off the 'to do' list. Our jobs were as following:

• Hip pain. Pretty bad hip pain actually, this was genuine 9 out of 10 pain on movement, zero on lying still. In went the drugs, and out went the patient...still in a considerate amount of pain, but coping. As soon as we had him on our stretcher, the only remnant of the pain was a dull ache, and that stopped soon after, namely when he fell asleep en route. Drugs worked a treat.
• Abdominal Pain, together with Nausea and Diarrhoea. Got the patient talking and comfortable, and had a smooth trip to hospital.
• Legs. We should have an additional set in the van for patients. We have a lot of patients with buggered legs. Why don't we carry replacement legs? Our next patient, for example, could have done with another set, together with another heart I s'pose. Patients legs were just absolutely, most definitely, quite over the top full of fluid (right sided heart failure, or congestive heart/cardiac failure aka CHF/CCF). The legs had ulcers on them too. So, what does big pressure, big water and big sores mean? Leaky Legs, correct! There were water droplets, like sweat, all over the legs. Mild SOB to go with it, but the legs were impressive (close to this prize shot I found on the web). A short explanation scribbled by somebody on her notes gave us a good chuckle: "Patients legs have swallowed today". Ah, no wonder they were so big, they had swallowed a 1.5 litre coke bottle *smirk smirk*.
• More Legs, this time the elements were in role reversal...from water to fire. A Stove had made unpleasant contact with the back of our next patients leg, burning it deeply. In correct drunken manner, a friend had applied betadine - an antiseptic cream. And hadn't cooled the burn. Ouch. Problem is, cream will trap the heat, and worsen the burn. So off we flushed it with Saline, cooled it with wet bandages, and then applied tea tree oil compresses - Burn Aid dressings (messy, but smell lovely!). Our patient stated he was in 10 out of 10 pain...so I considered, and even drew up our strongest pain relief medication. Only to see our patient had fallen asleep. So much for intense pain :-) I continued with our other pain relief instead, and made sure the burn was kept covered and cool.
• Last but not least to finish our limb-o: RFDS transfer for a patient who had taken a tumble and broken his wrist. It was 3am, so patient caught up on some sleep, while I filled out the paperwork and enjoyed the views outside.

Impersonator

Female, post assault, now short of breath, sweaty, complaining of chest pains.


It's late-night shopping in the 'burbs, Usually at this time of night we can get away with our lights only, but the traffic is flowing yet pretty thick. The siren bounces off the walls of the neighbouring houses, mushing a clean wail in to a warbled song from a dying duck who has just hit puberty.

A couple of minutes later we walk in through the doors of our patients house. Our first impression is to take  the pressure down, everything is going good so far. Turns out there was a fight between mum and daughter, and we have a more emotional rather than physical situation to deal with. Attendant attends to patient, I gather some background info for our paperwork. Apparently the daughter is still in the house.

"Hello?"


I turn around. This was a child's voice, a little girl. Was that the offender? Nobody to be seen.

"Hello?"

A child's voice, young female, a little scratchy, possibly even a little....

"Hello?"

...squawky. Damn bird! 

I had not consciously taken in the massive bird cage next to the front door. Cocky the cockatoo (well, a galah to be precise) was toying with my brain, and only trying to be polite. I walk up to the cage to reciprocate the greeting.

"Hello little bird!" I say.

"MEOW" it replies.

This bird has lost its conkers. Absolutely out of its mind, stark raving mad. Then again, if you are a caged bird surrounded by 6 cats, you would pick up a bit of foreign language here and there. As we leave, the bird looks at us and tells us to "nick off". No manners whatsoever.

- ~ -

The other jobs of the night weren't anything special, but here is a quick summary:

• Fellow released from hospital just hours before, still complaining of neck pain. Back to hospital again for reevaluation and pain management.
• Kid with Asthma, Kid was fine.
• Old feller with a blocked catheter/haematuria (blood in urine). Nice chap.
• RFDS transfer with a sedated, intubated and ventilated patient.

catchup post, thursday night

• Male, not communicating. Really, he wasn't talking, moving - nothing. Physically healthy, but had a history of mental health problems. His mother was distressed, understandably. Not much we could do at scene, so transport to hospital for further psychiatric evaluation. Weird, strange, I felt like a sausage talking to him at home. But I gave him all I could, and I hope he could hear and understand me, and I hope I came across in a good manner.
• Hyperglycaemic patient (high blood sugar). Again, physically fine, but felt thirsty. This is a good sign of high sugar - it makes you sweat, which makes you thirsty, which makes you drink a lot, which makes you wee a lot. Also, the sugar is high in you blood, but not in the rest of your body (it can't reach there). So you eat a lot. In medical terms: Polydipsia, Polyurea & Polyphagia. Another cool bit of info: Back in ancient greece doctors could tell the difference between diabetes insipidus and diabetes mellitus by...tasting the patients urine. You see, all diabetes is, is a pateint excreting a lot of urine. Insipidus is due to the body having hormonal problems, which lead to increased urine excretion - you are born with this. Mellitus is the body either being resistant to insulin (type II - 99% of the time older onset) or not producing insulin itself (type I - an autoimmune disease, the body destroys its own pancreatic cells, you have this from birth). Anyway, I digress. We took our patient to hospital.
• RFDS transfer, liver problems.
• Patient deceased in Nursing Home (see seperate post above).
• Priority 1 to a cold. Patient very panicky. I managed to calm her down a little, but in the back of my mind the question lingered "you called 000 for a cold? Anyway, I hope my patient treatment did not suffer due to the fact that she had a cold and was panicky. It probably did suffer from lack of sleep though, this job was at 5 am.
• This time no priority 1 dispatch, but still a cold. Patient walked sheepishly to ambulance, as he didn't call us, his overly concerned neighbours did. Again, why they didn't take him to hospital himself if they were so concerened remains a mystery. I still treated him as a person, not  timewaster.

No sleep that night. Really tired. Slept like a log that day.

catchup post, nightshift a week ago

The shifts were busy. Busy sleeping in between shifts, and then busy camping in my days off -> hence the lack of posts.
More for personal use (so I can look back and remember all my fun little jobs), here is work from a week ago:

• Male, cut to head, post fall. Turns out he has been regularly taking 3 instead of 2 sleeping tablets. Also, you are supposed to take these when you are already in bed, avoiding all outside stimuli. Well, this feller didn't, and went a bit crazy. Easy enough of a job, just an eye opener what sleeping tablets can do to you.
• Bicycle vs lamppost, guess who won? ETOH ++ (drunk). Worlds biggest, and worst, pain impersonator. Your claim to pain is not 10/10. I may be still young, keen and a little naive, but you aint foolin' me. Go to acting school, and try again.
• Female, SOB. More emotional and walking induced than anything else (familky funeral, and she was ~80 yrs old). Lovely old Lady though. Ramped at hospital for 2 hours :-(
• RFDS transfer, Female poly drug overdose (OD)
• Head on car collision, female self extricated, but complaining of strong abdominal pain. Car pulled out in front of her, seems like she didn't stand a chance. Lucky for her she was in a relatively modern car with airbags and some good safety standards. 10-15 years ago this prang would have had quite a different outcome...

Slow days

A Picture for your amusement. I do have to say, most drivers here are pretty good, and some are brilliant (thinking ahead, leaving us space etc) when we are on emergency runs...but you always get the odd one who just does not get the picture of MOVE TO THE LEFT.

- ~ -

Well, we did end up getting 3 calls on Saturday and 5 calls on Sunday. Both times our last call came in at 1730 - so we got some good overtime in, but then again I came home later than anticipated, slightly tired and bloody hungry. Note to self: take more food to work, mini Milky Ways are not the greatest in fighting hunger.

Saturdays jobs were nothing out of the ordinary, a transfers and two jobs where the caller really hammed it up in order to get a quick response. Gotta see the positives: I get to drive through red lights :-)

Sunday jobs were as follows:

• Severe back pain
• Elderly gentleman with a 'fuzzy feeling', home Blood Pressure measurements were slightly high. Could have taken a taxi, but a nice'n'easy job for us.
• RFDS Transfer. Patient walked from plane to wheelchair, from wheelchair to ambulance. I suggest that we get interchangable panels on the side of the van, so depending on occasion we can display what we are (like buses have). Some signs I would want: "AMBULANCE", "TAXI", "GET OUT OF THE FUCKING WAY YOU BLIND BAT". Patent Pending.
• Shortness Of Breath, history of emphysema
• Another one, this time in medical speak: SOB, Hx of COAD. Don't you just love abbreviations?

The first job was interesting, we had been warned our back pain patient may be violent, but was lying on the floor unable to move. At least he wouldn't be running after us if we got on the wrong side of him.
Luckily, his train of thought mimicked those of most of our clients; he saw us as his mates, people who actually took him seriously and would provide him some pain relief, plus get him to hospital comfortably.
That sounds corny, but here is why: He states he loves his parents, but cursed them for not having much empathy for his pain. He was lying on the floor unable to move, but they (parents) just told him to get up and walk to the car, gave him 4 panadol (Tylenol for the US folks out there). For their compassion, he somehow got hold of a walking stick and apparently poked his dad in the chest with it - hence our 'violent' patient.