Just 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.
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 really annoys me when people look at the job description, and consistently fob it off as the patient being a time waster.
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'.
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.
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.
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.
This job, this life is about enjoying yourself as much it is as helping others enjoy their lives as much as possible.
Do it together. And if you want to go down, get out. Don't pull me with you.
Coz I'm here to have a party.
Tuesday, November 23, 2010
Thursday, November 18, 2010
The October Handover - Wearing is Caring!
Another month has passed by on planet earth - which means it is time for another edition (number 20!) of "The Handover"!
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!
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:
http://emschick9.blogspot.com/2010/10/pockets-but-i-have-rookies.html
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?
http://justmejustmyblog.blogspot.com/2010/10/pockets-jingling.html
Jonathan B takes variety to a new level...from uniform over evening dress to...boy scout uniform? Hell, that's way cooler than I'll ever get to dress up when going on calls. Honestly, I would pay to see that. Kinda kinky too ;-)
http://jonemtp.blogspot.com/2010/10/things-i-carry.html
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!).
http://transportjockey.com/2010/10/21/are-those-shears-in-your-pocket-my-handover-post/
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.
http://futureditchdoctor.com/2010/10/20/my-handover-submission-wearing-is-caring/
Firing it up again, Ronnie swings us a 180, and explains why he does like to carry equipment on his person.
http://gatesofintegrity.blogspot.com/2010/01/on-duty.html
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!
http://notesfrommosquitohill.com/2010/02/im-not-overweight-im-overequipped.html
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.
http://insomniacmedic.blogspot.com/2010/06/suit-of-armour.html
- ~ -
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.
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.
Thursday, November 11, 2010
A dream.
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...
...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.
All of a sudden his arm is in front of my face. Is he angry? Is he attacking me? What is wrong?
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 Isowipes 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 (video from minute 2:38).
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.
What a strange dream indeed.
Wednesday, November 10, 2010
Duet
It 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.
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:
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).
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:
AN: Are you guys the day or the night crew?
US (grunting, in unison): night.
AN: You do long shift hours. 12 hour nights?
US (grunting, in unison): fourteen.
AN: Wow, you guys must be tired then!
US (grunting, in unison): yes.
AN: How long are your day shifts?
US (grunting, in unison): ten
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).
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 :-)
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?
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!
So I've teamed up with the wonderful troupe down at The Handover for this months Handover...
*insert drumroll*
"WEARING IS CARING"
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!
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