complicated communications

The dayshift had some challenges in it for me - all our patients were either demented, delirious or dead.

Included was one poor soul who burnt to death. Not a pretty sight, especially not for the bystanders who had seen the smoke and tried to help. There was nothing we could do for our patient, so after confirming this with our gear, we covered the patient with a blanket, and I took a look at the people standing around. With our initial patient having died in such a horrendous way, it was important to check on the members of the public to see how they were feeling.

I approached a lady who had an expression of fear and disbelief written all over her face. All I could do was offer her a seat in the ambulance, a chat and a glass of water. She seemed to pick herself up after a couple of minutes, and wanted to get on with her day. There was nothing more I could do, so I helped her out of the van and had another look around. Most people had left by now, but I had a chat to a few men standing around, who all declined any offers of help or seating. All that I could do now was paperwork and liaise with the other emergency services.

This job was up there in the top three of horrible jobs I've done so far. I would be lying if I wrote that it didn't affect me at all - it did. On the train going home that night I had to think about the job, not so much about the patient funnily enough, but the circumstances of it all. It was a sunny day, one of those days where you soak up the great weather and feel good all around, not expecting anything bad to happen at all. Then all of a sudden someone catches fire, and unsuspecting member of the public are drawn in to witness such a horrendous event, which may scar them for life. We as emergency responders expect to see these scene from time to time, even if we aren't immune to such sights. And the patients family?

It was more of a reflection of the job rather than feeling sad. I did not know the person. I did not see him die. We arrived and the the aftermath, no more, no less. Still, I doubt I'll ever forget that certain job.

Luckily I was working with a very understanding paramedic, and one with twenty years of experience. That job was also the first time that I had a good chat to my colleague about the situation. Just to talk about everything.

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.