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 :-)

Protégé

As a part of our uni course, the first years (pre employment/full time uni students) are get mentors from the second year student pool - so all Qs can be answered, a little guidance can be given etc etc. A good idea, unfortunately not everybody has been making the most of this teaming up...well, you can't force people.

Luckily I got a Protégé who is pretty keen, has an open mind and is thankful for any tips, tricks and exposure. He starts practical training next week, and is due to hit the road in three months, so he came along with us as an observer on a day shift to check out what life is like on a metropolitan ambulance. We had a relatively easy shift, nothing out of the ordinary...but anything from nana transfers to minor road accidents with no injuries he lapped up with unstoppable enthusiasm.


It was refreshing to have a student with me in a position that I was in 12 months ago. I see a lot of myself in him, the anticipation of not knowing when the next job will come in, what it will be. The thrill of the wailing sires, driving on the wrong side of the road, the eagerness to help us. Talking to patients, checking vital signs. A real pleasure (and help) to have him out with us.


'Twas also a great comparison of my advances over the last 12 months. I realise that I have picked up a lot of information, hints, tips'n'tricks along the way (that I love passing on!). Sure, I don't get massively excited about so called 'run of the mill' calls anymore, but: I still love coming to work every day, I am full of anticipation on nearly every single call that I go to (those three o'clock callouts can be an exception...), and no matter who I deal with, I am always polite and friendly to them. I try to get some further education going on, read articles, blogs, magazines to keep up with the times, talk to other paramedics.


But - I realise I still have a long way to go. Some jobs still chuck sand in my gearbox, grinding me from step to step, or making me forget some simple steps alltogether. I have a high expectation of myself, and want to be good at my job. Every job that I do give me a tad more experience. It is a slow process, and slowly but surely I pick up things along the way...and all of a sudden I take a step back, take a look back and realise I've come one step further.


A never ending trip forwards. And enjoying every step of it.

kicking back

Currently sitting at the depot, feet up, back rest near horizontal on one of the recliners. I realize that my last post was all over the place and reads 'busy', but that is exactly how I felt after the shift, when I wrote the post.

2 hours in to my shift, and still no calls. I'm going to go out in to the stores room now, and squirt some atomised saline up my nose. We use these devices to apply Intra Nasal Fentanyl for pain relief. Of course, squirting stuff up your nose can be a tad uncomfortable, so it's important to know

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Quick interlude: just got a priority one, unconscious person. Accepted the job, just about to put the address in my satnav, and then got stood down, as "person is now conscious, and we aren't required".

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how it feels to the patient, so you can honestly tell them how it feels. We also did this with thin flexible oxygen catheters up our noses in induction school. Yuk.

I draw the line at intubation, though.