Thursday, September 3, 2009

Busy of Late...

For those unaware, the WA Ambulance Service (WAAS) is run by St John
Ambulance (WA) Inc.
which operates both career Ambulance Officer and Paramedic
service (in the metropolitan area, and also larger regional centres) and also a
country Volunteer run service (for rural, remote and outer metropolitan).
The ambulance depot I work at is fully staffed by Volunteer Ambulance Officers (or VAOs), and is a Sub-branch of a depot fully staffed by career Ambulance Paramedics, about 15km away. Unlike many volunteer depots, we have easy access (and prompt back-up) to the experience, knowledge and skills of highly experienced Paramedics. Our depot has a high callout number for a volunteer depot with an average of ~3.4 jobs/day in 2008, but has had as high as a dozen calls in one 24hr period - and on some days we get none.

We volunteer normal shifts of our time, i.e. Day Shift = 0800 - 1800 and Night Shift = 1800 - 0800. When there is no one able to cover a shift, sometimes officers will respond from home, like most other volunteer depots which does increase response times, but nevertheless puts another ambulance on the road!

The last two shifts I worked was a fairly busy ones, which I much prefer as it increases satisfaction, and reduces time spent on Facebook and studying.

Night Shift: 2x Priority 1, 1x Priority 2 and 2x Priority 3 = 5 jobs.
  1. A chest pain, which turned out to be a ?H1N1 Influenza Virus. Pt. was worried as she wasn't getting better. Back to the van to don PPE. The husband cried "CHEST PAIN" for a faster response. Straight to the waiting room for that one... Cue evil laugh.
  2. Back pain, which our 3mL of Methoxyflurane didn't touch, as per normal... POWER OUTAGE, caused by...
  3. Car Vs. Powerpole, which both promptly burst into flames. After frantically manually rolling up our electric roller door, and continuing on our Priority 1 to the scene, O/A pt. was ETOH and A-OK, naturally! ("Hi Comms, 62-82 thanks." "Really?!")
  4. RFDS transfer from A+E to the aircraft. Pt. was real car accident victim. Pt. was all Vac-matted up and suffering a confirmed # pelvis and ?abdo injuries, ?spinal.
  5. A lovely, butt-naked elderly lady who tripped backwards, sustaining a decent (L) occipital boggy mass. Nil LOC and a good historian = fall, not collapse. BSL was hard/impossible to get peripherally, so I scooped some from the wound on her head which was still seeping from the 2x dressings and bandages... Damn you Clopidogrel!

Sleepy time from 0300 - 0800! Not bad, 5 hours!

Day Shift: 3x Priority 1, 1x Priority 2 and 2x Priority 3 = 6 jobs.

  1. A nice Priority 1 during van check to start the day to a severe SOB with wheeze. Hx of 41 (cardiac) and dementia. Response time was ~2mins as the address was 100m down the road. O/A SpO2 92% on RA and tachypneic, nil lung sounds, nil PmHx of COPD, asthma, recent respiratory tract infection, etc. Cardiac Hx as long as one's arm. Hmmm. O2'ed into A+E.
  2. Collapse of a 20yo ♂ with epistaxis. Turns out he fell flat on his face and seized for ~1min. Was relatively post ictal, however oriented to TPP. Nil Hx of epilepsy. O2'ed into A+E.
  3. Post fall c/o back pain. Basically a lift assist as the pt. had the same back pain since her fall 3/7 before and the pain meds were yet to reach their therapeutic level. 62-82'ed - ANR.
  4. A P3 to take a poor old dear from her home where she had been living independently with home carer visit support to medical care as she had not eaten anymore than 3 mouthfuls of porridge for the past week. She was now too weak to walk and required a 2 person assist. She had been sitting in the same kitchen chair overnight as she couldn't fathom the strength to stand up. After helping her to the toilet and giving her some good ol' H2O we trucked her off in her first ever ambulance ride, at 84 years of age. She had been travelling great until this. She will definitely need to be reACATed (Aged Care Assessment Team).
  5. What I like to call a "Green & White Taxi" job... The classic D+V, onset 12hrs prior, waiting outside with her bags packed. Rx was a lesson in 000-etiquette and off to the waiting room.
  6. Teenage ♂ pedestrian vs. car. Turns out he was riding his bike across the street, without looking, with no helmet on. Tut-tut... He got off lightly with minor ear lacerations and a head contusion, with spinal precautions. Not to mention the 3rd degree from the Highway Patrol boys.

All-in-all, a couple of busier and more stimulating shifts which gives me valuable experience and opportunity to apply what I learn at uni into practice within my VAO skills scope of practise - however there's no scope on assessment or knowledge.

Remember kids, wear your helmet.

P.S. Thanks to all for the support and particularly to Outback Ambo for the

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