Saturday, 23 May 2009

Never ending.

It seems like I'm always at work just lately. Over the last few weeks I've had a run of 4 shifts but thankfully they will end soon.

Monday night wasn't that busy, 4 jobs in total if I remember rightly.

Cat A S.O.B. A Lady in her 50's who had been diagnosed with Chickenpox and Pneumonia was having a job to breathe. She was very ill and in a lot of pain. Her sp02 was 85% even on high flow 02 which was very worrying. Her skin was mottled and her chest pain was impeding her breathing. We weren't on scene long and on the way in I drew some bloods and gave her 5mg of morphine which worked well. She ended up in ITU. I've never known someone of her age having Chickenpox before. Basically her lungs had become so infected it was interfering with her gaseous exchange therefore she wasn't oxygenating properly. Very poorly indeed.

Acute abdo. Male, 60's complaining of severe abdo pain. He had a massive scar which ran down his belly due to diverticulitis and had a small hard mass which was causing him agony. My crew mate said that there was nothing we could do and that we would just go. I was less than impressed with that. There was something that we could do and that was to relieve his pain. One thing I will not do is take someone to hospital writhing in agony especially when I know as soon as we walk through the doors a DR will want the patient to receive pain relief. Treatment of pain is humane, the patient can think clearer and physiologically can help to improve outcomes. This patient was more than grateful for the 10mg of morphine he received.
We did 2 other jobs but I can't remember those.

Tuesday, another quiet night.

Cat A S.O.B. Man in a car on the side of the road. As we pulled up we could see he was on O2. He had COPD and had been driving his car with his own O2 on when he became SOB. He was grey and sweaty and struggling. We gave him some nebs and ran him into hospital. After handing him over to the staff my crew mate was strolling back to us when I noticed our patients eyes rolling back. He was retaining carbon dioxide and had gone into respiratory arrest. I slammed back the head of the trolley and raced him into resus as my crew mate ran for help. In resus I started suctioning his airway, dropped in an OPA and started bagging him. Soon there was a hive of activity and IVs were put in, bloods drawn and blood gases taken. I had the easiest job maintaining his airway while everyone else got a sweat on. 10 minutes later and an Anaesthetist turned up and took over airway management, eventually performing an RSI.
The staff grade DR said well done on managing the airway and he thought that it went very smoothly. It's always nice to get a complement from a member of the hospital staff. I also thought how much easier it is managing a patient in a well lit environment with every thing to hand, not like an ambulance.

We also had an impressive RTA where a front axle had been ripped from a drink drivers car. Luckily there was no one hurt so we left the police to arrest the youngster.

Asthma, pretty much in the middle of nowhere, a lady who reluctantly came to hospital. She had some nebs and IV Hydrocortisone. We had to take her to another hospital in a different area so after clearing up we where desperate to get out of there and back to base. We managed it.

I did some overtime on Wednesday night and to be honest I can't remember what calls I went to, all the shifts lately seem to blur into one long one.

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