Private Paramedic

As an Aussie, I love it

No, it is an older model Holden Commodore ambulance, however.... that is a good idea. Might have to see about getting one fitted

I am posting this here because it is funny when you look at it... and to for the newbies not be disheartened when they do something silly.... Working single officer at an event today, I got called to a patient. Get on scene, assess patient, patient happy not have transport organised after treatment (wound assessment and clean only). As it is raining, I put the gear in the back and close the rear door, leaving it so the locking mechanism did not engage as I intended to put the gear away properly. Anyway, I got distracted talking to the patients husband about care needs as I recommended that the patient visit her GP for wound suturing so I kind of forgot about the door.... Get on the road to return to base location, get into a line of traffic at 100km/h.... hear the back door fly open.... look in the mirror, see the car behind me with the driver laughing when normally, you would see a closed rear door.... Lesson learned... close the damn door properly and you do not become the laughing point for a line of traffic.... and luckily none of the gear left the vehicle.

a couple of months back I attended an MVA around the corner from my office (first on scene after hearing the crash) and found 1 intoxicated male trying to impress the blonde next door by doing a wheelie on an unregistered trail bike. Of course, the bike flipped and he went with it. After calming him down from the head injury, hand injury, intoxication and embarassment, pt became combative again after I started a PCR on him. It seems that he did not want police involved and was afraid that the PCR would be handed over to Police (I have actually politely told Police in the past to go get a court order before I will release a patient care report, they are confidential for a reason...) After sorting this out, the pt gave false details, name, address, etc. No licence that I could verify against. Pt disappeared after refusing to sign PAC (Patient Advice Card - given to patients who decline treatment/transport). 5 minutes later, packing gear up into the ambulance, girlfriend turns up to collect the damaged motorbike, and I ask how Paul (pseudonym) is going, and the girlfriend replies "His name is Peter (pseudonym)", and through her I verify his details further. It shows that despite the trust, some people still do not want to share pertinent information. How many men actually admit to taking viagra when you have to administer GTN? Some choose not share info when they feel that law enforcement will be involved for an issue. And you cannot imagine how many patient care reports I have completed that bear the name of John or Jane Doe, with the address of refused to disclose. I generally write a physical description of the patient, along with the words "Patient refused to disclose identity to paramedic" and have the trusty partner countersign the PCR as witness. That way, if they sue, it is as good as a declined treatment. As far trauma assessments, I rarely will feel the crotch of a patient, and in 11 years I have not without a good reason. Even as a male, with female patients, I will not touch the chest area unless necessary for treatment or assessment (ecg, respiratory, etc) and even this is done after verbal informed consent if able. I have even dealt with an intoxicated patient who swore blindly before the deities that they fractured their tib/fib on perfectly level ground while walking to the shops.... and when you look up you see the balcony on the second floor of the local bar with people leaning over and giving the thumbs up after the patient decided that gravity no longer applied. Just remember, there is a small detective in us all, that must be suspicious of what patients tell us until proven (or disproven).

A mate of mine is a psych nurse, apparently at the moment, they have 1 jesus, 1 god and satan in at the moment., Jesus argues with god and satan. Believe it or not, God and Satan share a room and get along nicely.

i like them... have to keep them coming

http://memegenerator.net/Philosoraptor ok, not philosoraptor, but so relevant.... .... still going.... ....

I agree on the shoestring budget. I have often wondered how one of the largest ambulance services in the world can be run on one of the smallest budgets and the effects it has on the front line. I am enjoying the rants on the blog link that was posted. Good to see ambos letting it all out in a blog instead of holding it all in, and this is something we can all relate to!

Kiwi, you probably will not get them. Many services have their CPGs and protocols held as confidential and do not just release them to anyone without good reason. Sometimes, when I am questioned about care (or meds administration) I will pull out the protocols and encourage the government ambulance service officers to have a look, which leads to the comment 'they are the same as ours.... how did you get hold of them?' It is enough to say that we have a good reason, as it allows for continuity of care for our patients upon transfer. About the only service that I have seen in Australia that publicly published it's CPGs was Rural Ambulance Victoria. I think Queensland did the same for a while until people started using them in the private industry without permission. The release probably has nothing to do with that the service has something to hide. There are advanced skills in a CPG that require hours of training and clinical practice, and imagine what would happen of Mr Joe Public with a senior first aid certificate attempted an intubation with a garden hose because he saw the procedure written in a CPG he got off the internet. A lot of review, assessment, reassessment, committee meetings, research, time and money goes into developing CPGs, protocols and the regular review of such.

No, I dont work for ASA in Canberra. I work in a private company in NSW that operates as one of the legit ones.

I can understand your frustration Timmy, I too spent time in the Rural division and a metro division with St John in Vic, and there was a massive difference in the quality of equipment and vehicles. The rural division had a Mitsi L300 van fitted out as an ambulance, looked like it had been donated from the middle east (drove the same too, I threatened to push it down the hill at Mt Bright...) 3rd world, hand me down equipment, etc. It certainly did seem that St John did not exist outside of metro north. The metro division had a brand new Mercedes ambulance (this was back in 2001 - 2003), and the latest and greatest in everything. Access to training was a lot easier as the whole region would come together (this was when Mr Eade was running the show, I do not know what it is like now...). The thing i found most frustrating was the restriction of care. I came to Vic after spending time in NSW and was not allowed to administer methoxyflurane. I would have patients in pain and could only offer paracetamol or wait until RAV arrived. I quickly learnt the placebo power of 'medical oxygen' to cause some settling in pain. Came back to NSW, and felt somewhat normal again (how it all changes though... i feel naked without Fentanyl now lol, and do not use methoxyflurane any more...) The issues you mention about appropriate levels of medical support at events is certainly something that I face each day. Clients want the best they can get for the cheapest price. I certainly cannot offer intensive care paramedics for the same price as a first responder, I would be out of business rather quickly. But, if the risk profile warrants ICPs to be present, the client will be told this as a recommendation and quoted to accordingly. If someone beats that with lower levels of clinical support, good luck to the client and the provider they choose, I certainly do not lose sleep over it. 99% of the time, the client comes back with the words "we should have listened, these guys were way below what we needed". One thing is the title 'paramedic' is thrown around by anyone with a business registration and a first aid certificate, making it harder for qualified, authorised and competent paramedics in this industry to get ahead. St John vollies have referred to themselves as paramedics in my area in an attempt to get work from me (in fact, I have vollies apply for work as "ALS Paramedics" b/c they have St John NSW ALS certification - O2, Defib and methoxy...), as well as a large number of providers who are not licenced that call themselves 'ALS Paramedics' and 'Ambulance Paramedics' - with a senior first aid certification, possibly experience on O2, defib and maybe a 4 hour cannulation course along with the free AREMT accreditation as EMT-I that comes with the course. These are the providers that charge a cheaper rate (got me buggered how you can get 2 'ALS Paramedics', paid, equipment, resources, etc for $100 per day and still show a profit...) and undercut the hell out of what the legit providers are doing. Sorry for the rant there, it has been a long day and I needed to get it out.

All I carry on myself: Gloves in pocket Trauma shears in side trouser pocket (very rare though) If the situation requires it, I might put on my tactical pouch that has drugs, syringes, etc in it, otherwise most of the gear sits on the truck. The more you carry the more bogged down you get.

hehehe, I laugh, but I did that in our Holden Commodore Ambulance... damaged the rear step. After much laughter from bystanders (I had to take photos of the damage to the tree and vehicle for the incident report. They thought that bit was a riot...) and getting a revving off the rest of the team, we installed a reversing camera. Best $400 spent, fixing those damn modules can be quite expensive. Bins usually get hit when I am reversing lol. But to this day, I swear that tree jumped out behind me . I have the same fear at Eastern Creek sometimes (reversing into the medical centre) ...

Thank you emtcutie, the rap video has made my day lol. A few weeks back, working a rescue boat we came up with the idea for 'Belconnen Rescue' (Belconnen is a suburb of ACT, Australia) a complete rip off of Bondi Rescue...

I agree with Timmy here, and I am not promoting St John. In fact, I am going to declare that I work for a company that competes directly with St John for work in the private industry in NSW so there is no conflict of interest/problems. I am also an ex St John NSW volunteer. We cannot just write the bandaid brigade off due to negative publicity, every organisation has it's inherent idiots that make the rest of us look bad. St John WA got cast into a negative light on 4 corners last year, and it was the system, not the front line staff. ASNSW has patients die in the line of duty, as does every ambulance service in the world. It is the nature of the work that we do, when sometimes you work so hard that you are making deals with deities to save a patient and the deity does not get the request in time. Recently I had an individual mention that St John is responsible for killing more people than any other ambulance service in the world. When asked to provide evidence, no evidence was forth coming. I would dare say the individual was an ex volunteer with a chip off their shoulder. Let that be a lesson, if you are going to make potentially slanderous comments or libel without any form of evidence (i.e. based on a personal opinion or the opinion of others) be ready to defend your comments in court. I know if I was written off on a forum with someones views about me killing patients, I would be speaking to the solicitors about it. As an organisation, St John does have its role within the community. They cover the jobs that will not be able to afford our services. St John, with the exception of WA and NT are not in a position to become a replacement ambulance service, but from what I have heard, they are working hard to upgrade skill sets to allow the volunteers to do a little more. Whether volunteers accept this training as current or not remains up to the individual. And like any organisation, there are people who are very good at what they do, and there are some you could not trust with a basic task. We all have our place. The organisation I work with has the same skill sets as ASNSW, same CPGs and protocols, and yet, it does not make me an ambulance officer. It does not allow me to put flashing lights and sirens on a vehicle and fly down the highway with a patient on board transporting to hospital as it is simply not allowed (Section 67e of the Health Services Act 1997 (NSW) prohibits providing transport for fee or reward without consent of the DG Health). What it does allow us to do is to provide the best in care that is within our scope of practice, CPGs and protocols and expect that the same care will continue after handover for transport.