Some days you just feel that you’re chasing your own tail. Just about every shift (of late) we get called to do a welfare check. Normally it’s an old timer that’s pressed their medical alarm button or their family has called for an ambulance because they haven’t been able to contact them by phone. Today was no exception.

We knocked on the door and got no reply. There was a key lock in his meter box and we had the code. We unlocked his door and began the room to room search for the patient. Sometimes you find the old timer in bed having departed this mortal coil but, as in this case, most of the time they’ve left the house and bumped the alarm button on the way out the door.

We turned off the toilet light to offset the carbon emissions it cost us to get to him and left him a note saying that we’d raided his place. We spoke to the traditional nosey parkers across the road and to the lovely neigbours next door and left.

Fifteen minutes later we were back in our area having just exited the new tollway when we received another job almost from where we’d just been. Chasing that proverbial tail indeed. This time it was for a two car collision under the new tollway. Multiple patients. Where the hell were the ambulances from that area?

We flicked on the beacons and headed back onto the tollway, exiting about 100 metres from the accident. Windscreen assessment showed a nasty t-bone. B-pillar. All patients out of the car. Sweet.

That’s when we met Clair*. Clair, her mum and another sibling had been in the car that had been t-boned. All had minor injuries but for the sake of keeping them together we popped them all in to the one ambulance.

Clair had a nice shiner and some hip pain but just refused to complain. She asked first about how her mum was and then how her sister was. She sat in a seat by herself and chatted to my partner for the whole journey. She told him about her friends and how she was in the school play the previous night. And she just refused to complain.

I later found out that she had been fighting a tumour for some time. It was in her brain and most of it had been removed after multiple surgeries. She told me that she’d had 9 MRIs and was due to have another next week. She said that the first time she was terrified but now she could watch a DVD during the scan. That made it better. And her mum stayed in the room as well.

Then came the story of the laptop. Clair had asked her mum to grab a laptop that had been in the car. The screen now had a crack in it and the screen hinge broken. Her mum then told me that the Make a Wish foundation had given it to her because that’s what she’d always wanted.

I met a really cool kid today. She was totally selfless, totally caring, and totally funny. Let’s just hope that she meets a electronics or computer store that’s cool enough to look after her and repair the computer for her. She so deserves it.

It was an honour to meet you Clair. People like you make being a paramedic a privilege.

*Not the patients real name.

Arteriovenous malformation is something I had never heard of until a recently. In a nutshell it’s a connecting of the high pressure arteries directly to the low pressure venous side without passing through a capillary bed. These connections can bunch together and are prone to leaking or bursting.

We attended to a patient in her early forties. She had an AVM diagnosed some time ago and had experienced several small bleeds resulting in arm numbness to tingling in the roof of her mouth. These events all self resolved without intervention. She was also undergoing radiotherapy a part of an ongoing treatment regime.

This morning she had her breakfast and then went to the toilet. Her partner heard a yell and then incomprehensible sounds. He opened the toilet door and found her to have minimal movement down the right side of her body. She couldn’t get off the toilet and had trouble balancing on the seat. He called for the ambulance and helped support her until the crew arrived.

Once on scene we had to carry the patient out of the toilet and onto the stretcher. In the back of the truck the patient started vomiting and her conscious state began to decline.

From toilet to truck to hospital the decline was remarkably rapid. Her conscious state went from a GCS 14 to GCS 8 in a matter of 20 minutes.

She was sent away for a CT and as they returned the attending nurse just mouthed the words to me “it’s full of blood”.

From loving partner to tragic victim. So rapidly. So unexpectedly. As a paramedic it is all you can do to get them to hospital as fast as you can. It still leaves you feeling that more could have been done.

Drop us a comment if you’ve experienced an AVM. What did you do for the patient? What was the outcome?

4am in the morning is not the time to be hunting through people’s medications to find out which ones they’ve had washed down with a bottle of cheap red. 2008 I believe, not a good year.

Suffering from anxiety and depression, Frank (not his real name), has had 5 shots at this, so to speak. 5 attempts at departing this mortal coil. Fail, fail, etcetera. Poor bugger. The system is obviously failing him and this time he’s nearly succeeded in relieving himself of the pain that he has been fighting.

This time he’s swapped the mental for the physical pain. Choosing Voltaren as part of the cocktail, he’s started to damage the lining of his stomach. Pain ensues and Frank shouts for help. His wife calls us and we’re greeted by Frank, post vomit, sitting on the ground holding his substantial gut.

He’s also taken his wife’s blood pressure meds and some beta blockers. Good times – bradycardic, hypotensive and in severe pain. We call for another crew to help us get him out of the place and in the meantime pop a line in and give him a splash of fluid. Gotta keep those kidneys going.

Even supine, Frank’s BP is just over 50/P with a heart rate hovering in the mid 40′s. Good times.

We call for MICA but we’ll beat them to hospital anyway. Scoop and run as they say.

Moral of the story. Sometimes the pain you want to escape is better than the pain you get trying to escape from it. Or something like that.

Here’s the thing. Doctors and Div 1 nurses can call ESTA, 000, Triple Zero, and say they want an ambulance. Just say when.

The question they get asked by the call taker is “how long can the patient medically wait for the arrival or the ambulance” and here lies the rub. Some Doctors take the proverbial p*ss.

What’s got me so irate stems from a job a couple of days ago. Big guy, did some extracurricular work for a charity and damages himself. Sciatica time. We pop him up to the local private hospital. Job done.

Next day we get a call back to the same address. The patient has released himself the night before and now, at peak hour time he can’t get back up off the bed.

His Dr had seen him earlier in the day and said to wait it out to see if the back improves. Nup. So what does the Dr do. He calls for the ambulance and says that the patient must be seen in the next 20 minutes. 20 minutes!

This bloke has been lying there all day. Now all of a sudden the Dr thinks it’s a medical emergency? Because the Dr has said it’s a medical emergency (20 minute time frame) an emergency ambulance has to be dispatched.

Let me put it in perspective, the following jobs would be regarded as a “Code 2″ just like our sciatica man:

• 98 year old grandma has fallen and broken her hip.
• A 12 year old who has dislocated their knee during a football match.
• A person who has burns to their entire arm.

So overall the Dr screws the system. For all I know there was a cardiac arrest just around the corner that we were unable to attend due to us having already arrived to see this fella. Don’t get me wrong, he was in pain, he needed to go to hospital, but what’s so wrong with waiting a little longer and going with a non-emergency ambulance.

Show some commonsense people. Ambulance is a privilege (even if you have to pay for it) and not a right.

Some jobs just continue to surprise. Last night was certainly no different.

The first job of the night began as a car rollover at a major intersection and ended up being a remarkable piece of luck.

Husband and wife were heading over to their son’s home for tea when the husband feels himself passing out. As he blacks out his foot hits the accelerator. The car launches from the lights and the wife grabs the steering wheel from the passenger seat.

She manages to dodge and weave her way across the intersection. The car heads down a small embankment, onto the wrong side of the road, up the gutter and down the footpath. She remembers looking for something hard to hit but not too hard. She picks out a large signpost and her car strikes it hard. The car is stopped.

For her troubles she breaks her right arm, a small price to pay for being able to hang on to the steering wheel. Her husband has some discomfort from the seat belt.

A lucky escape indeed.