I expect that if I ever reach the ripe old age of 93 I’ll be a demented old fool. Drooling unhappily into my porridge-like steak and beans puree. I’ll be grumbling that back in my day, men like Kurt Cobain composed “real” music and the youth of today have no respect for the elderly, and will they please turn down that infernal racket.

Well, today I met a remarkable old duck. 93 years young and living alone. Her son was down for the holiday season and he was heading home tomorrow. She padded out the back door without her walking stick to fetch something from the garage and managed to plunge head first down a set of stairs leading from the back porch.

She landed with her arms outstretched and kissed the pavement with her forehead. Her son found her trying to untangle herself with her feet still on the top step and her head resting on the concrete path three steps below.

She’d given herself a golf ball size haematoma on the hairline dead centre on the forehead and her left wrist was at an awkward angle, an obvious fracture. She had skin tears on her elbows and several of her fingers were bloodied. When we arrived she’d righted herself and was sitting on the stairs. Shaken but only mildly stirred.

“Me arm hurts a bit and I feel a bit shaky”.

“No wonder”, I said, “Someone from my generation would be screaming and crying”.

I gave her the once over but she was remarkably unscathed for such a violent trip.

Cervical spine – check. Palpate spine – check. Head, teeth, shoulders, hips, legs and arms – check. It goes to show that good genes can take you a long way. She was even a smoker.

A super-nanna indeed.

A puff on the penthrane, an air splint and she was happy. I suppose that’s one way to have your son hang around a little longer.

Like most paramedics, a paediatric patient is both an unnerving prospect and an often distressing one. Today we had two.

Our first patient had a lot of history in his very short life. Six months old, born premature at 34 weeks and born to parents that had lost their last two children before birth. Sam* was special.

A few weeks earlier Sam had been brought into hospital by his mum and a maternal health nurse. He had been struggling with his breathing all day. As they walked through the doors of the accident and emergency department Sam went limp and stopped breathing. The A&E staff ushered him through to the rescuscitation bay and brought him back. They stabilised him and transferred him to the specialist childrens hospital in the city where he spent the next six days recovering from pneumonia.

Today Sam had been vomiting up phlegm and struggling with his breathing again. His mum called the maternal health nurse who came over to check on the little one. His skin was mottled and he was unsettled. The nurse called the A&E department and asked of them what she should do. Considering his history they said to call an ambulance.

We were sent lights and sirens with an intensive care ambulance backing us up. We drove to their street which turned out to be a big bizarre loop. We finally arrived and carried the works into the job. We found Sam lying on his play mat. He looked to have mottled skin but was bubbly and active. We called off the backup crew and got some history and observations. We got mum to pack some clothes for the little one and popped them both into the ambulance for the short trip to the hospital. Sam was later admitted for a possible recurrence of his chest infection. Poor little fella. Some lives start of tougher than others. I thought to myself that this may steel him for the future. Making him more resilient. I hope so.

Later that day we were dispatched to a 1 year old boy who was continuously fitting. This time we were backing the intensive care ambulance. Maybe it was an error in dispatch but we were sent lights and sirens as a backup crew. Maybe there was more to this job than was on our computer terminal. All that aside this was a job with a paediatric patient at risk so my partner pushed the ambulance a little harder than we normally would. This job was a long way away, a good 25 minute drive at normal speeds.

Halfway to the job we approached a round-about and in a freak of timing merged just behind the ambulance we were backing. As a procession we headed off to the job. We arrived in just over 15minutes. Not bad for a drive of that distance.

The MICA crew asked us to grab our monitor and oxygen supply. We were greeted by an anxious father and hysterical grandmother. Lying limp on the couch was Jordan, our 1 year old patient.

The other crew quickly assessed Jordan while I organised the oxygen. He started to rouse almost immediately. As I placed the oxygen mask over his face Jordan looked up and grabbed the mask. He popped the corner straight into his mouth and started chewing on it. I felt his forehead and he was warm. My partner measured his temperature and found him to be febrile. The MICA crew went on to explain to Jordans mum that he probably had a febrile convulsion. Common and probably benign. I went over to cheer up Grandma.

We ran mum, dad and Jordan up to the local hospital and the MICA crew left to save the day elswhere.

It’s always nice to be able to relax mum and dad after a bad experience like they’d just been through. It’s understandably reassuring for them to know that febrile convulsions are common. That their kids may have another but chances are that they’ll grow out of them. The parents commonly ask if their kid is going to suffer from epilepsy in the future. A slightly increased chance but highly unlikely. It’s just their immature brains inability to cope with changing temperatures (probably caused by an underlying illness like a cold).

We left the family at the hospital and met them there a few hours later. Jordan was 100% but they were just waiting for him to pass some urine befoe they could go home. Jordan wasn’t playing the game.

Two paediatric patients in a row. No dramas this time. I just hope there won’t be big dramas in the future. Life can be cruel but mostly, as far as kids are concerned, life can be magic. I hope Sams mum and dad find that magic in a healthy Sam. They’ve had enough of the bad stuff.

*Not their real names.

35 weeks pregnant patients should be nesting. Bustling around their homes making them ready for the screaming bundle of joy that’s about to arrive. This patient, Clair*, wasn’t in homemaker mode. She was in excruciating pain and couldn’t even lift her feet an inch off the floor when she walked.

Diagnosed by her obstetrician with an elevated relaxin level, Clair’s body was softening up early to aid in the delivery of her baby. Unfortunately with 5 weeks to go her preemptive hormone burst was just too much for her. Thankfully her Dr organised a bed in the midwifery unit and all she had to do was get there. Geography and weather conspired against her.

We arrived amidst a torrential downpour. Clair’s driveway stretched almost vertically and a steady river of muddy water coursed over its slick surface. Lugging the attendants bag up the hill I was exhausted by the time I reached the top. How on earth would we get the ambulance up to the patient? God I hoped she could walk.

It became rapidly apparent, after meeting Clair that she wasn’t walking anywhere let alone down the driveway. I sent my partner to solve the major logistical problem. How do you get a heavily pregnant woman down a very steep, slick driveway without letting her move. I just cannulated her and gave her a tipple of morphine.

From inside I could hear the roar of a straining diesel and the spinning of wheels. Shortly after my partner arrived with the bright orange wheelchair and the patient managed to struggle her way from the couch to the wheelchair.

We wheeled the patient out into the rain and down a steep hill at the back of her house. As we arrived in her carport I saw that the ambulance had made its way most of the way up the slick hill but couln’t get around the last bend up to the carport. The stretcher had been placed under cover in the carport.

Again the patient made the painful move. This time from the wheelchair to the stretcher. We then headed down the steep driveway to the ambulance. My partner was at the front and the patient’s husband and I anchored the other end. Slipping and sliding we finally made it to the back of the ambulance. I grabbed the yellow handles at the rear and held on to the stretcher while the other two manoevred it into the back. Made it. All we have to do is back the ambulance back down the driveway.

God bless four wheel drivers. The patient’s husband gave us a great tip. Pull the handbrake on a little as you back down steep slopes. It worked like a charm. I’m still sweating.

*not her real name

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.