Day 13: We got to ride in the ….
Ambulance! hehe, there’s something very exciting about getting to ride in an ambulance- well for me anyway (obviously the fun decreases when you’re the actual patient…) We talked to Sue about getting some paramedic experience and she kindly arranged for us to spend half a day doing ambulance duty.
We walked to the station (in the rain of course) which is about 10 mins away from the hospital. Upon arrival we were introduced to the friendly paramedics- some of whom we’d already met in ED- and we were split into 2 teams (as there were 2 ambulances operating). We then got taken out the back and given a tour of the ambulances (they had a fleet of about 7- which to me was quite large- and they were all well equipped). I proceeded to take a lot of photos, like a tourist, and in the middle of that we got our first call out. So I got a taste of my first ride in the back of the ambulance, sirens wailing, everything flashing by (apparently ambulances are only allowed to go 20km over the speed limit… my ambos told me they don’t look at the speed dial ;)). It was definitely an exciting experience (but at the end of it I felt a bit sea sick after being thrown around from side to side in the back seat). Anyway, we arrived at our destination and found a distressed patient on the floor, hyperventilating, shaking and complaining of chest pain. The paramedics quickly and smoothly took a history, vitals and did an ECG (which was normal), whilst reassuring the patient. They determined that a cardiac cause was unlikely and focussed on the hyperventilation and calming the patient. It was quite remarkable to watch how calmly and reassuringly they worked, in what was a little bit of a dramatic situation. The patient was then taken back to the hospital (this time without the sirens) to ED.
After that, we had 2 non urgent call outs- one to transport an elderly patient on oxygen to ED to have their catheter changed and the other to transport another elderly patient with unresolved pneumonia to ED. In the first case, I was quite surprised to learn that it was the ambulance’s duty to transport the pt to ED- it wasn’t an urgent case and the pt had to have their catheter changed every few weeks, so it was a regular job. Upon talking to the pt and the paramedics, I found that both of them were not happy with the arrangement- one simple catheter change meant 2 trips in the ambulance each time, was time consuming and costly for the QAS and was obviously a burden for the patient in both time and effort, not to mention the fact that they had to be disconnected from their oxygen supply at least twice. The paramedics were of the mind that if they were trained to do the catheter change themselves, then it would be much easier for them to deal with the situation themselves.
In the second case, I discovered a greater empathy for older patients. Watching the patient’s distress at being taken to the hospital, clinging onto their partner for support and observing how fragile elderly patients can be (a missed venipuncture caused a massive bruise, moving them onto the bed caused bruising to their neck), really made me more aware of how carefully you have to treat some situations.
After lunch, I headed up to surgery as Sue had arranged for us to practice cannulation with the anaesthetist. Only one theatre- the endo theatre- was running, so I got to sit in on a lot of scopes (gastric and colonic) in between cannulations. I was able to practice cannulating on 3 patients… and I can safely say I suck at them! At the start, the anesthetist showed me the equipment and I watched as he cannulated the first pt. When the second pt came in, I was handed the cannula (… wait a minute they expected me to do it by myself?!) This type of throwing in the deep end was something that was very common in the Hospital. Sometimes I wasn’t even shown how to do a procedure- it was just “go do this now.”Anyway I managed to get my first cannula in (success!) and then proceeded to stuff up the next two… I just can’t seem to get the hang of holding the needle still while pushing in the cannula. This, I have to say, was a bit depressing, for want of a better word. As a not very experienced student, giving needles and causing pain is bad enough, but having the dr have to take over because you just can’t get it right is just terrible and a definite downer for the confidence.
Next, at about 5:30 I headed home for the very long break of 2 hours before heading back to ED for the night. And we were in for a treat! At the start we did the usual waiting around, checking every so often if anything was happening and doing a quick check of all the wards to see what was on (nothing ;)). At about 10pm we got wind of something happening and talk of several doctors being called back in. Well it turned out that an emergency caesarhad to be done, so we headed up to surgery to watch. Comparing it to the first caesar (which had been planned beforehand), this was very different. No preparation had been done, many of the staff had just driven in from home (some had just finished a 10 hour shift in the day), it was nearly midnight by the time the surgery started and it was an emergency with 2 lives at risk- so as you can expect it was very tense in the OR and we were more or less ignored as everyone rushed around. Seeing a team operate like this was very impressive though, they approached everything with a problem solving attitude and quickly started the surgery, whipped the baby out (much faster with a general anaesthetic) and closed up the incision.
Seeing as we were not scrubbed in, we were able to leave the theatre and follow the bub to the neonatal unit to have their first ever check and cleaning (too cute!). As I said on my 1st day, being present at the birth of a new life is just AMAZING. The knowledge that for this baby, it was their first time seeing the world, first time taking in air, that they would never remember this and that half an hour ago they were happily within their mother’s womb just makes you really reflect (and go all mushy ;)). Like the baby check, I saw before, it consists of a physical examination- checking things like general appearance, the fontanels, eyes, ears, mouth, throat, sucking and swallowing, head circumference, weight, length, breathing patterns, size of liver and spleen (tiny!), heart sounds, breath sounds, genitals, anus and hip joints.
The baby then had their first bath (in a specially made sink), a jumpsuit, beanie etc put on, a ID bracelet (put on both feet) , wrapped in a blanket (this is quite important, newborns don’t have very good temp control) and the very excited family brought in, to take some happy snaps!
Overall this was the longest day I spent in the Hospital- a grand total of 14 hours, but it was one of my favourite days so far, I learnt a lot, saw medical and paramedical practice from new angles and pushed myself to be more hands on (even if I didn’t always succeed ;))