Ramblings of a Tassie Paramedic

R.I.P. Steve

2011-10-06T20:20:00.003+11:00

Ambulance Tasmania Is Advertising

2011-01-13T21:13:00.001+11:00

Paramedic Student (Multiple Statewide Vacancies) (511770)

Applications Close Friday, 21 January 2011

Positions Commencing in April 2011

Also on the jobs.tas.gov.au website are:
Paramedic Educator positions and a
Deputy CEO/Director Emergency and Medical Services position

Til then, be safe

Outcry Over Ambulance Staff Shortages

2010-11-12T19:29:00.004+11:00

This is the video from a new story on the ABC News tonight and the text from the same story on the abc.com.au website.

The Video

The link to The Text

Outcry Over Ambulance Staff Shortages:

Tasmania's Ambulance Service is under fire, accused of failing to provide enough staff to meet demand across the state.

Staff shortages caused the Bridgewater station in the state's south to close its doors last weekend.

The station was left unattended and on-call paramedics had to take vehicles home in case of an emergency call out.

The Health and Community Services Union claims similar incidents are frequent and have been for years because of staff shortages.

The Brighton mayor, Tony Foster, says the Bridgewater station needs two full-time paramedics.

"That's what we need to be able to, I guess, look after the community needs from here to Oatlands and we all know about the Midland Highway," he said.

"So we need to be able to go to an accident that may happen on the Midland Highway from Bridgewater, not from Glenorchy, and not from anywhere else."

The Ambulance Service is assessing staffing levels and infrastructure.

CEO Dominic Morgan says it plans to seek Government funding for additional resources over the next few years.

"Ambulance Tasmania has a significant number of strategies in place to take us in to the future," he said.

"We've just started five qualified staff, they'll be hitting the roads within the next two weeks.

"We've got another three coming on board between now and January and we have 17 officers who will graduate by December," he said.

As much as I'd like to make a personal comment about our staffing, I won't....

Til then, Be safe

Amblance Tasmania Is Hiring Graduates

2010-09-11T09:20:00.003+10:00

Well it's that time of year, again.

Ambulance Tasmania is advertising for Paramedic Intern's (Multiple State-wide Vacancies). The positions commence in February 2011 in the 18 month Graduate Program.
Applications close Friday, 24 September 2010

They were advertised:

in Wednesdays edition of the Tasmanian Governemnet Gazette 08-Sep-2010. Which links directly to this page, Paramedic Interns

Posted on the ACAP site on Thursday

And I saw it in todays local paper, so it would be in all 3 Tasmanaian newspapers and I'd suggest many interstate newspapers.

Til then, be safe.

Claim Ambos Work On Leave

2010-09-07T19:22:00.004+10:00

This is the text from an article in The Mercury Newspaper

by: DAMIEN BROWN | September 07, 2010 - 08.30am
http://www.themercury.com.au/article/2010/09/07/171245_tasmania-news.html

Claims have surfaced of ambulance officers being paid overtime to work during their annual leave to cover staff shortages, to the anger of the Liberal Party.

More paramedics and volunteer ambulance officers yesterday contacted the Mercury following a series of reports of disgruntled workers fed up with understaffing, not being properly equipped and having to cope with a massive 50 per cent increase in demand over the past five years.

And there have been reports of patients dying because ambulances have not been able to get to them in time -- and some staff being owed as much as a year's worth of annual leave.

Documents obtained by the Mercury this week show that ambulance officers, along with doctors and nurses, are in such short supply they cannot take their accumulated holidays.

A volunteer officer said yesterday that some staff were being paid overtime rates to work during their holidays to cover for staff shortages.

He also cited volunteer workers having to work up to 20 hours and not having their uniforms replaced.

"We are doing the same work as the career officers but feel like we are just treated like second-class citizens," said the volunteer, who did not want to be identified.

"The day you go to work and bring someone back to life or deliver a bub, it makes it all worth it, but we can't continue to be ignored by management for much longer or we're going to crack."

Ambulance Tasmania chief executive officer Dominic Morgan and Health Minister Michelle O'Byrne have urged ambulance officers and the Tasmanian community to be patient.

Mr Morgan has admitted things are not perfect but is confident that when a raft of initiatives is introduced they will make a difference.

But Liberal health spokesman Jeremy Rockliff said yesterday the program to help fix the sick ambulance service needed to be sped up.

"The State Government has supposedly re-injected millions into the Budget to secure front-line health services but you can't get any more front-line than ambulance services, so when staffing is stretched so tight why isn't the Government actively recruiting more ambulance officers to fill the gaps?" he said.

Til then, be safe.

Another Blogger Forced To Wind Up Their Blog

2010-06-24T19:43:00.004+10:00

Well,

Mark over at 999medic.com has pulled up stumps. It was not a decision he took lightly and was forced into this decision by people causing problems for him.

In his 2nd last post he stated:

"I know I have people in my own service who actively look for things to get me into trouble.
I now know I have people in my own service who have tried to cause trouble for me and this blog".

In the last 18 months, his blog grew into one of the best EMS related blogs on the internet and one of my favourites.

He had written and published 483 posts. Received over 3000 comments and the site had 250,000+ hits. He further created ‘The Handover’ EMS Blog carnival which is still going strong as the only EMS related carnival.

So Mark, farewell mate.
You will be sorely missed.

Til then, be safe.

Had To Share This Classic

2010-05-09T14:53:00.005+10:00

I heard this the other day from an interstate friend who is a nurse and I laughed so hard I had to share it. This is true. I have not made this up.

Several months ago, my friend was working on the triage desk at the Accident & Emergency department of the local hospital when a young mother came to the counter with her daughter in a pram. The mother was concerned about the health of her young daughter.

Presenting history, past history, medications and allergies were obtained and then came the time to get the child's name.

Nurse " what is you daughter first name"

Mother "Abseedee"

Nurse "Sorry I didn't quite get that"

Mother "Abseedee"

Nurse - with a look of confusion "Oh, how do you spell that"

Mother - with a look of disbelief/disdain "A B C D E"

Nurse - withholding a look of 'you have to be kidding' "Right"

Til then, be safe.

Back On The Road Next Week

2010-03-27T20:24:00.002+11:00

Well, 7 months on the fixed wing has come to an end.

I've consolidated my new found skills and knowledge, so I'm back on road next block so the other flight paramedics get a stint on the plane. The roster is only ever 4 weeks in advance but I'd take a guess and say I'll be on the road for several months before getting back on the plane as the plan is to continually rotate the ICFP's around.

With Tassie being such a small state, I felt I just couldn't post about jobs without someone recognising themselves or someone they knew.

Til then, be safe.

Do You Have An iPhone ?

2010-02-24T21:50:00.011+11:00

What, you still haven't joined the "cool kids"... Just kidding.

I got mine in August last year as I waited for the faster 3GS version to be released.

The iPhone (or iPod Touch) is a cool piece of kit but what really sets it apart is the App Store and the multitude of applications.

The fact that there are currently over 160,000 apps available means wading through the crap can be difficult and even though some very good apps are only a few dollars, several of them soon add up, but the following information will really help you.

The makers of most apps regularly reduce them in price, often to AUD$1.19 (US$0.99) for a short period to increase sales and get them back to the top of their category (sometimes they are even free for several hours).

Go to www.AppShopper.com and setup a free account.
You can then track the apps you have purchased (My Apps) and also mark apps that you'd like to buy (your Wish List) and the site will send you an e-mail when they are decreased in price.

Some of the applications that I rate highly are:
(the prices below are in Aussie $)

MEDICAL:
I only use these for reference and revision when it's quiet at work, but for under $10 total, I've spent very little. This also makes this post ambulance related, but who really cares.
ECG Guide - has been $1.19
Instant ECG: An Electrocardiogram Rhythms Interpretation Guide - has been $1.19
Pedi Safe: ICU, OR, ED Medications - $3.99
Pedi STAT - $1.19
NREMT Paramedic Medications - $2.49
MedCalc (medical calculator) - Free
Epocrates - Free
QAS for iPhone - excellent app but has been removed from the store for a couple of months now ??

GAMES:
Real Racing - $5.99 (try the Lite version, it's Free)
- Possibly the best racing game out there
Angry Birds - $1.19
- Challenging, fun, addictive, discovered this a few days ago, love it
Flight Control - $1.19
Solitaire - $1.19
Let's Golf! - has been $1.19 (& free for a very short time)
Coast Defense - Reloaded - has been $1.19
Action Bowling - has been $1.19

OTHERS:
Pocket Weather AU - $2.49
- the best Aussie weather app, I use it all the time
Mobile Maps Australia & New Zealand - is currently $59.99
- of the 4 or 5 Aussie gps apps available, this has been reviewed the highest and I believe it's the cheapest
Convert ~ the unit calculator - $1.19
- converts all sorts of stuff, I use it often
GoodReader (large PDF viewer) - read big PDF files with reflow - $1.19
- put pdfs, .doc .xls etc on your iPhone and view easily and very clearly, I use it for rosters, reference files, etc
Dictionary.com - Dictionary & Thesaurus - Free

I have lots of apps on my Wish List and when they drop to good prices then I buy them. I hope this info helps you.

Please post comments with any apps you think are worth having.

Til then, be safe.

Ambulance Tasmania's Newest Recruits

2010-02-23T21:13:00.011+11:00

Well, it's February 2010 and Ambulance Tasmania has just recently hired its LAST batch of student paramedics (they were advertised in June 2009). See this post for the difference between a "student paramedic" and a "graduate paramedic".

From next year they will only be hiring qualified officers or graduate students (those who have already completed a degree). No more being hired without any qualifications and being trained on the job (whilst being paid) over 3 years. This will make becoming a paramedic in Tasmania as a mature aged person very difficult.

Anyway, seventeen (17) new students commenced in the middle of February and are completing an induction period in Hobart which includes basic BLS skills and their initial driver training amongst other things, then the 5 coming to my station start here on the 15th of March with a weeks induction to the region and then they will spend a week riding on the ambulances as thirds. Then it's out on the road with a mentor.

Til then, be safe.

A New Name - AMBULANCE TASMANIA

2010-02-17T17:51:00.004+11:00

Everyone at work received an e-mail yesterday letting us know of few recent changes to the structure of the DHHS (Department of Health and Human Services) and new names for three major sections of the Agency.

Of interest to me was:

The Tasmanian Ambulance and Health Transport Service is now known as Ambulance Tasmania.

Very few people knew that the TAS - Tasmanian Ambulance Service was renamed about 18 months ago to the TAHTS - Tasmanian Ambulance and Health Transport Service.

So now it's Ambulance Tasmania.

Here is the organisational chart, if anyone is actually interested.

Til then, be safe.

High Flying Election Promise - (C) ABC News

2010-02-14T18:41:00.003+11:00

Tasmanian Premier, David Bartlett today announced $36 million for a helicopter for the Tasmanian Ambulance Service.

If re-elected the ALP has promised to spend $36 million over four years on a helicopter for the ambulance service. It will be staffed around the clock and based in Hobart.

The helicopter service is expected to be up and running within 18 months. Once operational it will need about 17 staff, paramedics and crew to operate it.

The Premier, David Bartlett made the announcement this morning with his deputy, Lara Giddings by his side. Ms Giddings insisted the new service will not make the current rescue helicopters redundant.

"The minute an emergency is called in, that helicopter can warm up and take off, right now, what happens is the helicopter is ready to go but we have to wait for a paramedic crew to turn up on site."

They also promised the Royal Flying Doctors Service (contracted to the Tasmanain Air Ambulance) based in Launceston will remain there.

Til then, be safe.

An Update

2010-01-24T20:04:00.006+11:00

I haven't posted for a while, have been a little busy and had other priorities.

I have been working on our Air Ambulance since late August (the last 5 months). Tassie has a Beechcraft Super King Air 200.

I spent basically the month of November in Melbourne with 2 other Tassie ICP's (flew home on weekends) and sat thought 4 weeks of classroom and other stuff for Monash University's Graduate Certificate in Emergency Health (Aeromedical Retrieval).

Since then I've had an Exam and have completed 7 of the 10 assignments and am completing a clinical logbook. It should all be finished in March.

We did a day long HUET (helicopter underwater escape training) course during our time in Melbourne as part of the Grad Cert, here is a video:

Til then, be safe.

A new direction

2009-10-20T09:40:00.004+11:00

I have removed most of my posts.

I was spoken to by management about their concerns over some of the content of my blog, thus I've removed nearly all the posts. Also, apparently there is a policy document about taking photos whilst at work. So the images have been removed.

I've copied all the posts back to my computer this time, so at least I can re post what is deemed appropriate after some more editing.

This means, I can have a work related blog, but with a more limited focus. That's fine with me. Don't want to do anything to jeopardise this great job.

Things will be lean on the posting front for a while as I'm very busy. About to go to Melbourne for 4 weeks on the Monash Uni Aeromedical Retrieval course and will have an exam and several assignments to do.

Til then, be safe.

What's On Our Pagers

2009-08-04T19:26:00.006+10:00

I wrote a similar post to this one, prior to the deletion of the blog, so here is the information again.

Our ambulances don't yet have GPS (apparently they are coming, maybe, who knows...) or data terminals. Another blog I read mentioned that they received their jobs via the PA at the station.

In Tasmania, we carry pagers and receive our jobs via them. If the job has some intricate details or the communication officers want to give us a "heads up" on the patient we are about to deal with, then we are rung on the mobile phone each truck has, to receive the extra information.

Here is an example of a standard pager message:

IN0154E 764
UNIT 2 / 123 THAT STREET,
SUBURB, 7012 Sa:86e5 SOUTH
UNCONSCIOUS, DIFFICULT TO ROUSE,
? OVERDOSE
BLOGGS, JOSEPH, 34, M
12:34P 22/05

What does it all mean:

IN0154E - Incident 154 for the state since midnight and the response code is an E - Emergency (lights and sirens).
Could also be an U or a D
U - urgent, respond immediately, but no lights and sirens
D - domestic, respond when clear or after the meal you just started (we very very rarely get D jobs).
764 - our ambulance number, confirms it was meant for us ?

UNIT 2 / 123 THAT STREET, SUBURB, 7012 - Address of the incident.

Sa:86e5 SOUTH - Street Atlas, page 86, grid reference e5, Southern Region - T.A.S is run under 3 regions.
Sometimes it will have Mb:123w23 - Map Book, page 123, grid reference w23, if the job is in a rural area.

UNCONSCIOUS, DIFFICULT TO ROUSE, ? OVERDOSE - General description of the job from what the Communications Officers has been able to obtain from the call, sometimes way off, but usually very accurate.

BLOGGS, JOSEPH, 34, M - patients name (if available), age (often estimated by caller) and sex of patient.

12:34P 22/05 - time and date of pager message.

We no longer complete our reports on paper.
We use a Panasonic TOUGHBOOK which is referred to as a VACIS (Pronounced VAC-ISS and stands for Victorian Ambulance Clinical Information System). I know Victoria (obviously) and Queensland also use them and other states are in the process of getting them. I may do a future post on the joys of using these.

Til then, be safe

Another Block

2009-07-03T11:04:00.004+10:00

The last block held the following jobs for my partner and I.

The jobs below are listed as:
Called To (as listed on the pager) -> Result of the Job

Unconscious/Fainting -> N.A.D.
Breathing Problems -> SOB
Transfer RFDS -> Transfer
Conditions Specific -> Post-ictal
Red Cross Alarm -> Cancelled
RTC -> Trip & Fall
Overdose, Police requesting assistance -> Substance U/K
Fall, Hand Injury -> ? Fractured arm
Traumatic Injury -> Post LOC / Concussion
Chest Pain -> Chest Pain
Transfer Home -> Back to Nursing Home
Abdominal Pain -> ? Abdo pain for investigation
Overdose -> Antidepressant Poisoning
Unconcious/fainting -> Cancelled by police
Pregnancy -> Born at hospital 15 minutes after arrival
Breathing Problems -> COPD, very ill
Sick Person -> Inner Ear Problem
Haematemesis -> Panadol & ?? Overdose
Chest Pain -> Rapid Af
Condition Specific, Chest Pain -> Pleuritic Pain
Breathing Problems -> Asthma

Til then, be safe.

Upgraded skills of a Tasmanian Intensive Care Paramedic

2009-06-17T09:35:00.005+10:00

Again, I previously posted (before rashly deleting the entire blog) most of the following information.

Tasmanian IC Paramedics previously did an in-house course lasting about 6 months but I recently completed an Advanced Diploma of Paramedical Science (Ambulance) over 9 1/2 months to obtain my Intensive Care qualification. I understand T.A.S. are still (maybe) planning on moving to a Graduate Diploma of Emergency Health (MICA Paramedic) through Monash University in the near future.

These are the upgraded skills of an Intensive Care Paramedic over those previously posted as Paramedic level in Tasmania (again this list is not complete but you get the idea):

12 lead ECG interpretation
Endotracheal intubation and cricothyroidotomy
-> Sedation to maintain the ET tube
Capnography
Gastric intubation
Chest decompression (12g cannula)
External jugular cannulation
Intra-osseous cannulation
Synchronised cardioversion
-> Sedation for cardioversion
Enhanced pain relief (Morphine and Midazolam)
Extra cardiac drugs: Adenosine, Amiodarone, Atropine, Lignocaine, Sodium Bicarbonate
Extra IV drugs for: TCA & Psychostimulant OD's, APO, Asthma, COPD, Anaphylaxis, Vomiting, Meningococcal Septicaemia, Crush Syndrome, Organophosphate poisoning,
Full Paediatric Guidelines & Pharmacology

And just for some extra information, here is what I've heard around the station, should be coming to Tasmanian ICP's at some stage in the future, as other states already have them.
It may be years before we get some:

Rapid sequence induction (RSI)
Thrombolytics
Transcutaneous cardiac pacing
Dextrose 50% - changing to 10% for hypoglycaemia
CPAP for APO
Syringe drivers for accurate drug infusions
Amiodarone infusion for conscious VT, before Lignocaine
Magnesium for severe asthma
Intranasal Fentanyl as another option for pain relief

Til then, be safe.

Becoming a Tasmanian Paramedic and our current skill set

2009-06-16T10:58:00.008+10:00

I previously posted (before rashly deleting the entire blog) most of the following information.

Becoming a Tasmanian Ambulance Service Paramedic can be done in 1 of 3 ways:
Try this link for some info from the DHHS website
or e-mail: wolfgang DOT rechberger AT dhhs DOT tas DOT gov DOT au

1) being hired as a "student" and completing 3 years on road whilst completing an Associate Degree in Paramedic Studies from the University of Tasmania (previously this was a Diploma in Clinical Practice (Paramedic) or similar, done by distance education via Charles Sturt university (I did this)). See this Newer Post from Tuesday 23rd Feb 2010 for more up to date info.

Some Australian ambulance services are moving away from this style of recruitment. New recruits are now having to complete their tertiary education prior to being employed, which makes changing careers (like I did) much harder for mature aged people, who might have a family and a non flexible financial situation.

2) completing a Degree, Associate Degree or Diploma in the pre-hospital care field (available from a number of universities) and being hired as a "graduate student" and completing between 12 & 18 months on road.

3) being hired on as a qualified officer because you were a qualified officer in another state or country (and have the appropriate education qualifications and experience).

In Tasmanian we moved from Protocols to Clinical Practice Guidelines about 18 months ago. Thus the skill set of a Tassie Paramedic is:
(This is not a complete list, but you get the idea)

Basic life support skills and the further enhancement of:
Interpretation of basic ECG's, SpO2, BSL, Temperature
Manual defibrillation
IV canulation
Limited narcotic pain relief (max 10mg IV of Morphine for non cardiac pain (max of 20mg IMI if no IV access))
Drug therapy (sublingual, oral, IMI and limited IV) for:
Cardiac arrest - Adrenaline IV & fluid
Chest pain - GTN, Aspirin, O2
Musculoskeletal Pain - Entonox, Penthrane, Morphine
Asthma - Salbutamol, Atrovent, O2, Adrenaline IMI
COPD - Salbutamol, Atrovent, O2
Narcotic OD - Narcan IMI
Hypoglycaemia - Glucatol, Glucagon, Dextrose 50% IV
Anaphylaxis - Adrenaline IMI & fluid, Salbutamol
APO - GTN & IPPV
Seizures & Agitated Pt's - Midazolam IMI
SVT - Valsalva Manoeuvre
Fluid resuscitation for Trauma, Anaphylaxis, Hyperglycaemia,
Airway adjuncts - OPA, NPA, LMA, Laryngoscopy and Magill's forceps
Limited Paediatric Guidelines / Pharmacology

My next post will have the upgraded skills of an Intensive Care Paramedic.

Til then, be safe.

Advertising For New Staff

2009-06-13T20:05:00.004+10:00

There were advertisements in today's local newspaper (Sat 13th June 09) and I suggest they were in the other 2 regional newspapers, for multiple statewide positions starting January and February 2010:

Student Ambulance Officers and
Student Ambulance Officers (Graduate)

Applications close Friday the 26th of June 2009

The Government Gazette will have them advertised this Wednesday.
Tasmanian Government Gazette

Til then, be safe.

My new Apple MacBook Pro...

2009-06-09T13:32:00.006+10:00

I'm an Apple Computer user (since 1992) and the latest WWDC keynote address released details on the new laptops...
http://www.apple.com/au/macbookpro/

I'm going to upgrade my 5 year old Powerbook to a new 15" Macbook Pro, woo hoo.

I won't be getting it for a month or two, but I'm really excited (been planning the finance for months now).

In 5 years (for the same money) the specs have changed to:

Screen: 15.2" (1280 x 854) --> 15.4" (1440 x 900)
Processor: 1.5 GHz PPC G4 --> 2.8 GHz Intel Core 2 Duo
Video Card: (64 MB) --> (512 MB)
Bus Speed: 167 MHz --> 1066 Mhz
L2 Cache: 512 KB --> 3 MB
Std Ram: 512 Mb --> 4Gb
Max Ram: 2 GB --> 8 GB
Std HD: 80 GB --> 500 GB
Superdrive: 4x Single Layer --> 8 x Dual Layer
Airport: 802.11b/g --> 802.11n
Bluetooth: 1.1 --> 2.1 + EDR
FireWire: 800 & 400 --> 800 Only
USB: 2 x 2.0 --> Unchanged
Networking: Gigabit Ethernet --> Unchanged
Modem: Internal V92 --> None
No Camera --> Built in Camera
Battery: 50 Wh --> 73 Wh

And the 2nd revision of the iPhone is out in a couple of weeks.
I've held out long enough, (I was waiting for the new model), so I'm finally going to get one.

I need to work some more Overtime.

Til then, be safe.

Branch Station Officers

2009-06-03T17:35:00.003+10:00

Well, I'm due to be back at the branch station this afternoon but something has come up with my family and I'm off work on carers leave, so I won't be going back to the branch station this block. My family comes first, as I'm sure it does for everyone else. (a wise Japanese sensei once said "family, work, sport, in that order")

Here is little more information about being a BSO (Branch Station Officer).
I have a more detailed overview post about the Tasmanian Ambulance Service, which I'll add a little later.

Tasmania currently has 13 stations where the salaried officers (BSO's) are supported by volunteer ambulance officers (VAO's). These stations are usually about 40 to 60+ kms from the larger city centres and thus service the smaller communities (populations of about 2000 - 5000) and then there are volunteer only stations that service the much smaller areas.
See this link for an idea...
http://www.tasmanianambulancevolunteers.asn.au/location.htm

Working at a branch station can be very financially rewarding for those that enjoy it and volunteer to become permanent BSO's or to those that put their hands up to relieve.

The extra cash comes from:
* the slightly higher pay rate you receive at a branch station
for working solo / with volunteers / training the VAO's
* on-call allowance
* the overtime earnt, by being called out
* living away from home allowance (for relieving officers)
* traveling allowance (for relieving officers)

The last 2 don't apply to officers who have chosen to become permanent BSO's, only to those that relieve in those positions.

Taking into account the extra money, it's not for everyone but some love it:
* You are away from home / your family for 96 hours straight.
* You are alone at the station unless you get a job
(permanent officers can pop home during the day and get to sleep at home, if they live in town).
* Your pager could go off at any time, (when you are in the shower).
* You don't have another qualified officer/student to bounce ideas off.
* But you are it, you make all the decisions.
* Quality back up is at least 20 minutes away.
* The work load is usually very light.

Til then, be safe.

Goodbye for now

2009-04-24T08:35:00.009+10:00

I've decided I'm currently not guaranteeing the privacy / confidentially of my patients due to wanting to post stuff straight away.

I didn't get any hard words put on me by management or anyone else, just an inquiring question from a fellow blogger who really made me think. I don't need any hassles from this hobby, so I'll focus on other things for a while.

Hopefully I'll be back one day.
If and when I do start again, people will NOT be able to identify patients. I'll change more details and post weeks or months after the actual event.

Read the blogs I read on the right, they are great reading.

Til then, be safe