8. Dangers: This job can bite you – quite literally April 2015
Keywords: Pre-Hospital Paramedic Ambulance
Kneeling on the floor, trying to avoid the blood stained fluid that is smeared across the floor I hold myself motionless. With her screaming barely out of my ears I had moved without warning from my initial excited, adrenaline fuelled joy to chilled fear. A low guttural growling now filled my ears instead. This noise perfectly complemented the warm cyclical breath on the back of my neck.
Every paramedic is drilled to the point of agonising despair through endless training scenarios to pay attention to dangers. Each scene attended has the possibility of some hazard waiting. Every scenario starts with the student proclaiming loudly ‘are there any dangers?’ At first there are always none. Then a few angry bystanders or the patient lying in the middle of a busy road get thrown in. The next step is the other students deciding to have more fun and making the dangers a bit more adventurous such as ‘the patient is in a house at the foot of a volcano about to erupt…’
There is a very good reason for this. The real job is dangerous. Sure not always. In fact it is mostly boringly safe. Or so it seems. Let’s condense down just a few real events into a single day to make the point. Oh seven hundred hours and the shift starts. You race out to the first call. Moving cautiously through a red light another driver does not even see you. Your slow speed and your second pair of eyes courtesy of your partner allows you to stop but the collision is barely avoided. You exhale through pursed lips then proceed.
Ten minutes later you walk into a house where a man sits silently on an armchair in his lounge room. His wife is worried about his mental health. Despite her invitation, the man simply says go away. You persist not thinking too much about the blanket over him pulled up to his neck. He repeats a few more times for you to go away. You persist in your efforts. He glares at you finally and lowers the blanket somewhat. He holds a loaded shotgun apparently intending to put it into his mouth. He points it at you and repeats his request. You leave quickly and await the police.
Matter sorted, you respond to the next case. You have to walk down a driveway to a bungalow out the back of a house. There is litter, rocks and pieces of timber on the ground. You have to stay focussed to avoid tripping. You ponder how you are going to carry any patient out without injuring your back. You stumble and the oxygen cylinder bag pulls at your arm and you wince as your shoulder complains. Entering the bungalow you recognise the patient is deeply cyanosed following a heroin overdose. As you kneel to help him you almost prick yourself on the dirty syringe.
A small break for morning tea and you are off again. The drowsy infant patient given to you by its mother has had a seizure. You determine a fever and appreciate the child needs to have its airway suctioned. As you unpack your equipment your partner notes the appearance of a rash on the child’s body. Quickly you recognise the potential for meningococcal infection. You don a P2 respiratory mask knowing that airway procedures are a great way to acquire this infection.
After lunch the day gets no better. Technically not after lunch as the call comes just as you are getting to the favourite piece of sushi saved for last. It is a motor vehicle accident. On arrival there is a patient trapped in one of the vehicles. With the ambulance parked to block the road you approach the patient. Almost slipping on some leaking oil you notice the smoke coming from under the bonnet. This distracts you from the power wire hanging limply on the other side of the car. It also distracts you from the jagged edge of the wrecked car door and the broken glass covering the seat. You do see the patient’s blood clearly enough. If you are lucky you might see the car trying to drive through the scene because he doesn’t believe that a little thing like a car crash and emergency vehicles should stop his progress.
To the last call of the day. You have been sent to a woman full term pregnancy in labour. You know you are at the right house since you hear the screams as you open the car door and are greeted by the sight of a heavily pregnant woman standing at the front door of her house crying out in pain. You have barely enough time to cross the front yard to her, have her lie down and unpack your childbirth kit before crowning is observed. A moment later and the child is born. You grin happily and, sitting inside the hallway of the house, you pass umbilical clamps and towels to your partner who is in the business position. The new mother, sweaty, tired but smiling reaches out for her new baby. Before your partner can clamp and cut the cord. You freeze with apprehension.
Enter the growling and hot breath. You are kneeling. Three large Doberman dogs fill the hallway. Their heads are perfectly in line with yours. Each of them snarl and salivate as if rabies is the least of their problems. The woman reassures you that they would not bite. You look at her and recall the recent screaming and note the bloody floor. You also note that in the midst of this you are the total stranger in the house from whom the dogs are apparently protecting their mistress. Their non biting disposition may have been recently reconsidered.
She calls to them to and assures them that all is well. You hope they believe her. She tells you that they are just hungry and to go in the kitchen and feed them. Dreading moving, you slowly rise and, very slowly slide your feet step by step into the kitchen. Sure enough there is a huge dog bowl on the floor and an even bigger box of dog biscuits on the kitchen bench. You pour some into the bowl, look at the dogs who even appear to be tail wagging, then pour some more for luck. No sooner have you stepped back than the dogs are into the biscuits.
Relieved you leap from the kitchen and slam the door. Your smug smile lasts only a moment as you hear the combined scurrying of the dog feet on the lino floor. Smile gone, the damn dogs know another way out of the kitchen. You race down the hallway to two glass sliding doors half way down. The dogs round the corner and see you. Luck holds as, like the final of an ice skating race, they all collapse on the lino floor and slide across the room. The seconds are a gift that allow the closing of the doors. Safety. You sit for a few minutes until either yours, or your partner’s hands, stop shaking enough to safely cut the cord.
And tomorrow night is a long fourteen hour Saturday night and all the night clubs will be open. You know you are a seasoned ambo when you realise that the patients are only a distraction to take your attention away from the next danger.
Jeff Kenneally – www.prehemt.com