Oh shit, it's arterial.

It had been another one of those thirteen hours days at another music festival filled with people on drugs and who'd been drinking all day and lost control of themselves.
I think we all know the kind of people I'm talking about..
My day had been filled with EtOH OD's, drug OD's, syncopes, assaults, epistaxis and blisters. Oh the never ending blisters that seem to plague my life when I'm on duty at music events!!
The day for us medics, exhausted medics, was finally winding down and we lazily packed up our gear, washing vomit off the sides of our tents, blood off the floors so we could go home to our warm delicious beds.
After a shower to scrub all the grime and muck of the day away ofcourse!!!

I'd just put on a pair of gloves and was about to pick up a stack of vomit stained towels when a young man came walking shyly up to me, his hand wrapped in the ripped off sleeve of his t-shirt which was literally dripping with blood. "I'm so sorry", he said, "but I've cut my hand and I was just wondering if you could take a look for me. I know you're trying to go home..I'm so sorry!!" Everyone else looked at me, the only one in the group wearing gloves. "Sure." I said, not ever one to turn down a patient, " take a seat and tell me what's happened."
The patient explained to me he'd been running to catch a bus and had caught his hand on the mirrored edge of a ridiclous looking sculpture. He said he'd felt a tug but had assumed it was the sleeve of his jersey and kept on running until he felt something flicking into his face. He stopped to wait for his girlfriend to catch up and she started screaming as soon as she saw him. His face, arms, legs and clothes were flecked in huge drops of blood which was streaming out of his hand. Luckily for him he'd realised the cut was bad enough to need attention and so ripped the sleeve off his t-shirt and came to find us. Upon hearing his story I began to get cautious about removing the shirt covering his hand, but I knew I needed to see his wound to decide what kind of treatment he'd need, if it was the sort of thing I could deal with on my own or if it was a job for the doctors in the ER. I slowly, slowly, slowly began peeling back the shirt, as each layer came off more blood dripped onto the ground by my feet. I finally pulled back the last layer.

Blood squirted out, narrowly missing landing on my uniform and face. I caught a quick glimpse of the gash before I grabbed my hands around his and started squeezing as hard as I could, raising his arm above his head. "Mate...it's pretty bad. You're gonna have to go to the hospital." From the split second I saw the cut I could tell it was a surgical one. It started on the palm of his hand, below his middle finger and extended inbetween his middle and pointer fingers, along the top of his pointer finger and back down to his palm inbetween his pointer and thumb. The bones in his finger joint were all completely exposed, the tendons and muscles had all been severed along with the small artert that ran along the back of his hand, which is where the blood had been steadily pulsing out of. I asked for the largest size combine dressing and quick as lightening slid it under my hands, covering the cut, and clamped my hands back down around it. Everything in my sector had been packed up, there was no way I could deal with his injury where I was. I asked my patient to press the call button on the radio I was still wearing and radioed for one of the paramedics to come give me some assistance. Everyones radios but mine had been turned off. No one heard the call.

I was the more senior of the medics in my area and needed to get the patient to our main medical area. "So here's what we're gonna do okay, I have to keep pressure on your hand and keep it raised. We're gonna walk, as slowly as you need, to our other medical tent where there's doctors and nurses." He nodded, looking nervous as we began our awkward trek to the tent.
"Can I get the doctor to have a look at my patient for a consult please?" I called out to the others as we arrived at their tent. "They've all gone home!" Someone said. "A nurse then?" "Sorry, they've all gone too. What's it for??" "My patients got a pretty serious cut to his hand." "Put him in a truck and we'll get someone to look at him." Together, my patient and I manouvered our way into the back of a rig. A few seconds later Patrick arrived at the doors, looking as tired as our felt. He took one look at my blood soaked patient, my blood stained gloves and the gauze I still had tightly around his hand, now starting to drip. "It's a good one Pat!!" His face lit up and he climbed in with us. "Let me have a quick look and I'll see what needs doing." I slowly released my hands as Pat lifted the gauze away. The patient flinched as blood came squirting out.
"Oh shit, it's arterial." Said Pat as I re-applied pressure.

We changed the dressing, which was then tightly bandaged to his damaged hand. I kept the pressure tightly on, with his hand still raised and chatted away to him while we waited for the ambulance to come. "Atleast it was the end of your night away eh buddy!!" He smiled, realising it could have been alot worse than what it was. "And you get a free ride!"

First of many.

The day started off slow with calls slowly trickling in one after the other.
We all sat on station trying to wake each other up with horror stories, hilarious patients and odd injuries. I was really beginning to get a feel of what the rest of my life was going to look like. Putting on a uniform every day, starting work before the sun and the rest of the city was awake, living my life in the sounds of sirens and the flashing of lights. I can deffinately see myself doing this forever, I thought to myself, enjoying every second of my shift.
The siren went off.
"City one you have a priority one heading towards Moonshine Road, code 9."
Code 9 slowly rattled through my head, down my neck and into my chest. My heart started racing. I knew what a code 9 was after my first ever encounter with a dead person. We were being called to someone in a cardiac arrest. I climbed into the ambo with my heart in my throat as we sped through the traffic.

As we pulled into the carpark of the office building, a lady came racing out to us. "She's stopped breathing! Oh god she's stopped breathing!!" She screamed through the open ambulance window. I instantly inhaled her panick, unable to keep my heart from beating faster still, I could feel my hands getting clammy as I climbed out the back doors, defib and oxygen bottle grasped tightly in my little gloved hands. I probably look alot more professional than what I feel right now, as I shook my head and plastered what I hoped was a knowledgable look on my face, that kind that said yeaaaaaah I turn up and saved dead people all the time, you have nothing to worry about!! I was hoping this would be another one of the calls we'd been going to, where everything had been made to sound alot worse than what it was. The lady followed us inside, she was visibly shaken and very upset and she pressed for the fourth floor. We stood quietly, apart from the tinkling elevator music, which I found oddly calming, as we slowly rode to the elevator to where we were needed. When the doors opened, it was chaos.

The office workers lined the halls outside the elevator, they all pointed us in the same direction with the same scared look on their faces. Down the hall I could hear someone yelling, "1,2,3,4..." We rounded the corner. I swear to god I will never forget how completely and utterly terrified I was. This call hadn't been exaggerated, this lady really was dying and I was one of the people here to help save her. She lay on the floor, flat on her back, totally unaware of the immediate peril her life was in, totally unaware of everything. One of her co-workers was doing chest compressions and her entire body bounced with every rib breaking pump as he forced the blood around her veins. Upon seeing us, he immediately stopped. "Keep going!!!" We all yelled, streweing gear all about the man as we prepared to take over. The paramedic moved into position alongside the woman and continued CPR. I knew from the scenario training I'd done on a resus scene what gear was needed first and where. I got to work connecting the bag mask to the oxygen cylinder, connecting the electro pads to the defib and placing them on the lady's exposed chest as the paramedic deftly cut away her clothing. "26, 27, 28, 29, 30", said the paramedic doing who'd taken over compressions.

Up until that exact moment I'd always worried that when the push came to shove everything I'd ever been taught would simply be lost in the complexity of the situation. It was something I spent hour upon hour stressing over before every single duty, while treating every patient who had the potential to deteriorate, while writing down every vital peice of information I heard.
I picked up the mask, tilting the womans head back to open her air ways before placing the mask fully over her mouth and nose, securing the mask tightly to her face to create a seal with one hand and squeezed the bag with the other. Her chest gently rose and then fell, like it should have been doing on its own. I squeezed the bag a second time. Her chest rose and fell again. I could have high fived myself right then and there. I could have high fived every single person in that room, gone to the pub and then bought them all a round of drinks. F*** yeah Fly, you did it!!! I thought triumphantly to myself as the compressions continued, you should never have doubted yourself! You were MADE to do this! You were made to breathe for other people!!
"Fly", panted the paramedic, "you need to take over compressions for me."
Oh f***...this is an entirely different kettle of fish, you can't do this.

I watched her chest rise and fall with the first squeeze of the bag and locked my hands into my CPR position, placing them above her chest ready to place them. My mind was racing, I could hear my instructor in my mind, repeating to me the correct technique for effective CPR. Her chest went up, and I watched, almost in slow motion, as it slowly deflated back down. Then it was my time to shine. Bang, my hands found their place on her chest as if drawn there by a magnet and without even needing to think my arms began pumping away ryhtmically, one blood pumping compression after the other. One of the paramedics charged the defib, "stand clear!" She called before administering a shock. The womans entire body jolted, exactly the way it should when a massive vault of electricity is suddenly sent through it. I looked at the screen, VT still made it's waves right across the screen. I continued CPR. After two more rounds the medic called out again, "stand clear!" Two shocks were sent through her this time, I did another round of CPR and then we prepared to shock again. It felt as though we had only been working on her for a few seconds, in reality it was more like 20 minutes. "Stand clear", said the medic, "final shock."

It was like watching the life literally being shocked back into her. She took a massive, deep moaning breath and began gurgling as vomit filled her throat. Over the noise of the suction machine as the other medic cleared her airway the first medic analyzed the screen. "We have ROSC." ROSC!!!!! I knew what ROSC was!!! It was something all rookies dreamed of. The stuff my fantasies were made of, restarting someones heart, giving them back their live, giving them back to their families and loved ones. We got ROSC!!!! Back up was radioed for in the form of firefighters and their Stokes basket to assist in extricating our patient to our rig, parked on a crooked angle with it's lights still flashing in the carpark. The lady was not of small size and was very heavy, a dead weight. It took four of the fire fighters and 2 of the paramedics to carry her down the four flights of stairs. I was left to carry out all the gear and clean up the medical mess we'd created in our attempts to save this ladies life. It was then that I was aware of just how many people had watched someone die and then come back to life. Had watched us bring her back to life. They all stood ashen faced, clutching tightly onto each other in fright. A few of them had tears streaming down their faces, their mouths open in shock. I hadn't even noticed an audience...as far as I was concerened until then there had only been four people in that room. Three medics and our critically ill patient. Everything else had been blocked out as if a curtain had been drawn right around us.

I picked up the last peices of waste, an unsuccessful ET tube, needle covers from the IV starters, toppers off saline bags and flushes, the pad covers for the defib electrodes and stood to quietly leave. A lady walked up to me, her eyes red, her hands shaking. "Thank you so much." She sobbed to me through a quivering voice. "You ladies did an amazing job."
We really did.
That lady survived her heart attack which lead to her arrest. And now I have a part in the rest of her life. The first of many people who will be walking and talking because of me.

Just hold my hand.

"City one you have a priority one call heading towards the water front. Status epilepticus"
Now, before this call I had seen several seizures. A man on a bus suffering a petite mal while holding his 6 months old baby. A young lad at a concert going down with a grand mal inflicted by the strobe lights. Absences of diagnosed epileptics on the netball court. I thought I'd seen them all. Hah!!!!

We arrived at the block of flats in the pouring rain, it was freezing, and in the short walk from the rig to the communal front door of the apartments we were all soaked. "We're after number 4", called the paramedic through her jacket hood. The doors weren't numerically numbered, 1, 6, 2, 8...wtf!!! We finally found four and knocked. The door was ripped open by an angry looking man.
"What the f*** took you so long!? He's been like this for twenty F***ing minutes!!" I was shocked. WHY would you answer the door like that? Let alone to the very people you'd called to help save your sons life!? He quickly ushered us inside and shut the door, pointing us in the direction of a bed in the corner of the single room studio flat.
The man on the bed began yelling and swearing, flopping himself all around the bed, violently flailing his arms around. A colostomy bag was strapped to one of the young mans legs. A quick glance around the room reveled several wheel chairs and sets of weights. This man was a paraplegic from the waist down. I later found out it was caused by a car accident several years eariler. The paramedic began taking obs on the man, asking his father several questions as she handed me a BP cuff. I'd learnt to always talk to your patients, explain to them what you're doing so that don't get startled or take your actions the wrong way. "Hi sir, my names Fly, I'm just going to put this around your arm and take your blood pressure."

He wasn't having a bar of it. His father began yelling at me. "He doesn't know what the f*** you're doing...you need to TALK to him!" I looked at his hands and noticed a drug pipe clutched in his tight fist. He was clearly not someone to be arguing with so I apologized and again tried to explain to his lucid son what I was trying to do. He still violently fought off the BP cuff, attempting to hit me several times before I finally gave up. His father angrily tried to 'explain' the situation. "We were watching tv and then all of a sudden he starts drooling then had a massive seizure. He's NEVER had one before, I don't know what the f*** happened. He's been like this ever since." "So this is not his normal behaviour?", asked the paramedic. "I just f***ing told you he's been like this since the seizure! NO he's not normally like this! F***...I call for an ambulance and they send me a pack of F***ing idiots. " I realized then that this man was still deeply in the clutches of a massive seizure. He was no longer in his mind as it had been taken over by electrical pulses in his brain that had lost their way. His father continued to storm about the room, yelling at us every chance he got. It was frightening. I'd never been in a situation like that before. Moving the young man, who at this stage was still seizing, onto the stretcher to transport him to hospital, was an ordeal made a hundred times worse by his father. The paramedics and I knew how to move this man, but his father insisted we were doing it wrong and the man was almost dropped to the floor and his father flitted about us, ignoring all directions we attempted to give him in a bid for his help to get his son, who was not a slightly built man, onto the bed.

After alot of huffing and puffing the man was in, wrapped in a blanket for his dignity as he was wearing only his underwear, and all strapped in for his own safety. We loaded him into the ambo and set about ensuring he was stable and began filling out the paper work before radioing to COM's on our actions. He started moaning and pulling at the seat belt straps that went across his legs, pelvis and chest, not understanding what was going on or why they were there. I explained to him that he needed to leave them be in order to stop him from falling off the bed, but still he fought to undo them. The more he fought, the more confused and agitated he got, no amount of comforting words from his father or I could calm him down and he managed to undo one of the straps. As I was buckling the strap back together, his hands clamped down tightling onto mine. The paramedic took a step forward, about to pull his hands away from mine. Normally I would have been afraid, but I understand that this man was sick and didn't need to be treated rough, he needed to be treated exactly how I would if I were in his shoes. So I smiled at him. "You can hold my hands if you want. You're probably scared huh?" He looked at me and I saw the faintest part of his personality slowling streaming back into his eyes. Instantly he was calm. The paramedic took a step back and continued with her paper work as we began our trip to hospital.

He smiled at me, a big beautiful smile and took his hands off mine. I held them out for him to hold. He smiled again and gently took my hands, giving them each a slight squeeze then began rubbing his fingers along mine, taking in the rubbery texture of my gloves. "Just hold my hand. We'll be at the hospital soon."

Always remember the first.

It was my first ever observer front-line ambulance shift and I was nervous as hell. Sure, I'd been volunteering as a medic for three years but during that time I'd always been working as the just in case medic, not the one that gets called when the shit has really hit the fan. I spent the entire day and most of the night before the shift reading up on my clinical procedures, trying so hard to cram everything I'd learnt back into my head, I was terrified of forgetting something at a critical moment and I wanted to be prepared. I didn't want to be the stupid rookie that everyone was expecting me to be. I want to be the best, and being the best starts right from the word go, you can't do a half assed job of being top dog.

Arriving on station I was even more nervous than before I'd left the house. Oh god, all the paramedics were staring at me, eyeing me up and down. I suddenly felt so over dressed in my uniform with the shoes I'd cleaned and uniform I'd washed and folded out so neatly the night before. I felt like I was wearing too much eyeliner, like my eye shadow was a little too bright. "You need to take your nose stud out. It's not in the uniform guidelines. And you're also gonna need to cover up your earrings, those aren't allowed either." I thought about the tiny, hardly noticeable star nose stud I had as I looked around the room at some of the other medics, tattoos covering both arms. She's worried about a little star?? I thought to myself, I ignored her and left my nose just how it was. My ears aswell. I figured if anyone was going to stop and complain about the person trying to save their life having a nose stud and more than one set of earrings in their ears then they probably weren't much in need of an ambulance anyway.
I sat down to have a cup of coffee. I hardly got the cup to my lips before a loud siren started blaring, I thought it was the fire alarm!! A voice came over the speaker, "City 1 you have a priority 1 call heading towards Queen Street, Code (I forget)." The paramedics I was crewed with both looked at me at the same time, "that's us kid!" One said as she started walking towards our bus.

My heart started pounding a crazy beat. Suddenly I was excited!! And still SO extremely nervous. The butterflies in my stomach were having a full on battle with one another as I buckled up my seat belt and the ambo began to roll out the doors, then the lights and the sirens flicked on and off we went. The nerves dissappeared as we flew down the road, cars moving out of our way as we danced through the traffic. My first ever ride in an ambo!!!! And it lasted all of about five minutes as we drove a few hundred metres up the road to a lady lying dramatically on the ground. Oh....that was it.

Call after call after call was like that. Elderly male with heart problems, lights and sirens!!! Disappointment. Car crash, lights and sirens!!! Disappointment. Diabetic in trouble, woman in labour, choking child, period pain, stroke victim, drunken hobo on bridge. Lights and sirens!!! Disappointment.
As I was sitting on station, truely realising exactly how much ambulance time is wasted every day on over dramtised calls, the alarm went off again. "City one, you have a priority one heading towards Greenlane, Code 9." "Whats a code 9?" I asked the paramedic as we headed towards the bus. "It's a cardiac arrest."
Two words started going through my head: oh shit, oh shit, oh shit. The butterflies came back in a full on storm, my mind was racing on the correct technique and hand placement for compressions, how to make sure you kept up the right rhythm, how to ensure the breaths you were administering were adequate enough to sustain life. Everything was gone. I couldn't remember a thing. Oh god, I thought, some poor bastard is about to die because I had the biggest brain fart at the most important moment of my life. My heart was now beating so fast I thought I was going to arrest myself as the ambo pulled up outside a small white house. I grabbed gear. I tried to grab everything, the defib, oxygen, suction, first response bag, paper work. Too much!!! I waddled like a donkey laden with gear into the tiny house behind the medic. A lady, tears streaming down her face stood in the hall way and pointed us into a room to her left.

So many different aspects of that room hit me all at once. The faces of all the family squeezed into the room, their emotions of grief and of a love so strong I could literally feel it. And the smell. Oh god, the smell. Now please note that this man had only VERY recently passed so there was no decay or bodily excretements to speak of. But as soon as I walked into the room, wether it be placebo or not, I could smell death. It was like it had soaked into the walls, the carpets, the bedding the poor man lay in, the clothes we were all wearing. Like we had breathed it in and were now living in the smell. But I could deffinately, for some reason, smell the death in the room. And then I laid eyes on the man. I'm not going to lie, and for feeling like this I still feel guilty, but I was absolutely terrified. Every inch of my body got instant goosebumps, from the soles of my feet, to the top of my scalp my body tingled with fear.

It was evident that he had been sick for a very, very long time. His exhausted body was literally no more than skin, bones and weakened, unusable muscles. The bones in his arms and face were visible through his paper skin and his eyes stared blankly in different directions, looking at things that no longer belonged in the same world as you and I. His weak fingers still clutched onto his blanket and his mouth hung slightly open, dropping down towards the left. The cloth nighty he was wearing was gently lifted so pads could be placed on his chest. A chest so frail it would not have held up against aggressive resus attempts, had they been made. As the monitor was turned on, only one thing appeared. A long, consitent line flashed onto the screen and coursed it's was along. Asystole. This man was gone. There was no longer life left in his broken body, it had simply given up the fight.
It was sad. Very, very sad. His entire family was packed into the room with us and they knew, even with no medical knowledge, that their loved one had passed away. They knew as soon as we walked into the room. As soon as we stopped moving fast, put our bags slowly on the ground, and went about confirming what we already knew.






















I have many, many goals in life. The one playing the most on my mind and that is with me every day is to become a fully qualified advanced paramedic. I want to go as HIGH as I can. I want to be the very best..the one that others talk about in regards to skill, intergrity, honesty, passion..you name it, I want it. I have worked, very hard, for the last three years to get the meagre qualification I currently have but I am constantly reminded of how far I still have to go. In terms of the peers I have worked with, without sounding vain, I am better than alot of them. Because I have an intense amount of dedication. I have my eyes on the goal, they've been staring it straight in the face since I was in single digits...I know it sounds exaggerated but I can recall piggy backing other children to the medical room in primary school when they fell over and scraped their knees. I've been that way ever since.