Contemplating life.

Pommy Pack

My first paramedic tutor shared a great tip with me once I added cannulation to my skillset: “keep everything organised”

He always kept a supply of so called “pommy packs” with him (yes, he is a “pom”); everything needed for cannulation in one handy wrap.

As a student learning cannulation, it took my mind off having to gather everything needed for the skill, thus enabling me to focus completely on the task at hand, and knowing I had not forgotten any crucial bit of gear.

Here’s what I do:





Grab a “Bluey”, a large sheet of plastic on one side and absorbent cloth on the other. I lay this under the cannulation site, saves the apologies and embarrassment of blood on patients furniture or carpets in case of drippage.




Fold a tissue – some cannulations can get messy!




Add your Tegaderm, or whatever else you use to secure the cannula




Add your favourite cannula sizes – I always had an 18 and 20 gauge needle with me, if I needed anything other sizes, they would be close by with the equipment.




Add alcohol swabs. Two, one for backup or particularly dirty  patients (mechanics etc)




Saline and Syringe




Fold ‘er up on the sides…








…and roll…




…and roll again. Secure with a bit of sticky tape, or an elastic band. I wrapped a tourniquet around my pack, to have one handy.

Now, go ahead and make your own pommy pack, you’ll love them!

ISBAR Clinical Handover App

I came across this whilst browsing through the web: ISBAR, a joint effort from the New South Wales and South Australian Heath Services.

What is it? A surprisingly simple iPhone and iPad app for clinical handovers, which I wish I had as a student: ISBAR stands for Introduction/Identify, Situation, Background, Assessment and Recommendation. Here are some in-app screenshots:







As you can see, there are specific handovers for different types of patients, and you can even save custom handovers. Brilliant, can’t wait to try it out myself.

More information and download links can be found on the official website:

Pregloved and Prepared!

Here a few tricks I found really helpful when I was brand spanking new out on the road. Sharing is caring, as they say, so here you go:

  1. When en route to a call, write down a matrix of vital signs including the time they were taken time on your glove. That way, when you at the patients bedside (or roadside), you will have a stuctured table to write down vital signs in, tracking trends, plus you won’t forget any specific vital signs (I like to forget the BP cuff every now and then)
  2. Also, when you are en route, write down the name of the patient on your glove (provided you are given a name). I always like to forget names, but patients respond much better to being called by their name (it does makes it more personal). Plus, if you are picking a patient up from a nursing home, you won’t have to run back to the van to get that name you forgot about.
  3. Carry a whiteboard marker with you. At the end of a call, write up the items you ned to restock you need on the inside of the van windscreen or side window. Also, if you are driving and you hear something in the back that you want to ask the attendant about later, you can whip out the pen when you are stopped at a red light, write it down and ask later. Also good for temporarily vandalising colleagues vans 🙂

How To: Mobile Guidelines/Protocols

Following from yesterdays post how to add flash cards to you smartphone – here the second part how to add you guidelines/protocols and how to keep everything neat and tidy. Same equipment used as last time.

1. Get an electronic copy of you guidelines/protocols.My service has them on the staff intranet, many services make them freely available online (a few here), and some…

…I guess you’ll have begin harassing your boss, or just start typing (hey, it’s a good way to process and learn the stuff!)

2. For easier access in stressful situations (i.e. on the way to an emergency), I have taken out the most important pages of my guidelines, and made individual PDF documents. In this instance, I am making a single PDF for Epipens (n.b.: we don’t carry Epipens, it’s from the volunteer guidelines. Email me for clarification.

3. Highlight the page you want to single out on the right hand sidebar

4. Open a Finder window

5. Drag the highlighted page to the finder window. It will appear as the filename with the name appendage ‘(dragged)’

For ease of overview, I have all drugs as slideshow flashcards for learning purposes in a flashcard folder, plus all my individual drugs and guidelines in a PDF folder for quick reference on the way to a job. Here’s how to sort it nicely:

1. On you iPhone/iPod Touch, go in to iBooks. Tap on the ‘Books’ button, top middle (in the below screenshot it says ‘Flash Cards’. You will get the ‘Collections’ menu. Tap ‘New’, and add the collections you want. I have my guidelines in ‘PDFs’, and my flash cards in ‘Flash Cards’, as you can see. Tap ‘Done’.

2. You will have a bunch of files in your folder. Tap the top left button ‘Edit’ – this is the screen you will see:

3. Mark all the ones you want to move to a specific category. In this instance, I will be moving Amiodarone, Aspirin, Cophenylcaine and Fentanyl to the ‘PDFs’ category.

4. Tap to select your category, and tap ‘Done’.

5. All my Flash Cards are in the Flash Cards category. To change to my PDFs category, just tap the top middle button.

No excuse not to have all your guidelines/protocols in your pocket anymore!

Hope it helps, and that it wasn’t too difficult.. As always, any questions at all feel free to email me.

How To: Mobile flashcards

For all you smartphone users: Take your guidelines with you on your phone, and make easy flashcards for on-the-go study!

Equipment used was MacBookPro running OS X 10.6.6, Apples iWork Keynote and an iPhone 4 running iOS 4.2.1, with iBooks 1.2.1 installed. Other hardware and software options should work in a similar fashion.


1. Create a presentation. For learning my medications, I have the prompts on one slide, and the answer on the following; e.g. Indications / list of indications / contraindications / list of contraindications.

2. Save the presentation as a PDF document (Share -> Export -> PDF). For other programs you may have to print the file to PDF (OS X), or save a file as PDF.

3. Go to your iTunes library, click on ‘Books’ in the left menu bar. Open a Finder window at the location where you have saved you PDF flashcards, then drag and drop them in to the main area (the grey colored file hovering there is me just dragging it from the Finder window to the iTunes window. Be sure to name them properly, so you know what you’re looking for in the heat of the moment.

4. Sync your iPhone/iPod Touch with your computer.

5. Switch to you iPhone/iPod Touch. You should see your imported PDF documents!

6. Start studying to your brains content!

7. Stuck? Send me an email!

Tomorrow: How to easily put your guidelines and protocols on to your smartphone, and keep everything in order. Until then – happy studies!

EDIT: I received an email from a reader who uses the Flashcards app. I did not know about the app, but also wanted to stay with apps that I already have on the phone.

Thanks though for pointing it out Chris!