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Florian Breitenbach

Rettungsdienst und mehr

2 1/2 hours

My phone rings. I answer.

Receptionist: Hello, Mister Bach?

Me: Yes, speaking.

Receptionist: Your blood test results are back, and the doctor wants to speak to you about them. We’ve just had a cancellation, are you available this afternoon for an appointment?

Me: Yes…

OK, rewind: After being discharged from hospital, the ENT specialist told me to get a follow up blood test in a weeks time for a liver function test with my GP.

GP appointment made, phlebotomy paperwork acquired, told to make an appointment one week after the blood test.

Not a problem – although being slightly needle phobic, I let my antecubital fossa be attacked by the phlebotomist the next day – needle in, blood out, thank you very much. Results will be sent to the doctors surgery in a weeks time.

Then the above mentioned phone call. This wasn’t “call me in a weeks time”. No, this was “the doctor would like to discuss the your results with you, come in two hours time”.

The department store I was in went a bit fuzzy. Normally being fairly level-headed, this disrupted my world. What is there to discuss? Something must have gone wrong…maybe my liver suffered more than expected, I developed hepatitis, I acquired some infection or disease from hospital, I will need a liver transplant, all my future plans are going down the drain. The christmas shopping I just finished half an hour ago? Meaningless. “Here, have a sloppily wrapped present, and by the way: I’m not going to survive next year.”

The following two and a half hours were torturous. The trip on the tube home was the longest ever – reading the paper was pointless, playing Sudoku produced a mass of errors, sitting looking in to space just made my mind wander to even more horror scenarios, and playing out different scenes how to tell friends and family. And clutching at straws, maybe the GP just wants to tell me not to drink alcohol over the Christmas period to give my liver a rest…but then again, it could be liver failure.

I arrive at the GP surgery. I wait. As always, the GP is running late. Half an hour later, it’s my turn. I get up, walk towards the room, take a deep breath, open the door, and sit down in front of the Doctor.

“Hello, how are you going?” he asks me cheerily. OK, not what I expected. I mumble that I’m alright, and ask him about my results. “Yes, your results are in. Your liver function test has come back fine, and all your other values are within normal limits. You’re feeling better, Yes? No coughing, or other symptoms? Great! You can get back in to your sports routine when you feel ready, too.”

Phew. That was it? That bloody receptionist. My bloody imagination. Damn circumstances. Probably lost a few years because of that…not a nice experience. At all.

After telling the GP of the doomsday scenarios that were playing in my mind, we had a bit of a chuckle (I had to let my relief out some how!), chatted for a few minutes, and wished each others merry christmas and a happy new year.

You may smirk reading the above, you may shake your head, but believe me, it wasn’t pleasant. But it did teach me a lesson, shoving me back in to place, with the realisation thrust upon me: Cherish your health, your life, your loved ones.

It could change in the blink of an eye.

NYC: Caribbean Care, part I

June 2011

 

[general chatter in the background, footsteps, doors opening and closing]

*cling*

*clink cling*

*tap tap tap*…pause…*tap tap tap tap, tap tap*

*beep beep*

*beep beep*

Such would have been the backdrop standing next to me at the payphone of the hostel I was staying in. I’m following up from the previous nights offer of getting out on shift with Paramedics in the New York City borough of Queens, having dialled Barry’s number. After a short wait my call is answered.

“Hello it’s Barry” it comes in a thick New York accent, reminding me more of “The Godfather” than “The Paramedic”. It seems that I am on speakerphone, and that he is driving. I imagine the telephone on the other side of the line set in a massive black Cadillac being driven though the streets of Manhattan, tommy gun on the passenger seat and a dead body in the boot. And the Fedora casually slanted on his head in true gangster fashion. I give myself a mental kick to focus back on the task at hand.

“Hey Barry, Flo here – the Paramedic from Australia. We met last night at the REMSCO dinner.”

“Yeah, how ya doin’ ?. You got something to write? June 32nd (obviously that’s not what he said, I’m just de-identifying the date for the blog), you come to our Hospital in Queens, and we’ll get you on a truck!”

Times and directions were exchanged. I was being picked up from the subway station. The shift was sorted. Brilliant. Gold Class service right there.

On the day, I arrive in Queens, find the hospital (no problems due to the easy directions) and call call Barry to let him know I have arrived. He’ll be there in ten minutes, I should have a look around in the meantime – something I don’t need to be told twice. There were a few ambulances parked near the Emergency Room entrance, so I went to have a sticky beak at the closest one, and take a picture whilst I was awaiting my chauffeur.

“Hey, you can’t take a picture of that without us!”

A loud female voice carried from the next ambulance parked just down the road, slightly bossy but with a distinctive giggle in there.

The three EMTs are just restocking their vehicle a few metres down the road, and are obviously not envious of the attention the other ambulance is getting. “Well, you better clean up the van and pose for the lens!” I reply, beginning to walk towards them. Apparently the girls didn’t quite anticipate this reaction, and looked rather startled. When you tell somebody to point their camera in your direction, you would never in a million years expect them to actually do just that, would you? Must be female logic…

Anyway, the three of them turned out to be bright and chirpy, with the startled face quickly turning in to a quizzical face, what I am doing here and what’s with the green trousers and the reflective stripe? Apparently, in NYC, green uniforms are associated with the sanitation department (some old medics will remember that NYC ambulance uniforms actually were green back 20+ years ago), but I was quick to take my jumper off and show my work shirt, revealing the (to Americans) foreign term “Ambulance Officer”. We all had a good chat, laughs; Discussions and comparisons followed, and a few minutes later i think we have three potential new visitors to Australia. Barry, the supervisor turns up, and sees me chatting away to to a bunch of his girls. He shakes his head with a grin.

We drive ten minutes down the road, talk about how things in NYC run, his history (active paramedic, paramedic and EMT instructor, his roles as supervisor). The station is again a large garage, parked full with about 10 ambulances, lockers, mechanical stands around, mess room adjacent. I am first introduced to the head of the service, we exchange a few introducturies and I quickly explain what I’m doing on this trip. No time for much more, I whizz off with Barry to the mess room, he has sorted out a crew that he wants to put me with, only the hand picked best guys for the Australian visitor apparently!

There are about ten EMTs and paramedics milling around the mess room, some on break, some ending their shift, some getting ready for their upcoming shift. Then I am privileged to one of the best introductions towards the staff:

“Everyone, i want you to welcome flobach – all the way from Australia! I met him at the REMSCO dinner the other night, a good guy, and I wanted to show him how we  do EMS in New York City (Yeah! show him the real NYC, people mutter, and nod their heads in a mix of love towards their home city and profession). I want you to look after him. Flobach will be going out with you, Drew and and Gozo. Your shift goes until 11pm – I want you to drop him off at the subway station, I don’t want him running around here on his own at night, do you hear? Take him right to the station, and look after him. Have fun guys!”

With that, he shakes my hand, gives me a smile, and leaves. None of this wandering in to foreign paramedic quarters, trying to explain to disinterested crews why you are giving up your spare time to do a shift. This was a smooth start!

With that introduction, I slot right in. The crews are interested about my background. We chat about Australia, their service, my trip, the lot. I feel more than welcome.

I show them pictures from Australia, and all of a sudden everybody wants to move there. Conveniently, I tell them, my service is just having a massive recruitment push…eyes light up…and I wonder if I should charge my employer commission for recruiting potential new employees. They like the idea how things in Aussie run. No calling for orders. The drug range is decent. The working conditions are great, leave, pay, vehicles, roads. A very attractive place indeed. Surgical cricothyroidotomy raises eyebrows. They may be getting ondansetron next year…I tell them to look forward to it:-)

Meanwhile, Gozo is twirling his neatly trimmed moustache, worried about the unilateral greying. I suggest colouring it in with a piece of charcoal a trick I learnt from my dad. He’ll give it a try, he reckons.

Finally, our truck arrives, after being held up on a late job for 45 minutes. A student on placement, Andrew, shows me around the truck, as he is attending today – the paramedics are really only there to help with extrication and make sure he is up to standards.

I need to briefly pop back in to the office to sign an indemnity form so I won’t sue them – fair enough – when one of the paramedics pokes his head around the office door and asks for Barry to come in to the mess room.

“Um, boss, student is out with us today, can’t really take flobach.”

“No way, he’s going out with you guys! He’s come all the way form Australia!”

“But student actually pays money (via his paramedic course) to come out on a shift…”

“But this guy has travelled all the way around the world from Australia!”

“Put him with the other crew”

“No”

Hmm…pensive silence.

“Can they both come out with us?”

“I guess so…nothing stopping you really!”

 

Stay tuned for part two…

Report, part 4

From Australia, where the last three reports have come from, let me whisk you away to Guatemala, one of the most violent countries in the world according to the BBC.

But on our way there, let’s stop via Cardiff, in Wales. There we will pick up Angie, our Paramedic, and transplant her from a relatively tame setting to the rough and ragged streets of South America.

I think she’s in for a bit of a shock.

You can read a bit more background information here from the BBC, or else jump right in to the show below.

[youtube http://www.youtube.com/watch?v=rORB6S2MwyU]
[youtube http://www.youtube.com/watch?v=BfX9h4fXZsc]
[youtube http://www.youtube.com/watch?v=ZgGgD9vJvyA]
[youtube http://www.youtube.com/watch?v=148OP328ASA]
[youtube http://www.youtube.com/watch?v=iDWoS379S-4]
[youtube http://www.youtube.com/watch?v=Sru2-7Rwhq4]

The Sums

A few points to sum up my recent hospitalisation experience:

  • Being a modern, single independent and everything is all good in health, but when it comes to sickness, I cannot tell you how dependant I was on my girlfriend who, no-questions-asked, helped me out with fussing during and after my hospital stay. I felt I’d probably ended up in a nursing home otherwise.
  • If you’re a healthcare professional, or a man, or both, or just stubborn: Don’t be too ashamed to end up in hospital. I went through ABSOLUTE AGONY prior to getting the relief I bitterly needed within an hour of arrival at the A&E.
  • The staff were been great. From cleaner/caterer to Doctor, I couldn’t pick a fault if forced.
  • And for my dear US readers, a friendly reminder: this (including the two GP visits) cost me exaclty Zero Pounds and Zero Pence. With the current exchange rate the way it is, that translates roughly to Zero US Dollars and Zero US Cents. And I moved to the UK two and half months ago.
  • On that aforementioned point: funding. From meals to medications, everything was covered. And obviously, me being a fairly new resident, this money ‘came’ from those who have paid in far longer than I have. But I have all intentions of continuing paying in to the communal kitty, especially now that I (in a strange sense) had the privilege to experience the system (and no intentions whatsoever of using its service again). Don’t forget that in the six years of time spent living in Australia, and the 17 years prior to that living in Germany, I paid my taxes, and never needed to be treated in a hospital once. I always knew that that is how a good system works, but now having experienced it (after much wailing and gnashing of teeth), I am eternally thankfull for the foresight of the politicians who set these systems up in the first place.

Sure, there is much to fix with the NHS and other systems that provide such services. People will abuse such systems. Boundaries must be drawn. It must be affordable. It must adapt to evolving conditions. But is must also be non-discriminatory and all-encompassing. And not leave you with a five-to-six figure hole ripped in your pocket just because you were unlucky enough to pick up a bug somewhere (or have a tree jump in front of your car).

And as much as many of the people in the UK mock their healthcare system, my first and unexpected encounter has left me extremely impressed with the NHS, the staff and the service it provides.

Thank You.

I’m back

You know, only old people go to hospital. And people who swerve to avoid trees jumping in front of their car.

Well, theres a third, statistically small category you forgot: trigenerians with Glandular Fever.

Somewhere between the crowded and coughing population of Londons Underground and the chilly streets of night time suburbia, I must have picked it up. Welcome to England! Make yourself feel right at home; over here you have Big Ben, that over there is Tower Bridge. And we’re really proud of our NHS too – want to give it a go?

Sure why not? Bit of stress from all sides of life, wearing your body to the ground…opens you right up for infections. It started with complete muscle ache, like after recovering from a cold. That was Friday until Sunday. Monday to Wednesday were similar, but I could function. Not at full pace, but still alright.

Wednesday night my throat turned from itch to ouch. Thursday morning I decided to stick my iPhone avec flash in to my oral cavity, and was quite disgusted at the result. And I love the occasional gory photo. But this? My tonsils were so swollen my uvula had about 1mm each side swinging space. Plus the tonsils had little continents of pus growing on them.

I should have gone to the GP right then and there.

But no, I do what I’ve been putting off, and google my symptoms. Probably tonsillitis. Rest, pain relief, and it will be a little painful but the next few days should get me through this.

Nope.

It was when I could no longer bear the pain of forcing myself to swallow what felt like a golf ball of broken glass. (Read THIS) I couldnt stand it. I couldnt to it any more. I swallowed my (false) pride, which I should have done far earlier, and made an out of hours GP appt (worked fairly well. I think most people who whinge about the NHS haven’t experienced anything else). Unfortunately said GP was rubbish: one look, one prescribption of Antibiotics, and everything I croaked on about the pain being really bad, he just wrote more pain killers to the prescription list. Clearly he wasn’t listening to me, but I somehow thought I could make it. So, Antibiotics bought from the 24hrs chemist, Paracetamol and Codeine too. Swallowed the analgesia under great pain, but it allowed me to swallow more pills (Antibiotics) after having the pain relief take the edge off the pain.

I got a whole three hours of sleep that night. I was positively surpised.

The next day I had a GP appointment I made the day before. Since the first GP was so rubbish, I thought I’d go and get a second opinion. This feller actually took my full observations with some history. And recommended the same treatment, together with 2-3 litres of fluids daily. And then he stopped listening. I protested I could drink 500ml at best under extreme agony. “Drink plenty of fluides or got to hospital”.

Thanks Doc. Very reassuring.

The day didn’t go well. The evening was worse. I had used up my available painkillers. I was dehydrated. Yellow urine is bad in my books. Dark orange…well I’d never had that before. But I couldn’t get anything more in to me. It was agony. I wasn’t going to survive the night (psychologically). Every waking minute was agony. Every minute was an hour. And the next day wasn’t going to offer any relief anyway.

Off to hospital then. The only way out. I saw no other choice.

Cab to A&E, sat down, got myself booked in, and it didn’t seem to take too long until I was seen to (remember this is a Saturday night!)

Sophie (my live-in-Archaeologist-turned-Nurse) did most of the talking thankfully, due to the swollen tonsils I could only speak quietly, slowly and gargly – nobody understood me, and repeating myself was painful, and left me very frustrated. I’m not carrying these two pus bags in my throat on purpose you know..

Anyway, I was booked in, and after around 5-10 mins I was seen by a nurse practitioner. By this time my tonsils were actually hiding my uvula. Additionally, geology had gone backwards in time on the surface: the spread out continents of pus had amalgamated to one large Pangaea-of-Pus super continent, and the little buggers had also reclaimed land. Approximate 80 percent of my visible tonsils were covered in pus. That night, Nurse, Doctor and ENT specialist all had similar things to say once they saw them: “Ugh!”, “Wow!”, and “You’re a brave man what you’ve been through.” I corrected the last remark to: “I think I’ve been a silly man.”

I was shown to my own little cubicle in A&E, got to wear my first hospital gown ever (yep, you’re not missing out on anything there), and just the thought of now being in the right place with thte right treatment coming up made me feel a little more at ease.

An IV was started (ouch, but necessary, so Im all for it), and through it the good stuff: Antibiotics, pain relief and fluid. I went from feeling Rubbish with a capital R to slightly better than rubbish with a lower-case ‘r’.

At this point I must mention that the staff at  Newham Hospital were great. I didn’t (well initially) tell them I was a paramedic, as I didn’t want to bias them (positively or negatively). They got me seen quickly, got their stuff done, were friendly an professional, and I can’t say I would have done much differently (If I was in their position), certainly no better.

But that was the acute treatment only. I still couldn’t swallow if my life depended on it (and in the long run, it really does!). Thankfully (and I am glad I didn’t have to argue the point in the slightest), and contrary to the two Prior GPs, the A&E staff realised this, and organised me to be seen by the ENT specialists at Whipps Cross Hospital. Patient Transport Vehicle called, an hour later I was being driven across town.

Checking in the other end was a little painful (again, Sophie to the rescue doing all the talking and form filling). By now Sunday morning, I was expecting a bit of a nightmare at the A&E, and yes it was full. Luckily, because I was an ENT referral, they were awaiting me, so it wasn’t an excessive wait. After the paperwork was done, I was in a cubicle within ten minutes (I think), with an ENT doc first taking a good med hx from Sophie (“you save your voice for now, I’ll get the details in five minutes”). Thats what he did, saved my voice. Great! Explained right from the word go that I will need to be admitted for at least a day, the way my tonsils looked. I apologized for being a stubborn patient, and said as a paramedic I should have taken myself in earlier. Look, no problem, but you should have said earlier, I won’t dumb down the language as much~”. He seemed appreciative to know that he was speaking to another medical professional. “Grab some sleep, I’ll see you in the morning!” he winked, and left. Shorlty later I was transferred to a ward – quieter and darker, and some rest was in order.

It was 3am by then. I was tired, but so happy that I felt much better than just hours earlier.

The next day was similar. ENT visit, quick update on the plan, continue treatment, get better. I felt like I needed to release energy. I wanted to walk the entire hospital. I felt pretty good. Until I had to swallow. The shards of glass were still there. A tad less painful than before (and steroids had reduced the swelling a bit), but still agonising. A day of supportive treatment and rest.

And that day is just coming to an end. I am sure I’ll be out of here tomorrow. I can eat milky desserts (albeit painfully, but not in agony). Sleep, letting the meds work, and time should get me there. I don’t want to hog a hospital bed longer than necessary. I want to get out. I want to be free from this life-saving yet restricting IV pole. Never as a paramedic did I think that I’d be walking around in a hospital gown, pushing an IV pole with three different bags attached around a hopital so soon!

This was written with my head in the clouds, high on drugs, high on the fact that I can live my life without agony, high on hope. I did need another day just to get me completely able to swallow and look after myself at home. Now, a week after being discharged, I’m well on the road to recovery.

NYC: Maimonides Medics

June 2011

The day had come: Time to see what New York City Paramedics do. The grime of the city. The hustle and bustle. The intensity. The size. New York City. I was excited.

I had sorted a shift out from Australia via some contacts (thank you again if you’re reading this!). A few emails and a phone call later, I’m booked in. After borrowing The Worlds Smallest Ironing Board from the hostel, coupled with The Worlds Worst Iron, my crease free shirt (NOT!) and I were on their merry way to Brooklyn.

The Subway, or any underground train for that matter, is a semi-magical type of transport. Descending in the the depths of the earths core, you are whisked away in a steel can on wheels, propelled through a network of subterranean tunnels, only to submerge in a completely different biotope.

I felt like I had come out on the Wrong Side Of The Tracks:

[youtube http://www.youtube.com/watch?v=uAFDeC7TVyQ]

…and when you’re in f*ckin’ Brooklyn, you best watch your back!

Woah. Dirty streets, rubbish lying around, big mean-looking guys with tats walking around. A dark freeway underpass. A broken fence. I looked around, and felt like the proverbial sore thumb sticking out. No one really took notice of me, but There was no way in the world I was going to do anything to draw further attention towards my person. No way was I taking my iPhone out to take pictures. I made sure my valuable were as safe as possible, and out of sight. I morphed in to “man on a mission”, and headed straight to the ambulance station, trying not to leak any signs of curiosity of the neighbours or indeed the neighbourhood. Because I was just that – curious. But I was attached to my health and my life. (I’m sure this was a bit of an overreaction, but you can never be sure…and this was precisely the landscape that is always portrayed in various US gang films…).

I arrived in one piece at Maimonides EMS depot (pronounced May Mo Nuh Deez. Maimonides was a medieval Jewish Scholar). Phew. Knock Knock? Noone. I walk in, and am greeted by some paramedics, who direct me upstairs to the supervisors office. A few doors and some very narrow stairs later, Henry greets me with a big smile, welcomes me, and eagerly gets right in to it: “Let’s head downstairs, I’ll show you around and introduce you to the paramedics”.

We head back down, but the crew for the shift is not there yet (admittedly, I am very early).  “Here, I’ll show you your truck!”. And yes, it really was a truck:
Untitled

We chat for a short while about the service, but then his phone rings and Henry excuses himself. “Grab some food in the meantime! It’s EMS week, help yourself, go right ahead”. Well, free food, can’t decline a friendly offer, can we? The banquet had been ransacked by earlier crews (it was early afternoon already), but still plenty to be had.
Untitled

Eventually, some people in uniform wandered in, who turned out to be the medics I would be riding with soon. We go through the different kit they carry, compare each others respective guidelines and protocols, and are bleeped immediately for a standby position. You see, in New York, all Ambulances except FDNY (pronounced fid-nee, or fud-nee if you’re from New Zealand) get dispatched from street corners, not from stations (more on that in another post).

Halfway to our streetcorner, we are sent on our first job. Oh yeah, this ALS truck is now running hot! Big, boxy, bouncy, bad. Together with the fine and silky smooth roads (NOT!) of NYC, it would make for quite an unpleasant ride if I were not so excited. And another thing: Drivers of all emergency vehicles are quite playful when it comes to sirens: wooowoop. wup. wuup woop. wooohoooowailwailwail. woop. wail wail. HONK yelp yelp HiLo. HONK woop.

A haemophiliac in a high rise building has called, thinking he has broken a bone. We’re in “The Projects”, the New York term for low income (generally ugly high rise) housing. And I get the picture pretty quickly: Dark and dirty entryway, a lift smelling of stale urine with goodness-knows-what smeared over the graffiti. Creaking, the lift sneaks us up multiple floors, spits us out in a tight hallway, where mum (or should I write mom) awaits us: her brother has a bleeding disorder, heard and felt a snap in his thigh, which is now slightly swollen and tender. And he can’t weight bear.

Luckily we have the carry chair handy.

Our patient is comfortable as long as he isn’t standing, but the upper leg is tender to touch. All vitals within normal range, declines pain relief, so apart from monitoring and transport there is is not much more to do.

We arrive at hospital after an uneventful transfer where, once again, it becomes painfully (for the seasoned US medic, not me) obvious of the stretcher systems that are in place in most of the US & Canada: Person A must hold half the patient + stretcher weight, whilst Person B must fold or unfold the legs of the stretcher. Man, you gotta hold a lot of weight, that can’t be good for your back! I think that topic alone is worth an additional blog post (at the risk of even more wrath in the comments section)

Back in the van, restocked and roomy (yes, this thing is rather large), we are sent to our street corner again. Not a bad corner, as far as street corners go: Close to a major road, yet quiet, a supermarket for food nearby, and free public WiFi.

And we wait for another job.

And wait.

And wait.

And wait.

And fall asleep.

A nine hour shift with one job. It’s light. Nothing. Then it turns dark. Nothing. BLS crews whizzing past us on lights and sirens. NYPD screeching past. Firetrucks honking their airhorns as they hurl past. But this ALS crew isn’t needed anywhere.

Observers Curse.

NYC EMS: An Introduction

June 2011

What would NYC be without EMS? Only half a trip for me!

Untitled

My first encounter with an ambulance. It conveniently parked in front of me, inconveniently the fence would not move out of the picture, despite much begging and pleading on my behalf (note to self: fences a much better behaved back home).

That day, twitter came to the rescue for my evening plans. Murphy (@Murphquake) told me about the Dinner Presentation that was being put on for EMS week by the NYC Regional EMS Council. A free event? Dinner? I’m there!

And there I was. Standing there, in my lonesome, in a big hallway, people with all sorts of uniforms coming and going. I enquired politely about the evening at the entrance desk, explaining that I was a visiting Paramedic from Australia.

“AUSTRALIA!? Wow, come right in. What T-Shirt size are you? (wow, free tshirt too??). Here, grab one, head that way, the buffet is in that corner, help yourself, grab a seat anywhere you like, and enjoy the evening. Speeches etc begin in 45 minutes. Here is a guide to the evening. Enjoy yourself!”

Right, thats sorted then. I may not know anybody by face, but there is free food, lots of people in the same profession, and a few empty seats around. Jump right in, I say.

With a precariously heaped plate in each hand, I navigate myself to a table where people seem cheery enough to accommodate myself. Turns out they were a whole family dedicated to EMS, from Daughter and Son in law right through to the grandparents. We got some great insights from each others country over copious mounds of food (this is America after all), and I was asked if I was heading out on a shift in New York at all. Even before I could answer, one of them had run of to fetch ‘a friend of theirs’, who came back shortly after. I was introduced to Barry, one of the Paramedic supervisors in the Borough of Queens.

“Here’s my number. You call me tomorrow, and I’ll get ya sorted”. Spoken in a perfect New York accent.

This was going to be excellent.

Hello London!!!

35 000 kilometres, 773 photos, 80 days, 14 flights, six countries, four paramedic shifts, one conference and many old and new friends later, I am touching down in London.

Phew.

If all goes to plan, the plane should land the minute this post is automagically posted. It’s been a great trip, but I am itching to get back in to a less nomadic lifestyle. Settle down for a bit. Sleep in one bed longer than three days. Live out of a wardrobe, not a suitcase. Infuse a bit of continuity back in to my life.

And get a job. It’s high time to get back in to the exciting world of paramedicine, experience the UK system, and finally have an excuse to wear a rain jacket. (P.S.: if anyone has any tips in regards to paramedic work in London or the UK in general, please let me know!)

Looking forward to a whole new experience. In the meantime, keep an eye out for my travel diaries that will be published here (last years UK/US trip, my stints in a rural setting, as well as this journey just gone by).

See you in London!

 

Creative Commons Licence [Some Rights Reserved]   © Copyright Christine Matthews and
licensed for reuse under this Creative Commons Licence.

Oxygen

Straight from the bottle:

“High concentrations breathed over extended periods may lead to coma or death”

Clearly the bottle was way ahead of its time!

20120813-163101.jpg

International Guidelines & Protocols: Update

I’ve updated the document with the below information. Thank you very much to everybody who sent in the links, and a special thank you to http://paramedichub.com & http://www.rettungsdienst-updates.de for their link collection.

The document can be found by clicking the above link named “International Guidelines”, or by following this link: http://flobach.com/international-guidelines/

Germany Mecklenburg Vorpommern – University of Greifswald http://www.medizin.uni-greifswald.de/intensiv/fileadmin/user_upload/dokumente/rettungsdienstleitlinien.pdf
Germany Emergency physician association of northern Germany http://www.agnn.de/index.php?file=tl_files/pdf/therapieempfehlungen.pdf
Germany Klinikum Munich http://www.klinikum.uni-muenchen.de/Chirurgische-Klinik-und-Poliklinik-Innenstadt/de/medWissen/algorithmen/index.html
Switzerland Zurich http://www.stadt-zuerich.ch/content/dam/stzh/pd/Deutsch/Schutz%20und%20Rettung/Ausbildung/Fachschule/Merkblaetter_und_Formulare/Algorithmen.pdf
Switzerland City of Basel http://www.medstandards.ch/notfallstandards/startseite.php
Canada Dalhousie University http://emergency.medicine.dal.ca/ehsprotocols/protocols/toc.cfm
Mexico CRUM Queretaro http://crum.emergencias.org.mx/protocolos
USA North Carolina http://www.ncems.org/pdf2012/