Paramedic Notes
Chapter 1: Introduction
Nat is preparing for her last shift with her longtime partner Leonard, who is moving on to become an intensive care paramedic. There is a surprise planned for Leonard to celebrate his achievement. Leonard expresses his gratitude and acknowledges the strong bond he has formed with Nat, reflecting on their shared experiences and the significant moments they've been through together. Nat jokes that she will be missed. They acknowledge that they are great colleagues, wonderful coworkers, and best friends. Nat says that working with Nat makes this the best last shift ever.
Chapter 2: Ruby's Chest
An 83-year-old woman named Ruby is experiencing chest pains and shortness of breath. Emily listens to Ruby's chest while Steve speaks with her daughter to gather more information about her recent hospitalization. Steve learns that Ruby has CCF (congestive heart failure). Congestive heart failure (CCF) is a condition where the heart muscle cannot pump enough blood to meet the body's needs. Ruby's ECG shows she is not having a major heart attack, but there are fine crackles at the left base, indicating fluid in her lungs. The fluid accumulation is due to the heart's inability to pump blood effectively, causing it to back up into the lungs, essentially causing her to drown from the inside out. Leads are put around the heart to monitor it.
Ruby's neighbors are waiting for news. The paramedics prepare to transport Ruby to the ambulance. The paramedics want to avoid overexerting Ruby so that they don't increase the workload on her heart. Paramedics are mindful that Ruby's condition could deteriorate at any moment.
Chapter 3: Assessing Car Crash Victim Lisa
In country Victoria, Flight Paramedic Ray is assessing Lisa, a 29-year-old car crash victim. Lisa was ejected from the rear window of her car at high speed. It's noted that such a mechanism could easily have been fatal, particularly if the C2 cervical vertebra was fractured, which could cause loss of breathing and death. Ray checks if Lisa is sore in the tummy. He asks her to wiggle her toes and squeeze his hands to assess spinal cord functionality.
Lisa's ability to wiggle her toes and squeeze hands indicates that she has likely avoided spinal cord injury. An ultrasound scan is performed to check for internal bleeding or damage to major abdominal organs. The ultrasound is used to check for internal issues.
Chapter 4: Congestive Heart Failure
Lisa reports pain and discomfort. Despite the severity of the accident, Lisa appears to have escaped serious trauma to her internal organs, but her suspected broken neck may require urgent surgery. It's noted that being on an ambulance stretcher after a major accident is a vulnerable position. She is instructed to use her right arm to hold her left arm to give herself a cuddle in order to make her feel safer. The paramedics don't know the extent of the neck injury, so it's a major concern. If any unexpected movement or a heavy landing, that bony fragment could slice through the spinal cord, and she's a quadriplegic.
Ruby is seriously ill with fluid building up in her lungs. The 83-year-old has a history of congestive heart failure and says that she has never been sick up until the last few years.
Chapter 5: Conclusion
Paramedics reassure Ruby to alleviate pressure on her compromised heart. They ask about her tolerance for needles, preparing to administer medication. The paramedics check if enough oxygen is getting into her lungs. Emily is going to give Ruby a milligram asprin. They ask if Ruby is feeling any tightness in her chest. They are prepping medications.