[AMA] I'm a Paramedic - Ask Me Anything! [Trigger Warning - Heavy Content]

sween64 on 23/10/2017 - 16:12
Last edited 23/10/2017 - 16:40

I'm a paramedic working in Australia, I have been for over 3 years. It's a great job and I'm glad I kinda fell in to it. I work in a large metropolitan city, mainly in the suburbs but we can end up almost anywhere!

It requires a 3 year bachelor degree and can be studied at universities all over Australia, some of them are double degrees with nursing.

I work a variety of shift lengths including during the day and over night.

Go ahead, ask me anything!

The views expressed here are those of myself and not of my employer.

Trigger warning: There's some emotionally heavy content and may be some gruesome stuff as well.

Introduce Yourself

closed Comments

  • Herodotus on 23/10/2017 - 16:18

    Are you afraid of automated redundancy?

    • sween64 on 23/10/2017 - 16:23
      +9

      Haha no. Even though there are plans to have drone based AEDs they'll never replace the large variety of work I do. Most of it is interacting with people that are stressed out because of the emergency situation they find themselves in.

    • jazattack on 23/10/2017 - 16:25
      +8

      What are you even talking about?

      • Kangal on 23/10/2017 - 19:56
        +1

        You know, those gov controlled DJI Phantom drones with an attached Taser.

        • banana365 on 25/10/2017 - 13:44
          +7

          It'll just be equipped with a syringe pentobarbital - "Please stay calm citizen whilst justice is administered"

    • pao2x on 24/10/2017 - 19:08
      +13

      Dude you cant even get a robot to get beer from the fridge, much less do ambo work. When they start fully automating garbage collection maybe add a few more decades for automated health professionals

      • suchan on 26/10/2017 - 11:45
        +4

        i'd prefer Baymax over any other cold scary drones

  • spackbace on 23/10/2017 - 16:18

    What's the fastest speed you've seen in the ambulance? ;)

    • sween64 on 23/10/2017 - 16:25
      +17

      When I was a university student completing a rural placement about 150km/h on the open highway. Although we can break the road rules during an emergency, we can never break the road safety act so we must always drive in a safe manner.

      • ATangk on 25/10/2017 - 00:07

        TBF in a rural highway straight section, you'd feel safe doing any speed. The road never ends, and if its an open stretch its misleading how slow you are going.

        • Chik5555 on 25/10/2017 - 22:54
          +11

          Until a kangaroo appears

        • patinadiary on 26/10/2017 - 19:29
          +3

          @DIVISIONX: I don't know why you got negged, i found it hilarious.
          PS I'm asian too.

        • Courier Ken on 28/10/2017 - 11:27

          "gaurav" sounds very indian… lol

        • ATangk on 28/10/2017 - 15:02

          @Courier Ken:
          You are replying to the wrong comment.

  • scrimshaw on 23/10/2017 - 16:19

    What's the most WTF or bizzaro moment you've witnessed during your job?

    • sween64 on 23/10/2017 - 16:25
      +17

      A hoarder that had nazi memorabilia and photos of nazi generals.

      • scrimshaw on 23/10/2017 - 17:22

        Awesome :) what was the most heartwarming or positive thing you've seen while on the job ?

        also; how important are maths skills when it comes to getting the bach. degree?

        • sween64 on 24/10/2017 - 11:04
          +17

          It's hard to think of a specific moment but I get a lot of job satisfaction from making people's lives better. One funny/heart warming moment was when I was assessing an elderly lady who had some pain and had fallen over but not injured herself and she was embarrassed and frustrated by her own ageing. She started to cry and asked if I needed a hug, I said, "I think you need a hug" and of course gave her one.

          Mathematics is important for completing drug calculations etc. A basic high school level competence is enough. There was a maths test when I applied for my job but I'm not sure if that's still the case.

      • dd22qq on 24/10/2017 - 03:06
        +52

        Wow, never known anyone that's been inside Andrew Bolt's house before.

        • Suspect420 on 24/10/2017 - 16:46
          +1

          ^Best comment lol

        • htc on 26/10/2017 - 07:54

          The columnist you can't ignore

  • retiredfeline on 23/10/2017 - 16:21
    +2

    What happens when you encounter a life threatening situation for the patient? Does your training kick you into automatic and you go through a series of steps to stabilise the situation? What is roughly the breakdown of the sorts of situations you encounter, e.g. heart attack, trauma, etc.? Have you ever lost somebody in transport?

    • sween64 on 23/10/2017 - 16:27
      +3

      On top of the 3 year bachelor there's also a 1 year graduate program where we are mentored by a senior clinician so there's a lot of training and support. What we fall back on in tough situations is the clinical approach which is a series of steps to ensure a thorough assessment.

    • sween64 on 23/10/2017 - 16:28
      +3

      Most of the situations I encounter are old people with medical conditions (chest pain, chest infection) or old people that have fallen over. There's also a lot of mental health that we deal with.

    • sween64 on 23/10/2017 - 16:29
      +2

      I have had a patient pass away in the ambulance, we were about to transport when their heart stopped so we attempted resuscitation in the back of the ambulance outside the patient's house. After some time we realised he wouldn't survive so we ceased resuscitation. We then transported the patient to the local morgue.

      • Kangal on 23/10/2017 - 19:58

        Local morgue?
        Don't you mean to the local hospital, where the doctors took them to the morgue after a preliminary check?

        • sween64 on 23/10/2017 - 20:06
          +13

          Local morgue situated inside the local hospital. The doctors didn't need to check anything. They were dead.

        • retiredfeline on 23/10/2017 - 20:07
          +37

          @sween64: I don't think you meant to say that the doctors were dead. 😉

        • Jared17 on 24/10/2017 - 08:42
          +3

          @sween64: interesting. I always thought u need a med doctor to confirm patient is dead

        • sween64 on 24/10/2017 - 11:05
          +23

          @Jared17: Paramedics can verify death, which is a 7 or so check point list to confirm a patient is deceased; heart sounds, breath sounds, pupils, ECG etc. While a death certificate can only be completed by a doctor and includes a cause of death.

        • Jared17 on 24/10/2017 - 12:26
          +2

          @sween64: thanks for the explanation

  • try2bhelpful on 23/10/2017 - 16:22
    +34

    First of all, congratulations on doing a job that is actually a benefit to society. More than I can say for most of my working life. Funny how well paid and beneficial job are often mutually exclusive.

    Have you ever been genuinly scared of a situation doing your job? The paper seems to have a lot of stories of paramedics being in dangerous situations due to being attacked by patients, their families, bystanders etc.

    • sween64 on 23/10/2017 - 16:33
      +22

      Thanks! It's a great job and I get a lot of satisfaction out of it and enough money to live comfortably (for the moment, I don't have children).

      I am fortunate that I haven't been badly assaulted. I was punched once by a drunk early on a Saturday morning after they passed out on a sidewalk but it was such a feeble attempt I wasn't injured.

      I have witnessed my colleague be assaulted, they were kicked again by a drunk patient. They may have also been drug affected. It does happen and despite the prevalence of drugs in our society the levels of violence & aggression towards paramedics is dropping.

      • dealman on 23/10/2017 - 17:36
        +8

        the levels of violence & aggression towards paramedics is dropping.

        That's reassuring
        Thanks

  • Topdog on 23/10/2017 - 16:22

    Have you ever been attacked by a meth head

  • ryban3z on 23/10/2017 - 16:25

    Have you ever been confronted with an emergency where someone is dying/severely injured/sick and requires your immediate intervention - how did you react when confronted with the need to act? Does your brain shutdown and training kick in or are you able to remain lucid/calm and address the situation? Or maybe somewhere in the middle?

    P.s. thanks for all the work you do!

    • sween64 on 23/10/2017 - 16:38
      +6

      Your brain doesn't shut down but you do become focused on the patient and you stick to a systematic approach (the clinical approach). I have attended an elderly patient who was involved in a car accident who was unconscious, breathing and was bleeding profusely from their face. I did have a brief out of body experience when I was inside the wreckage, taking the patient's blood pressure while the fire services cut away the car door for better access, I thought to myself. "This job's awesome!"

      PS You're welcome!

  • wayfastwhitie on 23/10/2017 - 16:26
    +4

    Do you find seeing some of the horrible things that you see in your job effect you in your personal life. Has there been any one moment has has stuck with you over the years?

    • sween64 on 23/10/2017 - 16:45
      +6

      Trigger warning - suicide.
      There are definitely situations that stick with you more so than others. It can be difficult to leave feelings behind at work and not let them affect your personal life.

      A couple of moments that I can easily remember are a Mod: Removed details of suicide per press council standards that I attended. The patient had Mod: Removed details of suicide per press council standards and their house mate had been home for a couple of hours before realising. They weren't immediately distraught but the patient Mod: Removed details of suicide per press council standards was a creepy scene.

      Another is a middle aged person who returned home to find their friend, who had been painting their house, had collapsed and had suffered a cardiac arrest. The middle aged person performed CPR whilst waiting for the ambulance. Unfortunately the patient had collapsed long ago and resuscitation was futile. The middle aged person had also been a police officer and of course had seen a lot of death and had retired due to PTSD.

      Fortunately however we have great mental health support with a 24/7 chat line and professional psychologist appointments available.

        • jacross on 26/10/2017 - 16:37
          +9

          What did you think a Paramedic AMA was going to be like? Ask me anything, and I'll give vague unsatisfying answers?

        • [Deactivated] on 27/10/2017 - 01:23

          Why are some people so fearful of death?

        • firedragon on 27/10/2017 - 07:39

          It's an interesting comment from you, Cannulator, cos with a username like that, I would've thought you worked in health too.

        • Cannulator on 27/10/2017 - 07:44

          @jacross: I’ve bern doing it 20 years not 3. So I know exactly what it’s like.

        • Cannulator on 27/10/2017 - 07:45

          @firedragon: I have 20 years of it, so I know what you do and don’t describe publicly.

        • firedragon on 27/10/2017 - 07:47
          +1

          @Cannulator:

          Ah okay. I can see where you're coming from. Thanks for reply.

      • [Deactivated] on 27/10/2017 - 13:21

        Cannulator is right on the money.

        You should know enough to be cautious detailing explicit method of suicide, especially on an open public interface such as this. Irresponsible is what it's called.

        Here's the Australian Press Councils standard on reporting suicide, which would have been developed with professional guidance. A trigger warning is not enough.

        I'll be reporting it and we'll see what the Mods do. If it remains then they will also be complicit in your irresponsibility.

        • Moderatorneil on 28/10/2017 - 14:47

          The comment has been modified per the guidelines you linked to, specifically:

          1. The method and location of a suicide should not be described in detail (eg, a particular drug or cliff) unless the public interest in doing so clearly outweighs the risk, if any, of causing further suicides. This applies especially to methods or locations which may not be well known by people contemplating suicide.

          Feel free to TWAM for further discussion (not here or not PM thanks).

  • barbarella on 23/10/2017 - 16:34

    What is the pay structure of a paramedic? eg. normal hourly rate and penalty rates
    TIA

    • sween64 on 23/10/2017 - 16:46
      +1

      Hourly rates with penalties for night shift, weekends, late finishes etc.

        • sween64 on 23/10/2017 - 16:55
          +6

          Link

          It's fairly accurate.

        • battler on 23/10/2017 - 17:21
          +34

          @sween64: if that is the case then you are underpaid IMHO.

        • GOB on 23/10/2017 - 23:07
          +5

          @sween64: My wife works in emergency and says you guys are absolute heroes \m/(-_-)

        • sween64 on 24/10/2017 - 15:04
          +4

          @mallymcl: Aww shucks. Thanks.

        • jasonb on 24/10/2017 - 17:58

          @sween64:
          What state do you work in???

          If you're fully qualified and that's what you're getting, move.

        • BartholemewH on 26/10/2017 - 17:48

          @jasonb:
          Agreed based on family member's earnings.

        • virhlpool on 28/10/2017 - 06:52

          @sween64: It shows a wide range though. Does it change so much with age, promotions, etc?

        • sween64 on 28/10/2017 - 10:03

          @virhlpool: It can increase with years of experience and with higher roles.

  • dylanando on 23/10/2017 - 16:36
    +5

    I love lights, Do you sit there and play with the sirens?

    • sween64 on 23/10/2017 - 16:47
      +19

      Haha! It can be mesmerising driving at nights and watching the beacons (red/blue flashing lights) reflect off the high-vis road signs. I'll also turn them on to amuse young children that wave at us while we are stopped at traffic.

      The sirens are loud and irritating, I only use them when I need to.

  • mskeggs on 23/10/2017 - 16:41

    How are your knees and back holding out?

    • sween64 on 23/10/2017 - 16:51
      +3

      At the moment, they're pretty good! I have some minor back pain but that's probably more due to my lack of core exercise. We have a lot of equipment now that means we minimise all lifting where possible. We have powered stretchers, wheel chairs with tracks that can descend stairs safely, inflatable lifting cushions to raise patients off the ground etc. We are also encouraged to put our safety before the patient's medical need and to take our time to complete everything safely. We also encourage patients, even those having heart attacks, to move and walk themselves as much as possible, rather than us moving them. Paramedics are notorious for some of the highest rates of time lost due to WorkCover but it's reducing.

      • unwashed00 on 24/10/2017 - 11:51

        I can vouch that core exercises (squats in particular) really help with back pain. When I train semi regularly I have to problems standing up all day. When I stop for about a month, the back pain appears when I spend more than 4 hours standing.

        • sween64 on 24/10/2017 - 12:20
          +2

          I'm gonna start a regimen of body weight exercises to help improve my core strength.

        • Karlos101 on 26/10/2017 - 11:00
          +2

          @sween64: hip flexor stretches will be your friend too whilst doing your core stuff. although, here is me, an IT guy giving health advice to the medical equivalent of a commando. ha ha.

      • [Deactivated] on 24/10/2017 - 13:04

        Yoga works wonders!

  • fossilfuel on 23/10/2017 - 16:57
    +3

    Thanks for the good work mate. I do St John on the side. We do handovers to paramedics quite a bit and we're told to do it in a specific way. What do you want actually want to hear from the handover? e.g Every bit of detail (name, allergies, medical conditions, drugs, observations, treatment) or more specific info?

    • sween64 on 23/10/2017 - 17:00
      +9

      You're welcome and thanks for your good work too!

      On to your question, it depends on if you have any documentation that you can hand to the paramedic. If you do have a document, hopefully that's got full name, DOB, home address, allergies, medications, past history etc. Otherwise a lot of this we can ask the patient on the way to hospital.

      Essential for a hand over is; patient's first name, age, main presenting problem, description of the event, symptoms, most recent vital signs (any notable trends), treatment administered.

      That's my preference, you may encounter paramedics that want something different. Mainly try to be clear, concise, logical and answer questions.

      Handovers can be difficult and it takes a lot of practice to get them right.

      • fossilfuel on 23/10/2017 - 17:04

        Thanks mate, keep up the good work! We do have documentation but most of the time paramedics want a copy.

        • sween64 on 23/10/2017 - 17:13
          +3

          Hospitals use ISOBAR which can be a good place to start.

          • Identify
          • Situation
          • Observations
          • Background
          • Agree to a plan
          • Readback

          The last two are probably less relevant.

  • Herodotus on 23/10/2017 - 17:19

    Have you ever had to engage with a patient who was covered in faeces? Is it true that a deceased empties their bowels?

    • sween64 on 23/10/2017 - 17:25
      +8

      Yes, and I dislike poo jobs especially. I've been to at least a few patients who have been literally covered head to toe in their own faeces and all over the room. I did five similar jobs to this in a week with one colleague of mine, it was a bad week.

      No.

      • [Deactivated] on 23/10/2017 - 21:24

        Why do people do this? Under what circumstance?

        I have met some pretty objective/heartless paramedics (imo the best ones); what is your take on this?

        • sween64 on 24/10/2017 - 11:15
          +8

          Explosive diarrhoea in the elderly who are unable to clean themselves easily, that's probably the most likely cause. Being wheel chair bound at home alone can make cleaning yourself difficult. I did go to one patient who had anxiety issues and would cycle between using laxatives and anti-diarrhoea medications and would end up covered in shit.

          Obviously seeing suffering and death a lot in our job means that to protect ourselves we need to distance ourselves from the emotional aspect of patient's lives some times. Although some paramedics may appear heartless, deep down almost all paramedics care about their patients, that's why they got in to the job and that's why they continue the job.

      • [Deactivated] on 24/10/2017 - 17:27
        +1

        Don't you mean 'it was a sh1tty week' ?

  • hell0 on 23/10/2017 - 19:12

    Have you ever met a celebrity patient?

    • sween64 on 23/10/2017 - 19:22
      +5

      A footballer who I didn't recognise at the time but my colleague did. He was the partner of the patient.

      • Save Medicare on 24/10/2017 - 14:07

        Do you have the same buddy in the ambulance every day, or is it luck of the draw?

        • sween64 on 24/10/2017 - 14:09

          Usually it's the same partner for at least a month for up to 3 months.

  • BertieBrown on 23/10/2017 - 20:34
    +11

    OP, I just wanted to chip in and say thank you for putting in the trigger warning in the title.

    • BertieBrown on 23/10/2017 - 22:44
      +6

      Not sure what the neg is about, it’s nice to see when someone genuinely cares enough to put that forethought in to their post. I wasn’t taking the piss.

      • SnakeCasablanca on 24/10/2017 - 13:39
        +3

        Id say the negs are related to the fact that people feel they need 'Trigger Warnings' these days.

        The fact that rather than someone who is easily 'triggered' being careful with what they read, the rest of the world needs to carefully consider how anything that they write or say may 'trigger' anyone else before they continue. The responsibility has moved from the person with the issue, to everyone else.

        You could say that it was just 'nice to have'. But in reality, out of the 10 people who may read this and feel that they required it, 2 of them will abuse the next person for not providing one. Then 100 people will back those gentle snowflakes up because 'feelings'.

        Trigger Warnings are regressive.

        • [Deactivated] on 24/10/2017 - 17:30

          How can you say trigger warnings are regressive? People here have no idea about me or my background. For all you know I could have lost a loved one in a car crash, suicide or cardiac arrest. At least with a trigger warning I have the ability to choose what I expose myself to.

        • SnakeCasablanca on 24/10/2017 - 18:13
          +8

          @AlphaBravo: And were that the case, do you think the context of what you are reading might be sufficient to warn you and prevent you from reading further?

          Trigger warnings are regressive because they reinforce the idea that none of us need to read, or be faced with anything that might offend or 'trigger' us. And not only that but it is others responsibility to protect us and not our own.

          The world is 'triggering' and doesn't care for your lived experiences. If one needs to be protected from the world and feels that this protection needs to be provided for by people around them then perhaps counselling might be in order.

        • MessyG on 25/10/2017 - 12:52

          @SnakeCasablanca: Snake I agree that the term might be overused but for people who have lost loved ones to witnessed trauma or suicide or have been assaulted, these warnings are necessary, and especially on a thread like this one.

        • joungs on 25/10/2017 - 12:58

          Trigger warnings are no different to those "viewer discretion is advised" warnings that have been on TV for decades. Never saw anyone kick up a fuss about those.

        • banana365 on 25/10/2017 - 13:53

          @joungs: You mean those "Recommended for people aged 15 and ova." warnings on the ABC? Can't say I've ever been concerned about my wife's unfertilised eggs seeing something unsuitable on TV.

        • burns13 on 25/10/2017 - 16:42
          -1

          @SnakeCasablanca:

          You know where you can stick your ideology! This Trigger warning only forewarns the paramedic won't be holding back the gross details. So be aware.

        • This Guy on 25/10/2017 - 20:42
          +1

          @AlphaBravo:

          In that case, 'I'm a Paramedic - Ask Me Anything!' should be enough of a warning. We have compulsory schooling in this country.

          If you seriously don't understand this concept please, please, PLEASE contact your state's department of education and keep explaining your situation until they explain to you how no one in your home community will ever be left behind again. You can help the next generation!!!

        • SnakeCasablanca on 26/10/2017 - 04:18

          @burns13: What is my 'ideology' pray tell?

        • [Deactivated] on 27/10/2017 - 01:29

          I don't understand this. Its just death. One of the most common conditions on the planet. Why are people so afraid of it. I will die, tomorrow, next week, sixty years. Its guaranteed to happen. Of course i'll try not to, but when it happens more or less it will be out of my control

        • [Deactivated] on 27/10/2017 - 13:29

          @lolbbq:

          MissG explained it in one line. A pity you and @SnakeCasablanca can't think beyond your own circumstances…

        • [Deactivated] on 27/10/2017 - 22:33

          @AngryChicken: Yea, I've had loved ones who died too. Doesn't explain why one should be so irrationally afraid of a natural phenomenon.

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