Saturday, October 30, 2004

M E T

Stands for Medical Emergency Team. Yesterday we had a MET call to the rehab ward, where a woman had developed sudden abdominal pain accompanied by tachycardia, work of breathing and decreasing O2 Sats (So her pulse rate was fast, her breathing rapid and laboured and her Oxygen levels in her bloodstream were going down). She was feeling crook, no doubt about it. We did an ECG which showed a tachy rate but nothing else overtly sinister (like ischaemic changes) and I took her Blood Pressure on both arms to find a marked difference (With sudden onset of abdominal pain and the other symptoms one might start thinking a large abdominal bleed, like an Aortic aneurysm dissection) - it turns out this patient had had major vascular problems in one of her arms however, which always caused difficulties in ascertaining accurate BP and even in finding a pulse. Ah well...despite this relevant history she still might have been having a big bleed. The poor lady was conscious throughout, with a large number of senior medical and nursing staff buzzing around her bed and was of course quite frightened. We tried to reassure her as best we could.
We moved her to ED where she was eventually intubated, had a femoral CVC line put in and sent her to a larger hospital attached to all kinds of devices. That took up most of the morning shift.
I wonder how she is going. I feel for the families that wait outside the resuscitation rooms whilst some of the more complex procedures are going on, although our staff are very good at communicating with them and letting them know what is happening to their loved ones in terms they can understand.
This was a serious morning, as opposed to the other night when I cared for a woman who was not seriously ill, but extremely drunk who kept telling me how "gorgeous I was darling" ~ as I commented to one of the other nurses, it's seems to be only the inebriated, demented or blind patients that give me compliments like that!

Thursday, October 28, 2004

An Elephant Stole My Toothbrush!

No...really...go see....
back to work tomorrow after one dull (weather-wise) day off today. 0700HRS start so I better get to bed...

Wednesday, October 27, 2004

Chakra Update

I have just had a chat with John, who triaged the fellow with the malfunctioning chakras (see previous entry). To set the record straight, "malfunctioning chakras" was not his presenting problem/complaint; he had actually presented to ED on the insistence of his son, as he had been generally unwell for a few weeks. The patient himself told John he thought his symptoms of general unwellness were caused by malfunctioning chakras.
As it turned out he had some significant electrolyte imbalances as well as malfunctioning chakras, which may have had just a little bit to do with his symptoms!
Today: In monitored area. No of patients currently: 0. Plan: Going for a meal break.
Later: The printer beside this computer is going crazy, printing out Powerpoint hazmat documents by the dozen...I don't know why, Maree only wanted a few, but that's Mico$oft programs for you! (of course it could be the operator) There is an acronym that tech support staff have been known to use: PBCAC which stands for Problem Between Chair & Computer.
There are many politically incorrect acronyms in many fields, Emergency medicine not being immune. PFO, PAFO & GPFO are variations of one that once was commonly used and which basically stood for "Became inebriated and involuntarily attained a horizontal orientation with/without traumatic injury"

Saturday, October 23, 2004

Party animals...

It seems like all we do is go to birthday parties lately...Grandad Jack's 80th, my nephews 30th, my nieces 5th (hell, I think she's 5...I am hopeless at remembering these things) Whatever...I am officially partied out. Then I go and visit Chapel Perilous via Melissa's blog Butterfly Teeth and get the shit scared out of me...I won't spoil it, but do not go here if you have problems with your heart. Really. Bsti is an interesting character, I wonder if he has read Robert Anton Wilson, the author who first introduced me to the idea of "chapel perilous" many years ago...besides his thought provoking Cosmic Trigger stuff (btw ~ three volumes? I only have one) the laughs I got from the Shrodinger's Cat and Illuminatus trilogies was just too good!
Ah well, more later...back to the exciting world of the emergency department tomorrow....Oh I nearly forgot, a fellow came to triage the other day with malfunctioning chakras! I'm not sure what he thought our medicos could do about that...I hope he found some help with it anyway. My chakras are no doubt fucked up good and proper by now...time for some serious chakra realignment!

Monday, October 18, 2004

Who, what where?

Blogging from work. Hi! how is everybody? It's been busy at the PunkClown ranch, I must catch up with my favourite reads soon. I had better check an make sure everything is ok in the ED...more later!
Later ~ and now a thank you to my sponsers *grin*
Thank you to Rivi, Meg and Amy who have left nice comments on my lilly images at my photoblog notReality. Thanks also to Jer, Kat and Bryn for letting me know they were listening when i was having my political gripe....
Thanks friends! Now...Here (below) I am trying out one of meg's opacity tricks...


Lillies are lovely...

Tuesday, October 12, 2004

Let them eat cake

Eating Cake
It has been a weekend for parties, both celebratory and political. The right wing have gotten back into power in Australia, which is an unpleasant fact that I am resigned to. I am usually not political in my blog, as there are plenty of pundits out there making their respective points. Opinions are like arseholes, everybody has got one...
I still find it hard to accept that a political stance that will lock children away behind barbed wire for years because they happened to arrive in Australia via a leaky boat with their parents and rationalize this inhuman (and illegal within the agreed International laws) with so much cynical rhetoric is a good one. In actual fact I find it and the continual lying and whitewashing of the facts by our current world leaders to be morally reprehensible and may I say, tainted with a touch of EVIL...That's right boys and girls you heard right, evil! - To claim to fight for freedom and justice on one hand and blatantly ignore and subvert it in your own backyard at the same time is not just hypocritical, it's something far worse.
You can disagree with me if you like, as is your democratic right, but you had better have a bloody good argument to justify yourself if you disagree on my turf here, because I might just call you rude names! Ahhhh, stuff it all...let them eat cake!

Friday, October 08, 2004

Vulcanism ~ not Mr. Spock!

A static image (updated every five minutes) of Mount St. Helens, Washington USA, taken from the Johnston Ridge Observatory. The summit of Mount St. Helens is at an elevation of 2,549 Meters (8,364 feet), at 46.20 N, 122.18 W.  The summit stood at 9,677 feet before the May 18, 1980, eruption. The Observatory and VolcanoCam are located at an elevation of approximately 4,500 feet, about five miles from the volcano. You are looking approximately south-southeast across the North Fork Toutle River Valley. The Mount St. Helens VolcanoCam is brought to you by the Gifford Pinchot National Forest, Vancouver, Washington, and Mount St. Helens National Volcanic Monument, Amboy, Washington USA. Via the wonderful meg blog here is a live-ish (updated every 5 minutes) view of Mt St. Helens, which has been experiencing renewed volcanic activity lately.


Tuesday, October 05, 2004

skylines

If you have a skyline you wish to share, or if you want to see some cool and groovey skylines from around the world visit the link (ahh... that means click on the headline). This is a project began by Stu Savory and currently operating on both Stu's site and on the skyline viewer I built for it - check it out, landscape lovers!

Politically correct speaking in Australia


HOW TO SPEAK ABOUT WOMEN AND BE POLITICALLY CORRECT:

1) She does not get PISSED - she gets CHEMICALLY INCONVENIENCED
2) She is not a SCREAMER or MOANER - she is VOCALLY APPRECIATIVE.
3) She is not EASY - she is HORIZONTALLY ACCESSIBLE.
4) She is not DUMB - she is a DETOUR OFF THE INFORMATION SUPERHIGHWAY.
5) She has not BEEN AROUND - she is a PREVIOUSLY ENJOYED COMPANION.
6) She is not an AIRHEAD - she is REALITY IMPAIRED.
7) She is not a BABE or a CHICK - she is a BREASTED AUSTRALIAN
8) She does not have BREAST IMPLANTS - she is MEDICALLY ENHANCED.
9) She does not NAG YOU - she becomes VERBALLY REPETITIVE.
10) She is not a SLUT - she is SEXUALLY EXTROVERTED.
11) She does not have MAJOR LEAGUE HOOTERS - she is PECTORALLY SUPERIOR.
12) She is not a TWO-BIT WHORE - she is a LOW COST PROVIDER.

HOW TO SPEAK ABOUT MEN AND BE POLITICALLY CORRECT:

13) He does not have a BEER GUT - he has developed a LIQUID GRAIN STORAGE FACILITY.
14) He is not a BAD DANCER - he is OVERLY CAUCASIAN.
15) He does not GET LOST ALL THE TIME - he INVESTIGATES ALTERNATIVE DESTINATIONS.
16) He is not a CRADLE ROBBER - he prefers GENERATIONALLY DIFFERENTIAL RELATIONSHIPS.
17) He does not get FALLING-DOWN DRUNK - he becomes ACCIDENTALLY HORIZONTAL.
18) He does not act like a TOTAL ASS - he develops a case of RECTAL-CRANIAL INVERSION.
19) He is not a MALE CHAUVINIST PIG - he has SWINE EMPATHY.
20) He is not afraid of COMMITMENT - he is MONOGAMOUSLY CHALLENGED.
21) He is not HORNY - he is SEXUALLY FOCUSED.

Monday, October 04, 2004

Moaning Monday...

Today is "abdo pain" Moaning Monday with one particularly vociferous case in the corner cubicle thanks very much. The other morning was compound fracture of the greater toe Saturday - facilitated by the swiftly rotating blades of lawn mowers. 2 cases exactly the same except for the foot (one on the left, one on the right foot - the feet in question on two different patients I should add, of course) Strange how cases present in statistical clumps. It's like runs of sequential numbers coming up in the lotto. Today, however, as I have previously mentioned, is moaning Monday...More later...
Later - after throwing a fair amount of morphine into this person's veins, as well as maxalon, Hyoscine(buscopan) and more morphine, the treating doctor decided IV Diazepam was in order...good move, it gave us at least 1 hours semi-quiet whilst the patient in the corner snored. It was soon after this respite that another patient in CT decided to go off their nut, rip their IV out, spraying blood everywhere, assault the medical imaging nurse and generally tell everyone to fuck off at the top of her voice repeatedly. Yes dear, it was one of those days at the office. *Delerious grin*

Tuesday, September 28, 2004

Pain, Body Language, Art, Man Ray

   An interesting entry from Mike regarding Body Language and specifically body language in relation to chest pain caught my eye today: Chest Pain Body Language. It is well worth looking into if you are involved in fields of Emergency, Cardiac and other health care areas, or if you simply have a healthy interest in these subjects...Thank you Mike.
    Emma asked about the Man Ray exhibition at the NGV (National Gallery of Victoria) that I went to last Friday. Well, I quite enjoyed it, seeing prints that I realised must have been developed by Man Ray's hands, as opposed to reproductions in a book. The funny thing is though, I found myself wondering what the difference was. What I mean to say is, in a high quality art-book there was no discernible difference to me than looking at these original prints on the wall, except that some are actually reproduced to a larger scale in some of the books I have seen. Perhaps I am a bit of a heathen. I have always loved books, I know that much. This is not to say that I found the exhibition without value. On the contrary, it was very educational to look upon a large collection of Man Ray's works all together and in the context of the descriptive text that accompanied sections of the exhibition. I enjoy the slightly rarefied atmosphere of the gallery too, we are very fortunate to have such a large collection of wonderful artwork available to the public. I almost always come away inspired.

Saturday, September 25, 2004

Opacity of the Gallery

Oh..and I went to the Art Gallery yesterday and took in the Man Ray Exhibition (The Impressionists had a queue 1 1/2 hours long) - Meg's Link Opacity Rollover trick works well with the thumbnail I see. Clever lassie that Meg.

Friday, September 24, 2004

Skyline with Elephant Cloud

I almost forgot, I put this together for Stu who has started a Skyline View meme on his site. This is basically the view we see (seasonal and weather variations notwithstanding) looking east from our balcony. We're pretty fortunate really. You can see the larger version here

Skyline View with Elephant Cloud
And just to show it's not just tree-tops that we get to see, here is a panorama of the view of the local farmland that one can see if they travel up the main road from our place a kilometer or so...
Skyline View of Local Framland
The larger version of this image can be seen here
You can all the skylines submitted to the Skyline thingy so far together in this Skyline Project Viewer - thing to facilitate your scene perusal pleasure! Get down!, get up again! go sideways....huh?

The Wheelchair with the Dud Wheels....

I was in triage yesterday, and one of our clerks came in from the ambulance bay telling me a woman was very concerned as her husband was "in trouble" and needed helping out of his car. The car was in the car park across the road (not at the patient pick-up point where I thought it was) Legally we are not covered if we go off the hospital grounds to attend a patient, but what are you meant to do, let him (potentially) die while he waits for an ambulance? I said "stuff it" grabbed a wheelchair and crossed the road to help the guy out of his car, he was pale sweaty and having chest pain. I wheeled him back to the department, straight into the monitored "chest pain" area so we could assess him and start treatment if needed. He was OK luckily. I thought I might arrest though, after pushing a 90kg guy in a wheelchair with under-inflated wheels a hundred meters and then up the steep incline to our department! (Why do you always get the dud wheelchair?)
This was actually posted as a comment to a new blog I discovered the other day called I-Tach, courtesy of Mike, the blog's owner visiting this site and leaving a message on a previous post (Noise). Check out Mike's site, it's a good'n!

Wednesday, September 22, 2004

Of Stu and Telescopes...

Just quickly, because I have to go to work... Stu kindly visited with a belated bloggerversary greeting (thanks Stu) and asked about advice on buying a new telescope for a starting out backyard astronomer. Well Stu, i found this good advice here:
So You Wanna Buy a Telescope... Advice for Beginners
If you have any further questions, I will be glad to answer them, just let me know...but for now I have to run off...

Tuesday, August 10, 2004

Noise

The noise in a busy Emergency department is hard to describe ~ for example, the sound of an autistic child (who had fallen and hit his head on some slate tiles, and was in for observation) alternately screaming at the top of his lungs or laughing, depending on his mood (which changed rapidly depending on the stimulus)...now ~ beneath that noise you hear people vomiting (loudly or quietly, you can get loud vomiters, or "retchers" as I think of them, and quiet ones, we often get the loud ones). Then there are the people moaning with pain counterpointed by the suicide attempts or O.Ders crying because they feel so miserable and the drunks and psychotics yelling abuse and/or flipping out in various vocal ways. Blending in with these noises is the continual hum and chatter of doctors and nurses talking to patients and relatives interspersed at random by the intercom system bleeping! loudly to get attention followed by a sometimes audible announcement (often to ask some twat to move their vehicle out of the ambulance bay) Today for extra noise we also had a plumber working on one of the sinks in my area with a few clangs and clatters of his tools and fittings...
OK...I suppose the noise in a busy emergency system isn't that hard to describe after all....
Oh, and I think it might have actually missed this blogs first birthday, being the terribly neglectful parent-of-the-blog that I have been lately...checking...Yes, I missed it! It was ONE YEAR OLD on the first of this month! Well there you go, break out the bubbly party-hats and streamers for a belated party...c'mon....let's make some NOISE!!!
p.s. Drop Cap idea borrowed from Meg at Mandarin Design, because...well she always has these great ideas! Thanks Meg!