Paramedic

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Kathryn Eastwood is a friendly, caring 28-year-old, but most people would hope to never have cause to meet her... at least not when she’s at work. As a trainee paramedic with one of Melbourne’s elite Mobile Intensive Care Ambulance (MICA) units, Kathryn usually only enters people’s lives when something terrible has happened to them. A normal day in Kathryn’s life is often the worst in many of her patients’ lives.

8am: As most of us are rising to prepare for the day ahead, Kathryn is sleeping. Today will be the first of her two consecutive night shifts, so she needs all the sleep she can get before it’s time to start work at 5pm. Kathryn’s regular roster entails two 10-hour day shifts, two 14-hour night shifts, and then four days off. “It’s a good roster because you have a few days off every week to relax or go on little getaways, but it’s hard to get your body into a rhythm,” she says.

Kathryn has been a paramedic for almost six years. On the days she has off or is working night shift, she will some-times lecture students studying for the Diploma of Ambulance Paramedic Studies or the Bachelor of Emergency Health at Monash University. “I love teaching. It keeps me on my toes and up to date. Most people who go into this field are very passionate about it so that makes it rewarding,” she says.

12 noon: Kathryn gets up and takes her two dogs, Milly and Sam, for a walk. Her boyfriend Steve, who is a MICA flight paramedic with Air Ambulance Victoria, will usually come along – the couple tries to work similar rosters. Kathryn might also use the afternoon to do some study for her MICA paramedic course. She began the extra 18 months of training in 2004, and will qualify in April. The course has taken her beyond the high skill level required of all paramedics to include greater detail in anatomy, physiology and pharmacology, enabling her to make more clinical decisions without consulting a doctor. “The first hour in a life-threatening situation is critical for the survival of the patient, and the more we can do on the ground, the better chance they have when they get to hospital,” she explains.

4pm: It’s time to get ready for work so Kathryn has a shower, feeds the dogs and heads out the door. She tries to get to the base in Hampton Park 15 minutes early, so if a job comes in just before shift change, her team can take over and allow the day shift team to go home on time.

4.45pm: Kathryn arrives at work, leaves her bag and jacket in her locker then heads to the staff kitchen, where she and her partner and trainer, Mick Azzopardi, will meet with the day shift team for a handover. “We might discuss the day’s cases, but usually we go over any particular things we need to know about, like equipment that needs maintenance,” explains Kathryn.

5pm: Kathryn and Mick head out to the ambulance, to check that all the medical supplies and equipment are in place and working properly. “The team coming off shift is responsible for replacing whatever they’ve used, but the crew coming on has to double-check that they have everything they need,” explains 38-year-old Mick, who has been a paramedic for 15 years.

5.10pm: Kathryn and Mick return to the station house to begin their 14-hour vigil, waiting for emergency calls to come in from Emergency Communications Victoria (ECV). The two-way radio buzzes constantly with activity from the ambulance service’s 123 teams, which handle about 800 calls a day across an area 9,000km sq. As one of 16 MICA teams in the service, Kathryn and Mick will usually only be called out for life-threatening or tricky situations. “We’re called out for all sorts of things, but mostly for cardiac arrests, bad road accidents or severe breathing problems,” says Kathryn.

5.30pm: If there are no calls coming in, there are a number of ways in which Kathryn and Mick can spend their waiting time. The station contains a small office with a couple of computers, a kitchen, a living room (complete with TV and DVD player), and even two bedrooms. “Some nights we can wait hours for a call to come in, while others are all go,” says Kathryn, who will often use the down-time to undertake training activities for her course. “We might do a drill with a manikin or go over some scenarios. There’s a lot to learn so it never gets boring.”

5.40pm: There’s no need for Kathryn and Mick to look for things to occupy their time tonight as the alarm sounds 40 minutes into their shift and they’re called to help a woman suffering from chest pain and shortness of breath. The voice on the other end of the radio tells them it’s a ‘code one’, which means the situation is critical and they’ll need to use their lights and siren to get there as quickly as possible.

It’s Mick’s turn to drive the ambulance, so Kathryn jumps into the passenger seat and takes charge of radio communication and navigation (a well-worn street directory). “You have to know your way around, that’s for sure,” she laughs. “It can be really difficult sometimes, especially at night and if there are road works that we haven’t been told about.” Mick is soon driving well over the speed limit (emergency services vehicles are the only vehicles permitted to do so), but negotiates each intersection with professional caution. “We do an advanced driving course as part of the training, but you just get to know what the vehicle is capable of... You can’t take stupid risks because you’d be no good to anyone if you crashed on your way to a job,” he says. Both Mick and Kathryn say their biggest frustration is other drivers who won’t get out of the way. “Most people are good, but some panic and others are just arrogant and keep going, which is upsetting because every second counts when we’re trying to save someone’s life,” says Mick.

5.50pm: Kathryn and Mick arrive at the scene, which turns out to be a small hospital that has no emergency department. One of their patients is having a heart attack and needs to be transported to a hospital with a cardiac trauma unit. “They called us because we can get there quickly and intervene with pain medication,” explains Kathryn.

The pair immediately swing into action; Kathryn takes the patient’s hand and begins to talk to her, while Mick prepares the pain medication. “I always ask the patient if they know what’s happening, because they deserve to be kept in the loop,” says Kathryn. “The selection process for paramedics includes quite a lot of personality testing, and you have to be the kind of person who can take control and keep your head.” Kathryn and Mick give their patient medication to thin her blood, relieve her pain and combat her nausea. They then carefully manoeuvre her into the back of the ambulance. As they do so, Kathryn is on the radio notifying the nearest hospital that they’re on their way.

7pm: Kathryn and Mick leave their patient in good hands at the hospital and are called out to attend to another two patients with chest pain. Once they arrive at each scene, however, both cases turn out not to be heart attacks and so can be managed by one of the service’s non-MICA road crews.

If you need an ambulance:

Dial 000 (111 in New Zealand).
Ask for an ambulance.
Be prepared to give the operator the following information:
- Exact location of the emergency?
- Call-back phone number?
-What is the problem? What exactly happened?
- How many people are hurt?
- How old is the person?
- Is the person conscious?
- Is the person breathing?
Do not hang up. Follow the instructions given by the ambulance service as the ambulance responds. This will help the patient and the ambulance paramedics.

For more information go to:

VIC – www.ambulance.vic.gov.au
NSW – www.asnsw.health.nsw.gov.au
QLD – www.ambulance.qld.gov.au
WA – www.ambulance.net.au
SA – www.saambulance.com.au
TAS – www.stjohn.org.au/tas/
NT – www.stjohnnt.com.au
ACT – www.ambulance.act.gov.au
NZ – www.stjohn.org.nz