Sir, I am a Paramedic!

Written for Jin Zhanhe

Even though I have ORD almost two years ago, it seems like my medic skills are still being put to good use.

Last month I attended a workshop. During one of the sessions there were bright flashing lights and loud music. Suddenly one of the participants collapsed. She was immediately surrounded by the trainer and several facilitators. They were crowding around her and did not seem to know what to do.

I could not stand it any longer. So I walked to the other of the room quickly and started what we medics do best: PAM (Patient Assessment Model). The trainer looked at me and said, ‘Are you medically trained.’ I said, ‘Sir, I am a Paramedic.’ ‘Oh you are EMT…’ (On hindsight EMT seems to be a more appropriate title for the level of training I have, but this is Singapore.)

The patient was a female in her thirties, and she was found lying on the ground clutching her chest. Patient responded to pain when inflicted via trapezius squeeze (P on AVPU). There was no distortions or disability in her neck, though she could not sit up without assistance. After a few minutes two more participants came to help out. One was an old staff nurse and another was NS Medic too. Yay, backup!

She was breathing slowly, and could respond to my questions in a rather weak and slow voice. Radial pulse was hard to feel. Capillary refill on her fingers was prolonged. She couldn’t feel sensation when I pressed onto her nails. She was a lady, so I didn’t bother with the Rapid Body Survey. Her skin was pale, cool and clammy. She was still able to respond to my questions at the point of time. Pulse at the ankles could barely be felt.

Her complaints were chest pain, and ringing in the ears. She said that she does not have medical history of heart disease, so I decided to rule out chest pain of cardiac origin. She was not taking any medication either. She said that she had similar fainting spell a few months ago, by the roadside. I didn’t check about the cause back then. There were bright lights and loud sounds, coupled with emotional stress, so that could have possibly been the trigger. In this case the underlying cause was quickly identified: she had not slept the night before. I concluded that she fainted due to physical exhaustion.

By this time we were able to make her sit up with the assistance of the other two participants, and she was able to take small sips of water. She was able to stand up with the help of the facilitators, who took her to a separate room for a short rest. Fortunately she was all right for the next few hours of the workshop.

Phew! Not too bad, but among the things I can improve one are:

1) I forgot to check for allergies.
2) I totally didn’t know that the ringing in the ears is a symptom of Vasovagal Syncope (According to Wikipedia it is). Vasovagal Syncope should have been the more accurate diagnosis. Hey I didn’t learn this at SMTI!
3) I had no idea on the most comfortable position for this kind of patient, since she was not unconscious we did not put her into the recovery position.

Okay, this case didn’t seem very life threatening so I shan’t gloat with the customary ‘One life saved!’

Yesterday there was another opportunity for some action. I was on the NEL on the way home, when there was this schoolboy sitting opposite who had a nosebleed. So I went to sit next to him to see if he was all right. Oh interesting, he was a Sec 1 Marist.

I didn’t do much. Just advised him to pinch the bridge of his nose and lean forward. Gave him my packet of tissue paper and a plastic bag to store the soiled ones. I asked if it has happened before, and yes, he said that it happened often. I advised him to see a doctor. There were some considerate passengers who offered wet tissues. It was at Hougang when I noticed him, but the bleeding stopped when we arrived at Punggol.

Marists can take care of themselves so I didn’t accompany him out. Still, it’s on days  like these that I am thankful for being a medic.

For your reading pleasure:

Wikipedia: Vasovagal Syncope
Wikipedia: Nosebleed

To Taiwan and Back: Part 3

Finally, we arrived at our long awaited destination. Taipei.

We were put up at various hotels. I was placed in a different hotel than from my unit guys. How disconcerting. The only people in my hotel are the medics, drivers and cooks. There were two of my clerks there too, and I shared a room with Jing Wei, one of the signallers from 41 SAR who incidentally followed our BCS team for ATEC.

On the first night, I did not venture far from the hotel, merely walking and exploring the neighbourhood. I was also trying to get some decent maps to navigate around with. The trip was quite long as well, and I was quite tired. I just bought some beef noodles from a shop around the corner and ate in my hotel room. On hindsight, I should have went out to see the nightlife. This was the only regret of my trip. Okay, enough lamenting.

The next day we got up pretty early and had breakfast at some restaurant. Most of the catered meals were at some local restaurants serving rice and various dishes such as vegetables and meat. Not very fantastic, but considering that everything is paid by for the army we cannot be choosy.

After breakfast we headed towards Yangmingshan National Park (陽明山國家公園). Basically there is nothing there but mountains and more mountains.

From right to left: Me, Jing Wei the signaller, Gan Kai Xian the ops clerk, Wee Liang the ops clerk, and two guys from SMI.

Road that leads deeper into the mountains.

Visitors’ Centre

Hands off the exhibits!

Flower Gardens

Some local Scouts having a day out

This so-called garden is actually quite big. It is a reputed hotspot for hiking and long walks. This road goes down..

and down..

and down all the way! So much so that we decided not to follow that path because was really steep and too far.

We headed back to the city for lunch, and had free and easy time for the rest of the day after 1 pm.

Okay, Yangmingshan bores me. Next stop, Ximenting!

To Taiwan and Back: Part 2

The best part of any overseas training is the R&R. We had our R&R in Taipei. On the last Friday we had reveille at 4 am. The buses left Hengchun camp at 4 am. It would be a long trip towards Taipei. There were numerous rest stops in between where we could purchase food. I bought some preserved quail eggs or iron/metal eggs (鐵蛋).I tried them before, so I was keen on purchasing a few packets home.

It was really a long ride. We entertained ourselves with the on-board movies. They screened Cape No. 7 (海角七號), which is supposed to be a best seller at the Taiwanese cinemas.

We stopped at LeoFu Village (六福村)which is supposed to be a Taiwanese Disneyland of some sorts. I had little interest in rides, and went off to the zoo to see the animals instead.

Leos of LeoFu

This is claimed to be the only white tiger in the whole of Taiwan. I wonder if it has mauled anyone yet. Ours has already beat this one!

Pink Flamingoes

Oh my God! Hippos! What could be better than hippos? Hippos are the best!

Rhinos at Rest

In the central area of LeoFu Village. Notice the marble hippos in the water.

We left LeoFu Village at 4 pm. We would only reach the hotel in Taipei at 7 pm.

Akan Datang: Part 3

To Taiwan and Back: Part 1

I was in Taiwan for three weeks of training. It was quite exciting to be deployed overseas for the first time. So yes, I will share what I have seen there.

Pre-trip preparation

On 24 October I went down to attend the pre-exercise briefing. What a waste of time. I was half-asleep, until the medical briefing.

Officer: Okay, the MO is not coming. The Senior Medic is not coming either because his wife has gastric. Where is the medic? Raise your hands! Come out and give the talk!

Me: (Looking around for other medics, but no hands were raised)

Officer: Eh Medic, come out leh!

I had not choice but to come out to the stage and give the talk. I was shaking like hell. It wasn’t too bad since I knew most of the stuff. I’m just glad they didn’t ask me to teach them to use condoms.

The rest of the day were spent with duffel bag inspection and weighing.

Day One at Hengchun

Our flight departed from Terminal 3 at twelve thirty am. We arrived in Kaoshiung at six in the morning.
I was happy to see Zhanhe again. He was waiting outside the airport.

On arrival at Hengchun camp, we were allocated bunks and made to move the stores in the ops boxes. I met up with the other medics. It wasn’t as bad as I thought. Since I didn’t see any of them on Friday, I thought I was the only medic for the whole frame, which was pretty scary. In any case, Zhanhe took us for hospital orientation at Hengchun, Kaoshiung and Fangliao. Along with me were some medics from Pasir Laba Camp and Bedok Camp. I was also introduced to Zhenhao, the other base medic; and Mark the Ambulance Driver. He was from Maris Stella Primary. He said I looked familiar, but I could not recognise him.

There are three hospitals in Hengchun. The 802 Military Hospital in Kaoshiung is where the complicated cases go to. On that day, we sent one fellow with persistent food poisoning. We spent the rest of the day at the hospital, and had dinner at the canteen.

Before we set off, we bought some bubble tea. I had this one called the Pudding Milk Tea (布丁奶茶). It was really good! And so began three weeks of drinking all kinds of bubble tea.

Day Two at Hengchun: Nights’ Out at Kenting

To our utter surprise, they gave us nights’ out on the second day. The nights’ out was at Kenting (墾丁), a tourist town by the sea. There were many stalls selling street food, and shops selling swimwear and other apparel.

A street in Kenting

Various shophouses

Sushi Restaurant and KFC

And who can forget the renowned smelly tofu of Taiwan?

I didn’t eat the smelly tofu because I could not stand the smell. I just had some pig’s blood cake (豬血糕﹐,米血) which is pig’s blood cooked with rice cake. It goes well with the soup and the prawn rolls.

We spent about 2 hours there, and they sent us back to camp by ten-tonner. Yes, you read correctly, a ten-tonner. We use five-tonners and rovers, but the ROC uses ten-tonner trucks with mechanized doors and Humvees.

We had another nights’ out in the second week. During the two nights’ out I took the opportunity to stock up on food, drinks and reading material.

Life in camp

I only went to cover for a total of three times. One was navex, one was bike navex and another one was live firing. Other than that, I spent most of my time in the medical centre on duty. Sure, business was all right. We even used the Body Cooling Unit twice. It’s the first time I ever seen the drill for heat exhaustion. I let Zhanhe do the job of placing the rectal thermometer into the patient’s… well it is obvious isn’t it? There were plenty of illnesses ranging from coughs to chicken pox to STDs even. Those were laughable. The doctor was quite amused. We had plenty of people warded in the sickbay too.

There is no Medical Informatics System in the camps there, so everything is updated manually. It was great not having to deal with computers. No computers, no downtime. There isn’t much patient volume everyday, anyway.

I spent most of my free time playing PSP. I managed to complete the main story of Final Fantasy 7: Crisis Core. I still have half the side missions left.

I’m glad I had ample time to say the office and my usual prayers, though PSP was quite distracting. I will reconsider buying one.

The bunks were furnished with double-decker beds. We had foam mattresses to sleep on. It was quite stuffy. Fortunately the window was just behind me. The only thing I had to contend with was the sun shining on my face at six am. In Taiwan, the sun rises that early. It goes down as early at five pm too.

As for the showers, the shower stalls had no doors. At least there was hot water. My only gripe is that toilet paper has to be disposed in the bins instead of being flushed down. I countered that by using more water to flush it down. In any case the condition of the bunks and showers never bothered me too much, because I slept and showered in the medical centre most of the time.

Food in camp was all right. They use the local short-grained rice. The food isn’t always good, but it is still better than SFI. Sometimes I just gave up on the cookhouse and headed for the canteen or the ‘White shop’ outside. There is this white coloured shophouse outside the camp which sells food and drinks. I had the pork steak rice and chicken steak rice on more than one occasion. It wasn’t that bad.

So sorry that there are no pictures of camp life! I don’t want MSD coming to my house in the middle of the night or during my off day!

Akan Datang: Part 2