This post is dedicated to my ambulance placement at Satakunta pelastuslaitos in Pori which I loved very much. It was an amazing opportunity to work with paramedics in Finland, in fact , nurses can actually work as paramedics straight after they graduate from nursing school, they will only need extra short course to obtain whilst working in ambulance. However in the UK you have to obtain a paramedics degree in order to work as paramedic.
In this placement I managed to get an overall perspective into the working
environment in the ambulance station in Finland and recognize the similarities
and differences between Finland and United Kingdom practices. I have familiarized myself with the
environment in the ambulance station in Pori- Finland and the various roles
within the ambulance station (Ambulance staff, fire men) and knowing how many
ambulance cars in the station (Three one for transfer and two for emergencies) in
addition to one in Meri-pori and one in Ulvila ( small towns near Pori). The
one in Meri-pori joins the Pori ambulance station after 10 pm. I have learned about the working pattern. The working
shift for ambulance staff is 24 hours followed by three days off. The team is
divided into four groups that work alternately every three days (24 hours).
Each group has a manager. Each car has two members of staff- one nurse and one
fireman or sometimes two nurses. Ambulance transfer car has a practical nurse and
not a nurse.
Despite the fact that I was not be able to perform the
documentation in the ambulance car due to the language barrier, yet I was
interested to have knowledge on what is involved in the documentation process
and interviewing the patients. I have tried to learn many Finnish phrases and
works that are commonly used in the interview, which has helped me greatly in
understanding the patient condition and the reason for the call.
I have learned about many aspects of the documents and what
is required to complete inside the incident reporting form, similar to timing (documenting
when the call is made, when the team receives the job, when the team arrives at
the site of incident, when we meet the patient, when we transfer the patient,
when we hand the patient to the hospital and when the job is completed). I have
learnt about the importance of timing and recording the times in case of
investigation. I have learned also about the importance of recording any past
medical history, the description of the patient condition at arrival and the
care that is provided to the patient. Important part of the documentation is
recording any drug allergies. These are the important aspects of the documentation;
this is in addition to other aspects similar the position of patient during the
transfer.
I learned about the multidisciplinary team working in the
ambulance, working along side with firemen and liaising with the police in case
there is a need.
I have observed and learned great deal about many care pathways
for many emergency cases. How to use the ABCD approach (Airway, Breathing,
Circulation and Disability) How to preform general initial assessment, using LP
machine and taking vital signs similar to blood pressure, pulse, oxygen
saturation, blood sugar level and assess patients’ pain level. I have come across trauma cases similar to
bleeding and fractures as a result of falls or car accidents, I have learned
how to initially care for these patients and what medication to be given to
provide quick and effective pain relief. I have come across patients with breathing
difficulties or chest pain and learned how to interpret the vital signs of the
critically ill patient; suspicion of stroke and how to neurologically assess
the patient and use (GCS) Glasgow Coma Scale, I have also come across patients with
convulsions and knowing the initial pre-hospital care for them. I have practised and learned many new skills,
similar to creating IV access and prepare and administer IV fluids, administer
emergency medication intravenous and intramuscular, similar to pain killers
(Oxynest), antiemetic drugs and cardiac medications. This is in addition to
oxygen delivery and learning about different types of dressings for wounds. I
have learned about the medication kept in the ambulance car and method of their
action and what side effects they can cause.
I had a great insight into mental health first aid, dealing
with alcoholics with aggressive behaviour knowing how to use the Alco-meter, liaising
with police in case they are needed. I have observed dealing with individuals
with serious suicide thoughts, and how to approach to them.
I have learned how to use the equipment in the ambulance car
and to know what is kept inside the car. There are many bags in the car each is
designated for various tasks, similar to dressings and supplies bag, intubation
and CBAP bag, birth delivery bag, Life pack machines that measures vital signs
and analyse EKG’s. There is a bag
equipped with all the cannulas, lines and infusion sets, replantation bags, a
bag for children emergencies. I have learned also about the different fluids
and infusion in the car and when to use them (The most commonly used fluid is
Ringer). This is in addition to various equipment for transporting or
immobilizing patients and supporting them if they have fractures similar to
vacuum mattresses, spinal board, cervical collars and splints.
I have also assisted in the morning checks for the ambulance
care, checking all the supplies in the car that they are sufficient and
adequate, checking the LP machine and replace the batteries. I have learnt also
about manual and handling the ambulance car bed and safe transporting patients.
Finally, my interest in learning the Finnish language and
communicating with patients in Finnish, introducing myself in Finnish and
telling them what I’m doing during procedures, comforting and offering them
help.
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| Medication used in the car |
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| Replantation Bag |
