Medical Jellybeans with @TheTopEnd

Jellybeans. Conversations with Care. The Jellybeans started here and are now also hosted on lifeinthefastlane.com (The Original) & www.IntensiveCareNetwork.com This is the complete collection. Sometimes containing more controversial offerings.

Jellybean 83; Pre-Hospital Medicine Slovenian Style with @GregorProsen

 
ED people doing house visits?
Medical retrieval teams having a cup of tea and taking a detailed social history?
Emergency doctors going to someone’s home before they come to the ED and recommending treatment at home?
Including End of Life treatment?
Sound Crazy?
Ever been to Maribor? Slovenia?
I spoke with Slovenian Emergency Physician and Pre-Hospital Gregor Prosen at dasSMACC. He talks like an emergency physician. He curses like an emergency physician. Gregor just exudes a type of ultra-competent critical care cool. He can do some fantastic shit and he does do it. He also goes on home visits. He gets in a car or 4wd and heads out into the country to see little old ladies, big old men, kids and strudel-makers. That part represents fantastic shit too. Listen to Gregor talk you through pre-hospital medicine in Maribor.
 
So here I am in Australia, in the western emergency medicine workforce. We are struggling with this and that. We are struggling with end of life care. We are struggling with the filter, or lack of a filter, between primary care and the so-called critical care service that emergency personality types all signed up for. We wanted to be intubating vomiting people, with no blood pressure, while upside down in a straitjacket and wrapped in chains and underwater. In a crater lake. Over an active volcano. Using an expensive machine. Any expensive machine really. That’s what we call rewarding. It’s just not fair. Whinge. Whinge.
 
So you go and try a bit of retrieval medicine. It looks very cool. Especially in the promo videos. (To quote Alex Psirides; “Helicopters!!!”) However, when you are getting around in one of those helicopters, or some other platform, there is a certain pressure on your use of that platform. How many times have aeromedical retrieval teams gotten out to the “scene” and decided to NOT bring that patient back to the hospital? Maybe that’s the best thing to do? And if it is the best thing to do then will your service get paid as much? Will your service get paid at all? How much does it cost to run an aeromedical retrieval helicopter anyway? (Clue; shit-loads.)
 
So at the end of the day it’s hard to use your judgement for some of the most important decisions. It’s hard not to get into the “You Call we Haul” trap. We even use “Time on Scene” as a KPI.
 
The pilot, the crew, the co-ordinator and even the helicopter itself seems to want you to get back to base ASAP. It might be whirring overhead or if it has landed just sits there and bristles. I do love these impressive women and men. I love working with them. I love flying around over Australia.
 
Slovenia clearly has a different history, different culture, different healthcare system, but maybe it has some seriously useful different perspectives.
 
Gregor Prosen is pretty bloody cool. He does cool stuff. He has a cool job and some of that cool stuff is done really very differently. Let’s learn.
 
I like FOAMed. I like it a lot. I would really like it to continue to facilitate knowledge transfer. We can learn something from the Slovenians. We can learn from the South Africans and Ugandans. We can learn something from the New Yorkers. It is not a one-way street.
 
Long live FOAMed. Long live non-english speaking FOAMed. Long live FOAMed from everywhere for everyone.
 
Long live the legendary Slovenian accordion player Bratko Bibič and thanks to him for the wonderful tune “Na Domačem Vrtu” or ”In the family garden” from the eponymous album by Bratko Bibič & the Madleys. I liked that title given Gregors story. You can find Bratko Bibič on iTunes but if you find it in on vinyl it would be more impressive.
 
If Slovenian or Serbian music is your thing check out Gregors friend and colleague; Sara Nikolić
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This entry was posted on November 13, 2017 by in Uncategorized.

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A rather different sort of trip today. @mpplunge
#hammockcamping where #hammocks don’t make sense. I’m always out on the trail with my #hammock but I’m often out there with people that sleep on the ground or in a hut. Funnily enough that’s not always the easiest place to find a good #hang ... maybe I’m hanging out with the wrong people? #frenchmanscap #tasmania #australia #incessantrain #underquilt @hammockgear & @dutchwaregear
New Post on the website. #hammockcamping with people who do not do #hammocks It’s a complex matter!
Sleeping up at about 1000 metres on the side of #FrenchmansCap in #Tasmania in the #rain and #cloud and in my #dutchware #hammock under my old @hammockgear #tarp at #Tahune outside the very nice new #TahuneHut Everyone was stuck in the hut, except the idiot in a hammock! That was me! I wanted to see how much rain and wind I could manage and I was beside the hut if it failed. I don’t know how much rain fell but my @hennessyhammock water collector caught 2000 mls in 6 hours and that was collecting from the highpoint of the #caternary cut on one side. It was around freezing and the rain and spray was actually going upwards as the wind funnelled up the valley below #LakeTahune There is one reasonable hammock spot on a tent platform outside the amazing new hut. The trees are small so you really get bounced around when the winds hit #galeforce but I stayed dry and warm. In four days I never saw the #Cap despite taking a very wet walk up to the #summit the day after the worst weather. Despite it all this has to be close to the #mostbeautifulplaceonearth even in the #incessantrain It was so dark I had to put the camera down for a 1/30 second exposure and it blew over twice.
Walked up #FrenchmansCap in #Tasmania in the #rain and #cloud and slept in my #hammock at #Tahune outside the very nice new #TahuneHut in four days I never saw the #Cap despite taking a very wet walk up to the #summit This has to be close to the #mostbeautifulplaceonearth even in the #incessantrain
#rooftop #urban #hammockcamping in #Melbourne This time we see a bit of #classy @hammockgear action with my old #cuben 4D4S tarp just about squeezing into a wee space and my new 0 degree econ #underquilt Off to #frenchmanscap in #Tasmania with this set up next week. It will rain and rain and rain!
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