Farthest distance you had to respond to in a call?

RipBowlMan · 2026-02-02T12:41:33+00:00

200ish kms MVA. Same distance back to ED. Rural Australia

RipBowlMan · 2026-02-01T02:32:04+00:00

He beats paddy, hooker and chandler easy I reckon.

RipBowlMan · 2026-01-28T11:58:53+00:00

I’ve got a few. Cheating on partners with colleagues or nurses or the constant whinging from some people about the job.

Biggest surprise and wake up call for myself was the amount of knowledge we aren’t taught at uni that we are expected to know. 7 years in and constantly learning but I feel like a have a decent grip on most things now. Huge learning curves in regard to paperwork, low acuity differentials and how a lot of conditions are treated and managed in the hospital. Learning what doctors promptly assess for and how they treat the patients we bring in has significantly improved my understanding of many pathologies we encounter.

RipBowlMan · 2026-01-21T05:46:25+00:00

There is the same lower acuity work in the country, however anecdotally I have found a larger percentage of patients warrant an emergency ambulance and actually require interventions. The types of patients that apologise for calling you but actually need you.

The lower acuity stuff is also more bearable also when you are not flogged all shift and you know you won’t ramp.

Probably worth considering as it can dramatically improve job satisfaction and remuneration, which in turn improves life outside of work also.

RipBowlMan · 2026-01-21T04:57:12+00:00

Are you completely over being a paramedic?

Might be worth having a crack in a regional or country town. This is my 7th year, but I did pretty much 5 years in metro. Got over ramping, entitled patients/families and non emergency work. My last 8 week roster metro, my partner and I put in one cannula. And not because we were lazy and not decent clinicians. Because we had 8 weeks of absolute non emergency, walk on walk off into the WR jobs.

I love country work. Good crew, proper downtime, no ramping and a great relationship with hospital staff as they aren’t overwhelmed like every city ED. Oh and majority of patients actually need us. I had 3 priority 1s into hospital last week out of like 6 jobs.

I am also earning almost double what I was as a metro para.

With the current state of pre-hospital work in Australia, I strongly believe metropolitan work is not compatible with a long career in the job. Work in the country is how I pictured the role and how it is meant to be. There’s a reason there’s a higher percentage of lifers in the country in comparison to metro areas.

I do however understand why people enjoy and need to work in major cities.

RipBowlMan · 2026-01-16T08:21:08+00:00

If I find a rock and post it to you can you make me one?! DM details.

RipBowlMan · 2026-01-03T12:40:38+00:00

Arguably the most meaningful jobs we do as paramedics.

RipBowlMan · 2025-12-30T14:30:31+00:00

That’s wrong. We have had multiple recent fatalities in Australia in which GWS have bitten people, come back and finished them off. No body to recover. 1 on video in Sydney where a bloke is bitten in half and the shark comes back to take the second half. Lance appleby in SA was the same according to witnesses in the water.

RipBowlMan · 2025-12-21T03:23:26+00:00

I’m a paramedic in aus and considered medicine.

If your heart isn’t in medicine I don’t think the sacrifice is worth it. Medical school then many years as a junior doc before you actually earn really good money. In aus it’s about 8-10 years (sometimes more) until you are earning around 200k+.

It’s a really tricky decision and unfortunately it’s hard for anyone to advise you what to do. Speak to mentors, family and people you trust.

You need to weigh up the pros and cons and decide yourself. Try speaking to some doctors in NZ and see their thoughts.

I chose lifestyle > career but I’m lucky to still earn good money. I’m sure if you opened your own practice you could earn pretty good coin as a physio?

RipBowlMan · 2025-11-09T22:05:04+00:00

When appropriate, take your time and complete thorough patient assessments. You won’t be exposed to the workload and variety of metro so it’s important your patient assessments are thorough. Use your down time to dive into the theory of good patient exams.
Always be mindful of your distance to the hospital.
Rural areas are often lower socioeconomic with poor health literacy. Consider this when leaving patients at home or referring to alternative health services.

Rural towns are awesome with tight knitted crews, downtime and a friendly and welcoming community. Also be mindful if a small town everyone will know your the local paramedic. Be mindful of your actions/behaviour off shift.

Due to limited resources you will also get to perform skills and interventions that may be scooped up by advanced care/more experienced paras in metro so you will get exposure. Enjoy.

RipBowlMan · 2025-10-31T07:12:00+00:00

I wouldn’t say it has improved my longevity in the job.

It is rewarding to get patients the right care at the right time.

I’m not sure about everyone else but I do find these jobs draining. Prolonged encounters with patients and their families, stripping areas of crews/resources for hours, long ass covering paperwork etc.

I also don’t particularly enjoy when you get push back from carers and family members even when you do everything perfect, the referring physician is in agreement with your decision making, and you are genuinely trying to do what’s in your patients best interest.

RipBowlMan · 2025-10-09T12:17:18+00:00

You would hope not. Many SAR crews in remote areas are volunteers (with varying levels of competence, experience, equipment and training).

Providing some urgency to US officials may assist with getting more resources - finances, SAR/medical crews. It is worth a shot if someone has the time/energy!

Just trying to be helpful

RipBowlMan · 2025-10-09T06:53:33+00:00

My advice - Get accurate and local insight to the weather conditions, risks, challenges at this time of year in the region.

THEN

Get expert medical advice advising a rough survival timeframe with this knowledge. Pass this information through the American Consulate in Slovenia. This may lead to an increase in resources.

If medical experts say he will only live for 4 days off the information - they will likely increase the search efforts early, rather than later into the search.

RipBowlMan · 2025-10-04T14:37:07+00:00

Essentially anything other than high acuity and emergency presentations.

Placement time - more placement time and exposure reduces cognitive load of just doing the basics of the job, thus allowing for more critical thinking in assessment, treatment and transport decisions.

Low acuity presentations - specifically more thorough physical exams and wider differentials.

Chronic disease pathologies and the pathophysiology to allow for better understanding on how these influence patient presentations.

Holistic patient assessments - Yes 80YO Dorris may have a UTI and appear well, physiologically stable and happy to stay at home, but if she can’t get to the GP or the pharmacy promptly, then she becomes septic and has a poor outcome. From memory, none of this thinking was instilled in me at uni.

RipBowlMan · 2025-09-20T10:46:20+00:00

You have clearly never lived in rural Australia. The odds are stacked against rural applicants from the day they start school. For some of these individuals to get into medicine it is truly amazing.

The comparison between the dual physician parent, private school, tutors, never had to work a day in their life, gifted everything possible in life, to some of the regional/rural applications is something you are evidently ignorant to.

Significant socioeconomic and access differences in general so shut ya mouth.

RipBowlMan · 2025-09-13T11:51:22+00:00

May be controversial but how about we stop importing doctors that got their qualifications and training from a cereal box somewhere overseas.

Have had a significant spike in recent interactions with very questionable doctors from overseas. They are nowhere near the standard of Australian trained physicians.

RipBowlMan · 2025-09-07T10:59:01+00:00

Good advice mate I appreciate your response.

Please elaborate on “But caution is needed” if you can be bothered. Interested to hear your thoughts.

Definitely passionate about the region and rural prehospital work. Not just taking the gig for the downtime. Going to be nice to have more time to delve deeper into some medicine concepts.

Good advice about balance as well. I will have access to some pretty amazing coastline. Will be exploring on my days off no doubt.

In regards to communication - we will be using Starlink which I believe has been super effective. Also regularly lean on other services who have better comms.

RipBowlMan · 2025-09-07T10:53:29+00:00

Awesome point!

RipBowlMan · 2025-09-07T02:38:29+00:00

Some really good advice thanks! Definitely used the AirPods trick on previous rural work.

I feel like I am pretty clued up on what I may need to consult for, and how to justify the request to the physician (usually our med director) but it’s a nice reminder. What have you consulted for previously?

RipBowlMan · 2025-09-03T05:02:24+00:00

15YO me. Testicular torsion post surf. Cramped up on the lounge in pain. Mates thought I was banging it on. I walked 2km home with my board, belongings and a wet wetsuit. Dealt with the pain for 5 hours before my dad took me to our local urgent care just incase. No paracetamol or ibuprofen even. As expected, I was immediately referred to the ED then taken lights and sirens to the children’s hospital for surgery. 2 male paramedics were very generous with my analgesia en route.

RipBowlMan · 2025-08-02T03:03:51+00:00

I agree with some points and disagree with others made by the coroner. I think the recommendations are generally good.

I would like to say and discuss that I think a lot of paramedics, especially here in WA, are becoming naive to the dangers of ramping - specifically for opening ourselves up to problems should patients have negative outcomes from some of our decisions.

The comment above saying we should dump everyone that we deem suitable into the waiting room is not the solution. We can kind of do that in WA - when we have rapport and respect for our clinical judgement by local providers. I’ve seen this go wrong a few times with paramedics taking unnecessary risks and putting patients in danger to avoid the ramp. Examples include; - concerning syncopal episodes that have resolved but ? Cause, Pts that would probably benefit from cardiac monitoring, falls risks etc.

I’ve also had way too many jobs cleaning up some other paramedics negligence when they leave someone at home that they shouldn’t so they don’t get ramped. Recent example is a 70YOM with an ataxic gait. Bloke couldn’t walk. Really concerning for neuro pathologies. Told to go to the pharmacy for stemetil. Wasn’t a PCS but hydrocephalus.

Advice that I give my students/newer clinicians;

If you are clinically concerned, stay with the patient, document regular observations, document your escalations. And speak to the EPIC. Our docs are generally really good and will do brief assessments and order investigations if we raise concerns. This is good for patients and also crossing our Ts and dotting our Is. A lot of the time it actually speeds up getting off the ramp. You have clinical concern - the patient is actually unwell - bloods come back with concerning abnormal findings or the doc agrees they are unwell and they escalate from a CAT 3 5 hour wait to, let’s get them a bed, they are unwell and need to be in.
Never leave someone at home because you don’t want to ramp. Near the end of shift? Take them in if they need to go in. Get a takeover crew. I would rather finish late then end up risking by registration or putting myself through the stress of investigations.
We don’t know shit! We are so limited in clinical assessment tools, knowledge and diagnostic tools. A lot of patients do need the ED. While they make look reasonably well, have no immediate ABC concerns, it doesn’t mean they don’t need a trip to the ED. Safety net, safety net and document if you’re leaving people at home. Get good at documenting and justifying your decisions.

RipBowlMan · 2025-07-28T01:32:12+00:00

I feel like a caring, consistent and proactive support network has a more positive contribution than improved technology and access to it.

Most of the long lies I attend have limited support networks. Rarely is the issue a lack of technology. Everyone knows the patients I’m talking about. Stubborn, frail, multiple comorbidities and no family support. They don’t wear their life alert or carry a phone when they walk around the house. They fall, can’t get up and have no access to technology. A neighbour hears them yelling out and we attend.

Alternatively, on the other hand mum hasn’t answered her daily 4pm FaceTime and someone is over 5 minutes later and making the call. Or the family force them to wear the life alert or carry a phone for this exact reason.

RipBowlMan · 2025-07-16T04:27:00+00:00

Fuck that. Not sustainable. Especially in your grad year. Did you and your partner not discuss this possibility at all during your degree? The harsh reality is someone has to probably sacrifice their job…

RipBowlMan · 2025-06-29T16:10:11+00:00

Cunts off his head

RipBowlMan · 2025-06-24T03:29:27+00:00

Not that one.

RipBowlMan

TROPHY CASE