Alexander Matkin

Registered Paramedic MACPara, GMACPP, Educator, Passion for Event Healthcare, Trauma and Advancing Paramedic Practice.

[Alexander Matkin @AlexanderMatkin]

@DCollingsHughes Privatised systems see collaboration as competitive. Lots of resources could be utilised for the greater health delivery with centralised coordination.
Governance isn’t as big of an issue as it’s made out.

[Dr Aidan Baron @Aidan_Baron]

- It’s not the citrate -

Hypocalcaemia Upon Arrival to ED in Major Trauma Patients varies little between those who do and don’t get prehospital blood

Challenging Dogma

Honoured to work with my mate Dr Tim Rushton + @HawkmoonHEMS & David Tian on this

https://t.co/a0OOoiIlSn

[Alexander Matkin @AlexanderMatkin]

@Aidan_Baron I’ll keep FFP, calcium gluconate and TXA on my trauma Wishlist then.

Keen on seeing future prehospital RCTs on this.

[Alexander Matkin @AlexanderMatkin]

@jdhibb @Aidan_Baron I fear teaching vent only to this cohort will see continuous ventilations after arrest has occurred. Which may look the same in a very peri OD patient. The same with naloxone, waiting for effect not realising it’s been almost 10 minutes of no ventilations.

[Alexander Matkin @AlexanderMatkin]

@jdhibb @Aidan_Baron This is what I was thinking.
For a non ALS First responder, BVM will be a part of CPR anyway treating the hypoxia (albeit slower).Once ALS on scene conversion to vent only and titrated/aggressive naloxone can occur.

[Alexander Matkin @AlexanderMatkin]

@mhnparamedic Local/internal teaching due to giving TXA over 10 minutes. They teach that until it’s finished you can’t push anything else in that line. I believe it was infusion oriented. Small pushes every few minutes with a flush probably fine to give analgesia/antiemetic in between.

[Alexander Matkin @AlexanderMatkin]

@mhnparamedic Yea it’s creating lots of discussion. I haven’t thought about the securing property side of it.
AEA have provided their take on managing the changes to response but not specifically entry/securing. Might be worth discussing for clarification for sure.

[Alexander Matkin @AlexanderMatkin]

@samteachernsw Outside of the initial trial, PAs were really only employed in Queensland as the health department made changes to allow them to prescribe/order imaging/pathology under supervision of a Doctor, a single health service was the biggest hirer for limited roles.

[Alexander Matkin @AlexanderMatkin]

@samteachernsw Aus used to have a PA course but has been discontinued.
Our PAs were already health professionals before PA degree. They followed US model with supervision arrangements.

Some minor procedures can be performed by Nurses/PAs in some places but definitely not neurosurgery alone.

[Alexander Matkin @AlexanderMatkin]

@Jo_McGinn @clmac1996 @mmamas1973 I suspect that this morph is what is causing so much stir currently.

In Aus we trialed it with success but didn’t take off. Followed US PA curriculum, 2 year degree. had to be a experienced health professional first. Was used like a Junior doctor but found helpful.

[Alexander Matkin @AlexanderMatkin]

@wwso251 @_JaceMullen Hold onto your socks. We turn them up to 15LPM for preox and passive ox. Also have ran NP and mask turned up for BIPAP effect.

[Alexander Matkin @AlexanderMatkin]

@Arron_Pearce_ Humble Paramedic treatment.
Cardioversion for poor perfusing rhythm, reassess ECG post for underlying rhythm (STEMI/AF/block etc), Amiodarone if not completely reverted/stable. To a cardiologist.

Electrolytes could be interesting but don’t have Magnesium/potassium to mx anyway

[Alexander Matkin @AlexanderMatkin]

Showing our value beyond a taxi with first aid will help to professionalise modern Paramedicine to the wider health system, to government and to communities.

This will help with funding, collaboration and expanding our footprint into other roles.

[Alexander Matkin @AlexanderMatkin]

I don’t prescribe to the “Ambulances are only for emergencies/Paramedics only do emergency care” culture.

Modern Paramedicine should focus more on Community out of hospital healthcare.

🧵/rant

[Alexander Matkin @AlexanderMatkin]

To me, modern Paramedics should triage, assess, initiate treatment and refer/transport to the most appropriate service for people in the community.

If we can do this well we can do our part to reduce system pressures.