Emma

Emergency medicine, dressage, frailty, running and dogs in no particular order

[Emma @EmmaAtSplodge]

@L101Mike @ItsnotrightUK Overconfidence? I’m well aware of risks with HALO’s - nobody has vast experience - and we need to drill, and know where to go next in case of failure/complications. Which is my point- not true to say most Drs in EM couldn’t do or most EM Drs would do badly.

[Emma @EmmaAtSplodge]

@L101Mike @ItsnotrightUK Nature of HALO procedures - and why EM physicians drill them, are tested on them and don’t just ´think they can’ and muck them up. 3 is more than some ophthalmologists will have done as emergencies

[Emma @EmmaAtSplodge]

@L101Mike @ItsnotrightUK Really? I’ve only seen 3 - patients sight was intact afterwards in all cases so not sure I’d agree

[Emma @EmmaAtSplodge]

@L101Mike @ItsnotrightUK But pretty much every emergency physician could, definately taught, SIM’d and on exam syllabus for FCEM

[Emma @EmmaAtSplodge]

@jabberwock951 Thank you - you’ve also encapsulated the difference between a PA and a ACP (who would usually have many years as a Nurse/Paramedic to learn medicine is more complicated than the text books BEFORE starting their masters)

[Emma @EmmaAtSplodge]

@PaulReadGB We can’t adapt from rescue - our oldest lurcher has a congenital spinal abnormality identified as a young dog, he needs all the muscle bulk as possible - we have an enclosed , private field for off lead exercise so didn’t neuter. An entire in the household - automatic no

[Emma @EmmaAtSplodge]

@NatashaMDay For a head injury guideline to apply there needs to be a head injury- I’d argue that if there’s NO visible external injury and no symptoms or neurology to suggest injury the NICE guidance doesn’t apply. Harder are those with a minor graze or bruise!

[Emma @EmmaAtSplodge]

@dr_benoy_n_shah @DrNeenaJha @mmamas1973 @DrAsifQasim @doctor_oxford @ShivaniM_KC @ShrillaB @amibanerjee1 @vass_vassiliou @nolanjimradial @drphilhammond @GMCharlatan Given that to do this job the applicant must pay for GMC, professional indemnity and RCGP’s surely it’s actually BELOW minimum wage?

[Emma @EmmaAtSplodge]

@KymriskaDraken @doctor_oxford ‘Double handling’ generally - 111/triage (really an initial assessment due to expected waits), very junior clinician, refers to speciality junior, first senior decision maker following morning.

Brief triage (+- trainee ) direct to senior delivered care much more efficient

[Emma @EmmaAtSplodge]

@KymriskaDraken @doctor_oxford Agree - but we could help by employing the GP’s who are currently unemployed as no funding, carers to help people get home and patient transport staff to physically get people home in the evenings and avoid staying the night in ED to ‘await transport’. Not the whole answer but….

[Emma @EmmaAtSplodge]

@Nat_O_Byrne Was the diagnosis made only after imaging? We don’t get to moan if we need to do more tests to prove you wrong! And with dissection, the mortality is way too high to not investigate if it’s a reasonable differential.

[Emma @EmmaAtSplodge]

@Dr_ErinLS Why would it be crazy to audition? Worst case scenario you have a pleasantly difficult choice to make

[Emma @EmmaAtSplodge]

@RCEM_VP @RCollEM By definition ‘corridor care’ is suboptimal care that I would not choose for my family … therefore it’s not acceptable care for my patients

[Emma @EmmaAtSplodge]

@Dr_BellaR Write it, save it and read it in about a months time, then decide if it will genuinely be taken as constructive feedback (in which case it’s reasonable) or if it’s better staying in your drafts folder :-)

[Emma @EmmaAtSplodge]

@EMdocFarah And that’s NOT a dig at MH staff (who tend to do their best with limited resources) but at where commissioning priorities lie

[Emma @EmmaAtSplodge]

@EMdocFarah Absolutely lower threshold needed - waiting till people are at complete crisis can’t be helpful. Also why suggesting a non-organic diagnosis is often taken badly - physical cause? Treatment and sympathy, MH? Here’s a few helplines and feel free to cope (even if suffering equally)

[Emma @EmmaAtSplodge]

@DrLindaDykes Hope so… was on call last night so happily in night mode- nibbles, bubbly, spaniel and sofa … hopefully have something to celebrate !

[Emma @EmmaAtSplodge]

@DrLindaDykes The ‘simple’ explained ones have already been discharged by EM - endocrinology only ever hear about the ones who’ve made it past GP/paramedic/ED clinician

[Emma @EmmaAtSplodge]

#colnecustomer

[Emma @EmmaAtSplodge]

@docib Or … really radical - neither.