@LizzyFerret 2/2 If you want to improve PT safety, focus on building people and professions up positively, not admonishing and undermining public confidence in them. My profession is lucky in that I've never experienced the volume of toxicity and unhappiness that medtwitter exhibits
@LizzyFerret 1/2 Umbrella statements questioning the competency of well established and regulated HCP roles, based off an anecdotal case, is quite saddening. All AHP roles differ in their autonomy but we're all one big team.
@teddyhla Absolutely! NHS understands metrics-change to Amb Resp Prog to incl AED on scene w/in 6 min to encourage services to engage w/ local stakeholders. Encourage innovation eg high mobility deliveroo drivers urban / amazon rural to get AED to scene, pay company if 6 min target met
@teddyhla As a system, shouldnt we be aiming to improve the basics in the chain of survival for all before we allocate funding (asides from research setting) for a very costly treatment that has such a small subset of patients who would benefit?
@teddyhla Great ๐งตs! Cost to treat per OOHCA ECMO PT? KSS observational data suggest no OOHCA rural subset would benefit? Would funding be better invested where there's a great evidence base, free public cpr training / public access defibrillators / first responder schemes?
@EducationPara 2/2 High acuity time critical require familiarity and speed, eg shoulder dystocia management. Greater risk carried by underperformance in time critical patients vs urgent care where there's time and bandwidth to research / discuss on scene during decision making.
@EducationPara 1/2 Even though high acuity is small %, management needs to be familiar. Also the jobs that thought of cause most anxiety. Urgent care can be developed over time, with patient safety during learning phase mitigated by discussions with senior colleagues re referral etc.
@neilorpen @DrHannahBB Everyone completes the same 4 weeks advanced driving course before driving an emergency vehicle. In any field age does not equal experience. Would you rather a 40yo that has only had their licence a year vs a 24 year old who has had theirs 6 years?
@MaskedAMHP 2) when conveyed, ED often not being set up optimally for MH pts, they will be sat in a waiting room for hours, away from their home environment where they feel safe. Would pt need b better met (where little imminent risk) with a commissioned specialist emergency MH service?
@MaskedAMHP 1) Agreed, but % requiring ED conveyance rather than just assessment and referral in the community is changing. It's more challenging for us, with little hx or knowledge of the patient, to liase with the local crisis line for hx and / or referral.
@georgebellstarr Tbf, the mess is the home of living in service personnel, imagine a dress code to dress up to eat dinner at your kitchen table. Discussion above to allow people to dress comfortably to switch off when not at work and ensuring female dress equivalent essential for inclusively ๐
@simontutt88 OA=primary survey & environmental factors noted. Paint picture of the scene and whose there for those reading the paperwork. Has been the most useful part of my paperwork for police/coroner/trials/complaints. In hospital and OOH different beasts & ultimately clinician preference
@Paramedtweeter @ParamedicBarry@Ed_CritCare_On Absolutely agreed David but this context, when volume resuscitation is required, is often when I see small octopus on large bore. Can be an easy fix as you said, but it's one bandwidth occupier that can be eliminated in advance with awareness and education ๐