Chris Sim

SWAST HART Paramedic in Bristol. With a beautiful wife & 2 beautiful sons. Have a special interest in moving to Australia.

[Cliff Reid @cliffreid]

The most important change in my practice in cardiac arrest in recent years: checking defibrillator pad position
https://t.co/3dBBH2L9h2

[Cliff Reid @cliffreid]

Do you look after cardiac arrest patients?

Ever notice the difference between American & European Hs & Ts?

Can hypoglycaemia cause cardiac arrest?

What are the Cs ?!

Do you know the Ischaemic / Structural / Electrical model of cardiac causes?

https://t.co/oEZYJ3ygNG

[Chris Sim @CSim93]

@ParaAndy90 Slow & large doses in overwhelming majority of patients.. 1-2mg a minute to 10mg, with almost always desired effect!
The 2.5mg clinicians have always heard ‘this one time at band camp someone gave 0.0005mg to Joe Blogs and put him into respiratory arrest’

[Chris Sim @CSim93]

This happens far too much in practice. These are stressful situations but if we spend that extra 5 seconds placing pads optimally, it might make that difference between ROSC or no ROSC..

[Resuscitation Council UK @ResusCouncilUK]

Defib pad placement is important. Positioning them correctly can double someone’s chance of survival.

Side A is correct. The key difference is that the pad on the left hand side of the chest has been placed on the side of the rib cage, closer to the armpit.

[James Yates @heli_med_james]

Anecdotally, I think this is a relatively common issue in cardiac arrest care.

Take time to perfect the essentials when managing an arrest. Don’t accept anything less. If you’re a team leader, or team member, take time to notice these little things that make the big difference

[Chris Sim @CSim93]

@nqpcharlie Anything that requires the slightest Paramedic intervention should be your responsibility..
Most ECAs will absolutely understand this & those who don’t, have a chip on their shoulder & will get over it :)
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[Chris Sim @CSim93]

@nqpcharlie At the end of the day you’re the clinician and decision maker, to start off you do what makes you feel comfortable.

In time you’ll gain experience/judgement/confidence, learn your thresholds & what you’re comfortable with!
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[Chris Sim @CSim93]

Merry Christmas from HART Bristol white team! Huge respect to all of those giving up their time to look after the public today 🎅🏻 🎄

[Chris Sim @CSim93]

Incredibly proud to finally be able to call myself a HART Paramedic, and what a privileged job it is!

[Cliff Reid @cliffreid]

“One day we will…stop making patients lie flat”

- @HumanFact0rz

[Chris Sim @CSim93]

Saturday, been up since 5:45am, left in charge of my 2 sons, and this is why it shouldn’t be allowed..

[Chris Sim @CSim93]

Incredibly fortunate to call this work!
Great 2 weeks with some awesome people completing my first module at HART.
BA is fun.
#paramedic #HART

[Chris Sim @CSim93]

@JessicaSpara

[Chris Sim @CSim93]

@dsairambulance Of course!

[Chris Sim @CSim93]

A fantastic experience for my son with @dsairambulance who took the time to engage with him whilst clinicians dealt with an incident. A fantastic and very well needed service!

[Chris Sim @CSim93]

Congrats to all Para students passing their courses 💪🏻 🧑‍🎓 in 7 years I’ve gone from working in a supermarket, to ECA, to student, to NQP, to HART. Dream big, your careers are only just starting!

[Leanne Sim @leasim2603]

The next generation @CSim93

[James Yates @heli_med_james]

Large US/Canadian cohort study finds no overall difference in survival to hospital discharge for children moved intra-arrest v those resuscitated on scene.
But intra-arrest transport in under 1s = lower survival.

#stayonscene https://t.co/nHz60ngqDK

[Chris Sim @CSim93]

Australia, a special place with some special memories with my beautiful wife and children.
Is Queensland in need of a UK Paramedic..? 🙄
#paramedic #australia

[Brooks Walsh @BrooksWalsh]

The paradox of interpreting the ECG with a RBBB:
- Overt STE may be present, satisfying OMI/STEMI criteria, but it is not appreciated; or conversely
- The widened QRS of a normal RBBB ECG is misinterpreted as suggesting OMI/STEMI, despite normal ST segments.
A 🧵.
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