@TJCoats@jabberwock951 Do medical directors usually get involved this sort of policy?
IME, usually left to individual specialities to manage their 'criteria'.
@brionytheliony I think what's not often made clear is the difference between signing an ECG to say it's not an immediate life threat and actually interpreting it.
We know know the doc who signs it does the former and the doc who sees the patient assumes they did the later.
@Nat_O_Byrne@TheRealRead Srsly tho, I cannot think of a single case where a GCS hasn't required a more specific explanation of *how* it is abn.
A GCS of 10 in an aphasic 18 year-old girl is very different to a 3 in a collapse outside a pub is very different to a 13 in an agitated head injury.
@Nat_O_Byrne@TheRealRead GCS exists to prognosticate traumatic brain injury.
Not to debate whether Doris' longstanding cognitive impairment loses her 1 for voice.
@MaxMarsden83@rachelgemma90 In my mind, we need to educate, train & empower clinicians at every level to use their brains and think about why someone is in arrest.
But, I think we need to be mindful that the basic (and advanced) life support drills need to keep your options open.
@MaxMarsden83@rachelgemma90 It's difficult cos the label gets applied early; who hasn't been dispatched to an "RTC, traumatic arrest" when a car has rolled to a gentle stop against the central reservation?
@Roseberrykate @mancunianmedic@DrNeenaJha But 111, the ambulance service, an EM clinician and a medical one have all decided not to discharge...
I don't think it will be a huge percentage.
@Shanghai_Rose@mancunianmedic@DrNeenaJha In order to get to post-take, they've been through a triage and at probably two clinicians. If all of those people thought they needed to be in...
@Dr_JSA Or, if you'd prefer it more GP oriented, if a GP reg turned up at your practice and decides that they were going to initiate penicillamine for RA or offering ear syringing & microsuction, how would you suggest that be managed?
@Dr_JSA That can only effectively work when employees of those services work within those constraints.
So, in that context, when do you think it's appropriate to go off piste and disregard your employers direction on what can and cannot be offered?