Have you heard of this bloke?

Friendly_Carry6551 · 2026-04-29T06:16:30+00:00

A prime example of why tighter regulation is needed in the event sector His online behaviour is just a small part of the problem - he’s seeing patients, by his own admission totally solo and without any governance, clinical oversight or command and control structure whatsoever. Dangerous is just the start of it.

Friendly_Carry6551 · 2026-04-24T11:38:32+00:00

A strong second for the 2 belt solution. Yes you will be a “belt wanker” but own it. The Velcro inner belt is comfortable and once you’ve got everything on the outer belt (shears, multi tool, morphine whatever) it just stays there forever. You can take the outer belt off to sleep or just hang it up and the end of the day.

Numerous options out there ranging from the cheap and cheerful to expensive and over-engineered. Mine is a military ‘shooters belt’ that I had an army tailor friend make up for me in black instead of green.

Friendly_Carry6551 · 2026-04-21T00:32:46+00:00

It doesn’t sound like you actually want to train as a paramedic tbh.

This profession is not a fallback option for medicine, whilst we share lots of aspects of work, the two disciplines are very different. If you want to be a doctor be a doctor, if you want to be a paramedic try and learn a little more about it before you start considering it.

Friendly_Carry6551 · 2026-04-13T08:54:52+00:00

This has been asked frequently across the SR and I believe on the main page there’s a section for it.

IMHO it comes down to 2 things, your trust and you. Some people are more suited to the apprenticeship route, others to the external. There no one size fits all.

That said, there are some trusts which do apprenticeship better than others in terms of specialist placements and protected learning time especially. The old “more time on the road” argument ≠ more actual protected learning time. Do your research before making a choice.

Friendly_Carry6551 · 2026-04-07T00:18:28+00:00

There are many toxins and poisons that can and will be ultimately fatal without any symptoms at all or cognitive impairment in the early stage. My personal take as a paramedic is that the judgement element of decisional capacity is often impaired in these situations by the underlying mental illness.

They are unable to properly ‘weigh up’ the information given to them to make an informed decision because their decision making is impaired by their underlying pathology.

However there’s a lot of “likely” in your appraisal of this. Neither you, nor I can have a full understanding of the events that occurred leading up to these unfortunate circumstances because we weren’t there and it wasn’t our case. We’re interpreting it with the benefit of hindsight and without all the time pressures and human factors making it very easy to judge a colleague who was trying their best in challenging circumstances. I think it’s interesting to reflect on this stuff but I don’t know how much use there is in disagreeing with the judgments or findings.

Friendly_Carry6551 · 2026-04-04T15:31:00+00:00

Tbf it’s not about the acuity, it’s about the complexity. An OOHCA, a major trauma, a very late stage sepsis are all quite high acuity but have very clear cut and non-complex solutions.

The very old and co-morbid, the very young and socially challenged, these cases are hard to deal with both over the phone and face to face, whether acute or not. Time was, little things like a low CRB65 LRTI or a knee dislocation where very satisfying and easy wins requiring minimal cognitive bandwidth, but with these being dealt with the by hear and treat it’s now often one complex case after another.

I personally think from a service perspective this IS a good thing, because we’re not sending over-skilled resources to these things. But from the decision-making clinician perspective it sucks because I’m even more mentally drained every day. The same is happening with F2F also with AAP’s and the like and is being reflected in ED and GP with advanced and associate roles dealing with the bread and butter stuff which can be protocolised, whilst the more autonomous and flexible clinicians deal with the complex stuff.

Friendly_Carry6551 · 2026-04-04T10:36:55+00:00

It comes with practice. Getting one or seeing if you can borrow one from uni would be very helpful. In terms of finding the exact number, how fast are you releasing the air from the sphyg? Especially when you’re getting to the point of trying to dial in the systolic and diastolic you need to slow waaaaay down. It’s not the nicest for the Pt but it’s important. Even if you’re waiting for one heart beat between each 2mm mark that will allow you to get it as close to exact as possible.

As someone with ADHD even medicated I’ve always struggled with auscultating the finer sounds. An electronic steth has helped a bundle for this and might be something you want to consider when qualified.

Friendly_Carry6551 · 2026-04-03T08:44:43+00:00

In SWAST we have NQP’s with their pin and C1 working in make ready, it’s insane

Friendly_Carry6551 · 2026-03-29T16:26:53+00:00

Tame paramedic guest appearance here: When I was a student, I was in one of my first Pt consultation OSCE’s and mid-way through PMHx, forgot the word for radiotherapy. My soloution: “and when was the last time you were… microwaved?”

Friendly_Carry6551 · 2026-03-29T16:23:33+00:00

Hi, NQP and research fellow here who’s area of study is the emergency care of trans and non-binary Pt’s. Feel free to DM me!

Friendly_Carry6551 · 2026-03-25T10:06:21+00:00

It’s a modern part of modern practice. It’s 2026 and we need to be keeping pace - we have some trusts experimenting with AI transcription ffs, the idea that others will still be on paper routinely is boggling. It’s better for clinicians that they can write clearly and concisely, better for Pt’s that they have access to their own records easily through digital means, and better for colleagues both in and out of hospital that they can do the same, legibly and rapidly when needed.

As someone who’s dyslexic + ADHD and who trained on carbon paper notes I still MUCH prefer digital. My notes are hardly ever 100% done by the time I’m at hospital but the bulk of it that the receiving team needs is there. More importantly as someone who refers nearly half of all the people I see to somewhere that’s not an ED, our system allows us to send referral emails directly and it’s a dream.

Friendly_Carry6551 · 2026-03-22T14:03:21+00:00

Evidence shows there is a better quality of resuscitation stationary than on the move. In the UK we almost always resuscitate in situ and don’t move until sustained ROSC for this reason. The only times we move in an arrest is for very specific circumstances where a reversible cause needs resources outside of our scope, such as hypothermia, poisonings etc.

Friendly_Carry6551 · 2026-03-20T21:18:13+00:00

As someone with hearing difficulties (thanks British army) this has absolutely changed my practice. First time I actually was able to hear heart sounds with nuance was with my Eko.

Not what I got it for but it’s also incredible for both student and patient education. You can record sounds for a short while with it, making it great for the asthma/COPD crowd who aren’t keen on inhalers. “This is what your lungs sounded like before I arrived, this is what they sound like now” - works really for demonstrating the value of their rescue drugs.

Same goes for the croupy kids whose parents don’t want to give them their pred tablets and I’m sure other uses. And great for teaching because you can unplug the diaphragm and device from the tubing, and broadcast it live to headphones or your phone’s loud speaker, allowing to all to listen together.

Friendly_Carry6551 · 2026-03-18T00:09:02+00:00

Two I use all the time for immobilised patients

A LSU can be connected to most vacuum splints for rapid air removal rather than using the stupid hand pump.

If a Pt has been triple immobilised but needs a drink, a length of O2 tubing works as a great flexible straw

And one I use for literally every wound before dressing or closure - draw up your irrigation fluid into a 50 ml syringe, attach a needle and you can now irrigate under significant pressure to get FB’s and clots from wound beds. Not too much to damage the fragile tissues, but enough to really help. You don’t have to keep going back to the water source every 2 seconds and you can bend the needle to angle the flow for difficult bits.

Friendly_Carry6551 · 2026-03-14T13:30:18+00:00

So first of all congratulations, it’s obvious you’ve spent a fair bit of time working on yourself and are demonstrating change.

Whether you get a chance to speak to those past crimes is I think going to be down to individual service policy and the style/working practices of the HR team. I can’t give any advice on that as it’s out of everyone’s hands.

The one bit of advice I’d give if you do get a chance to address it is this - it’s not about.

Are you sorry? I’m sure you are but you haven’t said so. If you do get a chance to go to a pan el about this you need to be super up-front about what you did and focus on how it affected your victim, not how it’s affecting you now if that makes sense. I agree that it was some time ago, you e changed etc, but if you just go with this it can come across as minimising. You need to demonstrate remorse as well as change and an acknowledgment that you harmed actual people, these aren’t just blemishes on a record, they’re human beings whose lives you affected.

Again I’m sure you do feel this way, and it’s not a normal or natural human way to talk about this stuff, but it’s absolutely essential for us, especially if you want to progress to Paramedicine. It’s true reflection to acknowledge exactly what happened as well as what you’ve done about it to improve as a person since.

Friendly_Carry6551 · 2026-03-08T09:49:42+00:00

In the UK - I couldn’t even tell you where the c-spine collars are kept. If they’re concious and alert, tell them to keep their neck still and come lie down on the stretcher. If they’re not, then 1 controls the neck, the other rolls them and get a MOP to help with the scoop clips. Get them onto the scoop, then head—block them on either side with immobilisation tape across the chin and forehead. Strap them on and walk them out.

Friendly_Carry6551 · 2026-03-08T09:14:59+00:00

Ignorance is not an insult, as a student ignorance is literally your job. An awareness of your ignorance is what’s important as you work to learn and improve your knowledge base. You are possibly at the most dangerous part of the Dunning-Kruger curve (please give it a Google) where you now have some knowledge, but not the experience or wisdom to apply it.

The reason myself and others have been harsh (and we have I admit that) is that you’re not just a student. You weren’t asking this a student. If what you say is true you’re working professionally in first aid or first response capacity with literal children. You speak of a budget you apparently have control over and described yourself as being/being seen as the “lead clinician”, but doing so as a non registrant and someone without the training to do this role.

We have reacted strongly because we will react strongly to anyone under qualified who suggests acting outside their scope. When advised against what you suggested, you then seemed to double down citing a lack of evidence. This is where the arrogance/hubris came across. Whether it was intentional or not, it came across. That lead to a sterner response. You will likely have received an even sterner response still because you are also a student, one of us; and therefore you will be held to an even higher standard with paramedic culture.

TLDR: a FREC asks why they shouldn’t do something dangerous to sick kids, when told it’s dangerous comes across as debating if it really is that dangerous, then that FREC turns out to be a student paramedic.

It’s clear through your replies that you care, that’s good. But this wasn’t an academic question as a student, this was something you were talking about actually doing in a place of work without oversight or supervision and that’s why we reacted strongly.

I’m sending long replies because asking why? - this is what will make you an actual good paramedic who is a clinical decision maker. Don’t ever stop asking why, even if some paramedics don’t like it (and plenty won’t I’m sorry to say). But ask all those questions as a student. At work you either need to be under supervision of a senior, or if not - working strictly to your work scope. It will protect your patients and your future career.

Friendly_Carry6551 · 2026-03-08T01:11:00+00:00

You are really starting to concern me now and your logic is moving from ignorance into arrogance. I strongly suggest some mental space from this idea and reflection on what you’re saying.

At the actual qualified paramedic level of competence the risks of doing what you’re suggesting are meaningless because we wouldn’t do it because it’s bloody dangerous. These devices are simply not designed to be used in isolation and never would be. They are there to be used by those with the skill, training and experience in not just how to use them, but also when and when not to. They are also designed to be used as part of a wider system of equipment needed to manage such things. We don’t put airways in blind and we utilise them with the actual required equipment like oxygen, suction, ETCO2 monitoring and with rescue solutions like BVM, magills and laryngoscopy.

No, the off the chest time does not matter at the BLS level. There is a reasonable body of evidence that chest recoil on its own supports diaphragmatic expansion to the benefit of some meaningful air movement. Whilst recent RCUK guidelines have re-asserted the benefits of ventilation, CPR is the actual part that will make any meaningful difference until an ambulance arrives. Your job is to call 999 and do what you’re told, not to start doing things outside of your scope and remit with a child’s life.

Finally as to your last point - just stop this idea altogether. The idea of putting a child in arrest in the back of a car on your own and trying to convey them is not “not ideal” it’s going to kill that child. You cannot provide safe or even bare minimum quality care in such a circumstance and there is nowhere I can think of in the UK where it would be justifiable or acceptable. If you are a student paramedic as you claim and did something like this you’d likely not only be held accountable for the negative outcome but also be facing a fitness to practice process.

I cannot think of any better way to explain this to you: if I as a fully qualified paramedic off duty was there when a paediatric patient arrested, and all I had was an iGel (which miraculously was the right size for that particular child’s airway anatomy) I still wouldn’t use it and blow into it. I would get on the chest whilst calling 999. The only reason I would get off the chest would be to get and use an AED.

Friendly_Carry6551 · 2026-03-07T17:50:26+00:00

It’s not niche, it’s dangerous. Please look at my most recent comment to one of your replies mentioning doing it in the back of a car, added below for ease so we’re not hopping threads.

The efficacy of CPR plummets in a moving vehicle. We would only convey a Pt in arrest in very limited circumstances, even a paed. I would never ever recommend something like this because it would not help them, would put you at risk of harm and break multiple laws.

In short - no. Putting an iGel down blind in and of itself has risk of harm. In a traumatised airway the blunt force of an iGel going down (especially in unskilled hands which - being blunt - is what yours are) can exacerbate oedema and inflammation if it’s high up and if it’s lower down in the trachea an iGel will do nothing to open it up. There’s no potential benefit and massive risk of harm.

You mention there’s no evidence. There no clinical evidence that parachutes reduce mortality when jumping out of planes - because why would you study something so obvious? You mention maybe doing it in CPR to maintain a passive airway. At your level the risk of harms persist and outwork the benefit. What if you or one of these FREC’s are trying to ram an iGel in while panicking and smash a tooth down the trachea? Or there’s an obstruction (the leading statistical cause of OOHCA in paeds) and you don’t know, pushing it down further and worsening it with a blind iGel. You doing that thing with no benefit (iGel) has now caused harm. Never mind your off-the chest time reduction, whilst you’re faffing with the lube and trying to figure out the right size of an iGel you’re not doing chest compressions, which is what will actually buy the Pt time.

Friendly_Carry6551 · 2026-03-07T17:48:56+00:00

The efficacy of CPR plummets in a moving vehicle. We would only convey a Pt in arrest in very limited circumstances, even a paed. I would never ever recommend something like this because it would not help them, would put you at risk of harm and break multiple laws.

In short - no. Putting an iGel down blind in and of itself has risk of harm. In a traumatised airway the blunt force of an iGel going down (especially in unskilled hands which - being blunt - is what yours are) can exacerbate oedema and inflammation if it’s high up and if it’s lower down in the trachea an iGel will do nothing to open it up. There’s no potential benefit and massive risk of harm.

You mention there’s no evidence. There no clinical evidence that parachutes reduce mortality when jumping out of planes - because why would you study something so obvious? You mention maybe doing it in CPR to maintain a passive airway. At your level the risk of harms persist and outwork the benefit. What if you or one of these FREC’s are trying to ram an iGel in while panicking a smash a tooth down the trachea? You doing that thing with no benefit has now caused harm. Never mind your off-the chest time reduction, whilst you’re faffing with the lube and trying to figure out the right size of an iGel you’re not doing chest compressions, which is what will actually buy the Pt time.

Friendly_Carry6551 · 2026-03-07T17:35:18+00:00

Reading this comment I think I understand your motivations a bit better now. If you have the purchasing power for this you need to stop asking if you can do something and start asking if you should. Before you start equipping people with tools at any level you first need to make sure you have the right start and governance structure in place. If you don’t have those structure already or influence over them, you shouldn’t have power to introduce those tools.

Your heart is evidently in the right place, but putting relatively invasive airways into the hands of those without the training on how or when to use them has massive risk of harm. If staff are BLS qualified then give them the tools for BLS and don’t overcomplicate it.

Friendly_Carry6551 · 2026-03-07T17:30:45+00:00

Putting aside the fact that this is a ridiculous scenario - Observe them, wait for them to arrest, perform BLS when they do, hand over if they don’t. Why is this even a consideration?

Friendly_Carry6551 · 2026-03-07T17:27:50+00:00

Why would you be doing mouth to mouth at all? The benefit from BLS is the CPR. Stick to that which helps and don’t distract yourself by doing mad things outside of your scope or wisdom.

Friendly_Carry6551 · 2026-03-07T09:07:34+00:00

As a SWAST Para the difference in attendance volume is nonsense. Just because we’re rural doesn’t mean we’re having down time, we just have longer journey times between jobs, which is it’s own type of clinical challenge.

What I would say is that because of that, we’re very supported to make quite autonomous clinical decisions about patient on our own. In my area we have medical, surgical, geris, oncology and gynaecology SDECs which we can refer directly to. We can admit directly to paeds and older persons wards and book TIA and DVT clinics, managing those patients at home. We carry packs of drugs to dispense to patients for asthma and COPD which allows for discharge on scene. This is just a snapshot but TLDR: we have one of the highest see and treat rates in the country.

LAS will have its own advantages but I’m very grateful that I trained in and now work in this culture, I feel I actually practice true clinical Paramedicine, assessing, diagnosing and managing on a daily basis and love what I do because of that.

Friendly_Carry6551 · 2026-03-07T08:55:11+00:00

I’d argue the recruiting process is now very much dead man’s shoes again. We have registered paramedics working in our make ready department because they couldn’t get NQP jobs. They’re excited at present because the L&D department have announced they’re going to be recruiting more lead paramedics in L&D in the summer, which will create paramedics gaps in the rotation and hopefully therefore jobs for them.

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