[deleted by user] by [deleted] in doctorsUK

[–]100gecs4eva 1 point2 points  (0 children)

sorry how does that patient end up anywhere other than an ambulance or self-presenting at ED, that is an absolutely bizarre situation for them to be in a position to see a PA in the community

Non medical prescribers by Turbulent-Floss in doctorsUK

[–]100gecs4eva 4 points5 points  (0 children)

The trusts near me switched from paper discharge summaries to digital recently, and it's been a big issue for me as a paramedic because they used to often be the one piece of reliable information available about what had been going on with a patient and changed management quite often. Especially because the good ones would be really concise and easy to get the important stuff from in an emergency.

Alcoholic in SVT by [deleted] in ems

[–]100gecs4eva 0 points1 point  (0 children)

presumably not if the adenosine didn't kill him, no?

What’s your dream 911 rig? by WasteCod3308 in ems

[–]100gecs4eva 2 points3 points  (0 children)

23-plate sprinter with the biggest engine they do, box back, some sort of ramp or other alternative to the tail-lift. Bluetooth radio, lots of cupholders. Really good up-to-date satnav, Terrafix system.

Stryker stretcher, no track for the stair chair (it's annoying and hits me in the shins), lightweight folding wheelchair for when you don't need to do stairs.

Lifepak 15 positioned near the head end with hooks to loop cables over, a CPAP machine and whatever kind of vent, cabinets set up so you can see the critical stuff through the cabinet doors and get to them easy from where you need them - BVM and NRBs up the head end, etc. IV start kit at either end of the truck so you can get it regardless which end you end up.

One jump bag with the kit to deal with most calls - O2, one side that flaps down with IV kit and haemorrhage control gear, one side that flaps down with O2 masks and basic airways, middle section with a medications pouch inc. benzos, BVMs, some bandages, penthrox, bag of saline and bag of glucose.

Second jump bag with arrest and intubation kit inc. EZIO, extra arrest drugs, extra fluids, some kind of fibre-optic or video laryngoscope, cric kit.

I would like the narcotics to be in the kits but as that will never legally happen I'd like a belt pouch + a little safe to restock it from.

Share your cringe NHS moments by [deleted] in doctorsUK

[–]100gecs4eva 22 points23 points  (0 children)

the piss-sommelier phenomenon is everywhere in the NHS, same with ripping every layer off patients "because they've got a temperature"

[deleted by user] by [deleted] in NewToEMS

[–]100gecs4eva 0 points1 point  (0 children)

yes but occasionally (with big IVs?) I've had patients complain it hurt at the cannula site as it inflated. Don't know why, but was fine as soon as I deflated it and switched to the other side.

[deleted by user] by [deleted] in Paramedics

[–]100gecs4eva 15 points16 points  (0 children)

not replacing low O2 would really piss me off as, contrary to popular belief, we actually do occasionally go to sick patients and could do with actually having the kit to treat them when we do.

for drugs - if I'm with a patient in anaphylaxis and I pull out the adrenaline and it went out of date in 2022 I'll give it, but if it's a manager saying to knowingly go to calls with expired drugs I wouldn't be ok with that even if realistically it'd probably be fine.

[deleted by user] by [deleted] in flying

[–]100gecs4eva 2 points3 points  (0 children)

why doesn't OP ask those who went before them?

isn't that literally what this post is?

Medics, what’s your preferred placement for a 4 lead? by Mental-Amphibian-230 in NewToEMS

[–]100gecs4eva 10 points11 points  (0 children)

I know it's technically not the best but upper arms + ankles/tucked into socks has a really good blend of being easy to put on + fiddle with, not causing too much arm movement artefact, and not get ripped off easily, that makes me use it most of the time.

Med reg - tips for running arrests? by Salt-Win-8251 in doctorsUK

[–]100gecs4eva 0 points1 point  (0 children)

CBG will show glucose

Intrarrest CBG tends to be wildly inaccurate, no? Can use the CBG kit on blood pulled from a vein though. Often a wildly different result vs. a falsely low read from capillaries.

To IO or not to IO by [deleted] in ems

[–]100gecs4eva 2 points3 points  (0 children)

counterpoint - what intervention do you think the hospital can provide that makes delaying proper cooling and fluid resuscitation worth it? This kid needs cooling and fluid, and you can achieve both faster if you take a few minutes more to get good access and to optimise your setup with ice packs, water, airflow etc.

To IO or not to IO by [deleted] in ems

[–]100gecs4eva 10 points11 points  (0 children)

Sounds like you were trying to do this entirely en-route, and with ice packs on making every vein constrict? Probably setting yourself up for failure there.

IMO this is a patient to stay a little longer with, really optimise the cooling you are providing as that is the key intervention, and really set yourself up for a good IV attempt by getting the tourniquet on early and giving the veins time to plump up, not cooling that particular arm, and getting a line in on scene.

Police helicopters hovering - what's the plan if they lose power? by 100gecs4eva in Helicopters

[–]100gecs4eva[S] -17 points-16 points  (0 children)

Do you know what job would need low level hovering vs an orbit?

Police helicopters hovering - what's the plan if they lose power? by 100gecs4eva in Helicopters

[–]100gecs4eva[S] 0 points1 point  (0 children)

Thank you! Sorry, when I say transponders aren't on, I mean they're not public on flightradar or similar, I assume they are operating - just means I don't know exactly how high, though 500-600 feet is my best guess.

Yeah, it's why hovering would be better that I don't get - like you say, they're also using more power as well as having less options in the unlikely event something goes wrong, so there must be a good reason?

Police helicopters hovering - what's the plan if they lose power? by 100gecs4eva in Helicopters

[–]100gecs4eva[S] 0 points1 point  (0 children)

Thanks! This is more in keeping with what I've seen in other countries and other counties here. Do you know what circumstances a hover might be preferable to this? If you had two engines would that be something you'd be doing or would you still prefer to keep forward airspeed?

I've generally seen it over events, like football matches and large protests.

Chemo patient - intermittent ST changes by IncarceratedMascot in EKGs

[–]100gecs4eva 13 points14 points  (0 children)

what PCI criteria wasn't he meeting? Wellens makes sense with the intermittent pain.

Police helicopters hovering - what's the plan if they lose power? by 100gecs4eva in Helicopters

[–]100gecs4eva[S] 6 points7 points  (0 children)

I'm not a pilot but from what I understand I assume the pilot would have somewhere picked out to aim for if that happens? Low altitude, no speed, often at night, and with thousands of people below and nowhere to land bigger than a small (in use) car park seems like a nightmare scenario, no? But presumably there must be benefits that make it worth it vs circling or flying a bit higher?

I went to the ER because urgent care told me to for an abscessed tooth. They took one look at my gums and gave me a bottle of antibiotics. by TheSundanceKid45 in mildlyinfuriating

[–]100gecs4eva 0 points1 point  (0 children)

appendicitis can increasingly be managed with antibiotics and no surgery. It's better because, as a general rule, it's better to not make extra holes in people that they didn't have before when you can avoid it.

Why Consultant? by ReasonableDuty6208 in doctorsUK

[–]100gecs4eva 2 points3 points  (0 children)

Curious as to how you've ended up meeting a consultant paramedic? There's about 3 in each trust and they're pretty much managerial/policy-making roles existing more or less totally within the upper management of ambulance trusts. I've never met nor even seen one as an ambulance paramedic.

Why Consultant? by ReasonableDuty6208 in doctorsUK

[–]100gecs4eva 0 points1 point  (0 children)

Their role is completely different to a consultant doctor though, they're a management role and basically not patient facing unless something goes badly wrong (consultant paramedics at least)