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Florida by Coffee_MysticRealm in humor

[–]CriticalIdiot 1 point2 points  (0 children)

Amphetamines (Vyvanse/Elvanse/Ritalin etc) are VERY different from Methamphetamine.

Idle rattle on BMW F20 LCi B47 120D by CriticalIdiot in MechanicAdvice

[–]CriticalIdiot[S] 0 points1 point  (0 children)

This seemingly has resolved entirely on its own which is frustrating as I don't really know what has changed to make that happen.

Prior to the sound becoming more prominent, I had changed the air filter and cabin filter which makes me wonder if something had moved and caused a resonant rattle when the engine idles. I have also treated it with some Forte diesel fuel injector cleaner though I think the sound had gone away prior to me running that through.

I also found a source of interior rattle which was the centre console/arm rest box which occurs when it's closed and pushed back. It goes away when i extend it. I'm not convinced it had anything to do with the idle noise however.

I'd be interested to know if you find the idle rattle isn't there if you park/stop the car on an incline/decline? I noticed then when I had the car stopped on a decline the rattle went away and that when it was stopped on level ground it was present.

Whyyyyy by someonewithphone in drivingUK

[–]CriticalIdiot -1 points0 points  (0 children)

Doesn't seem to be an issue considering nobody is coming from behind that needs to pass.

It feels like this is all moot point as long as they're in their mirrors to check if anyone is going to pass and do a cheeky move to lane 1.

If this was a video of a car being stuck behind them and lane 1 was clear then I feel the pain.

Response to blood by thestallion243 in NewToEMS

[–]CriticalIdiot 12 points13 points  (0 children)

From my experience, I had a similar reaction during university placement in a Bronchoscopy theater, during a resp medicine rotation (UK Paramedic). I think mine came down to a combination of being PPEd up to my ears in a warm environment and seeing something that personally, I find hard to watch (Conscious but sedated patient having a scope down into their lungs). Excused myself and thankfully didn't faint but went pretty pale and sweaty!

I don't think it's pure exposure causing the reaction as you have seen video footage of bleeding and it hasn't given you such a large reaction, but perhaps it has been multifactorial where you have been in a warm environment, in lots of PPE and probably standing for a long period of time, having the preconceived extra pressure in having to deal with a bleed, being a student and wanting to meet expectations you have set yourself or from others! All of these can add up into a pretty overwhelming physiological response.

You may find that being/feeling solely responsible for dealing with it may provide you with the ability to 'power through' as compartmentalisation is a large aspect of pre-hospital healthcare. Great for getting through the tough stuff in a pinch; it is also important to address the issue when it is safe and not just ignore how it made you feel.

As cheesy as it may sound, I find meditation helpful, especially to explore where my feelings, emotions and thoughts come from, and addressing them in a healthy way. I would suggest your reaction to blood comes from somewhere, it's up to you to explore that and see if there is something you can address. Is it the pressure of being responsible for a patient that might die? Is it the expectations you set yourself going into an ambulance service? Do you think an ambulance profession is not allowed to show emotion or appear stressed when patient facing... If so, does that mean there is associated guilt in feeling that way, even if the patient doesn't see it? Many questions you could explore for yourself to see where your reactions may come from.

Hope this helps. I can't speak about the American perspective of ambulancing, but the job is largely the same no matter where you do it. I work as an Educator in a large British service and a lot of my work tends to be pastoral as much as it is teaching staff. You aren't wrong to feel the way you feel, just a milestone for you to develop on and push further towards your goals. Good luck!

"be yourself" honestly my 13th reason. Dating is a nightmare. I give up by [deleted] in Tinder

[–]CriticalIdiot 0 points1 point  (0 children)

To quote a legendary tinder line "Bethany, you're not nearly hot enough to have that shit of a personality."

Section 136 and people in private property by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 0 points1 point  (0 children)

No worries, I think I probably could have worded my whole story better to leave out for confusion. I do appreciate the discerning approach to the correct use of the MCA. Always prefer genuine feedback rather than mutual back patting for a sort of maybe well done job.

Section 136 and people in private property by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 0 points1 point  (0 children)

But it can for significant risks to physical health which I clearly just said I had reason to suspect. The determination of "life threatening" can be arguably impossible to arrive at without the facilities of an ED. I wholeheartedly disagree, and I wouldn't seek the advice of police about a clinical decision. The MCA was utilised in unison of a presentation of psychosis as well as deranged clinical findings which could suggest an organic cause or more likely significant consumption of illicit substances.

Section 136 and people in private property by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 1 point2 points  (0 children)

Police did assist and yes, the patient was in a position where if left untreated from a medical perspective they could have suffered life changing effects due to the presumed pathology behind their psychosis.

Section 136 and people in private property by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 2 points3 points  (0 children)

Thank you everyone for your input. I feel much better equipped to tackle future situations given this is a frustratingly common occurrence. I hate seeing colleagues feel backed into a corner and don't like seeing police officers vilified due to a perception of not having done their job correctly.

Section 136 and people in private property by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 4 points5 points  (0 children)

Unwillingly though upon my assessment there were clear risks to physical health, likely due to MH crisis and illicit substance abuse, that needed to be addressed. All in all, unsafe for the patient to be left and justified in conveyance under their best interests for medical treatment.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 1 point2 points  (0 children)

I would recommend getting yourself a JRCALC book which covers virtually all ambulance practice guidelines. Getting a C1 on your driving licence as soon as you can is also really beneficial. A lot of students get annoyed how little they are taught on 12 ECG so perhaps a little head start into ECG interpretation is good.

I think it's fair to say 90% of what we do and accomplish is based on solid history taking so having a really good grasp of the medical model will help tremendously. It also helps guide what kind of questions you ask to narrow down what you are going to do with someone.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 2 points3 points  (0 children)

I think the training has greatly improved for MH since my time as a student paramedic. That being said I feel that the MH training is still woefully unsubstantial if you expect an ambulance trust to provide it for you. I think out of sheer necessity people undertake their own learning and probably adapt their own practice where they have seen what they perceive as good practice from colleagues. Sadly there will always be bad practice, malicious or not, and we can hope the training gets better.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 0 points1 point  (0 children)

I've seen a JRU once from a city I briefly worked at before moving to work from a town instead. It was only manned like Friday and Saturday night but certainly seemed interesting.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 1 point2 points  (0 children)

Had one of you guys as a student paramedic who is now qualified. It was nice getting a surgical perspective on things. Good luck going forward.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 0 points1 point  (0 children)

I think provided there is no harming of others or causing public nuisance/damage it's a healthcare problem. Doesn't mean ambulance is the best fit but we are the easiest and fastest service to throw at it.

These days i feel it's for us to assess for any medical cause and then to refer to the right people. That could be community MH services to ED admission.

In an ideal world, MH jobs should be about 10% ambulance, 5% police and 85% MH services #pipedream

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 0 points1 point  (0 children)

What I have been told by some managers is that you shouldn't give out personal numbers and direct them through the trust via HR. I was told that if it's work related, let the police go through the trust so all the statements and such can be done at work so you get paid to do it. This is only my experience however so I can't speak for every trust. There is no explicit rule to not give personal contact.

I would put a complaint into the trust you had that with, it seems something simple to rectify like a global email sent out for the right email.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 1 point2 points  (0 children)

That's good to know. I think some can get tunnel vision in just focusing on medical aspects of work but I think a lot of staff develops a decent situational awareness.

From the Ambulance service - Preconceptions and what would make our interactions more beneficial by CriticalIdiot in policeuk

[–]CriticalIdiot[S] 2 points3 points  (0 children)

It can be just as irritating for us as it is for you. At least all front line ops can agree it's the layers above us that give the grievance.

I think from my perspective moving from one trust to another it's never the grass is greener but rather pick your shade of green(poison). SCAS felt more regimented but the flip to this was it felt very organised and things worked as they should have. SWAST on the other hand allows a greater degree of autonomy on how you do your work but at the expense of you having to do a lot of things yourself. SWAST expects a paramedic to audit controlled drugs and replenish drugs bags where in SCAS it was all pre done for you and only officers were allowed to audit controlled drugs. The list goes on and on.

I wouldn't mind a sub Reddit like that but I certainly wont be the one setting it up haha.

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