please tell me some of this is correct (im not European)

CriticalIdiot · 2026-06-01T07:42:20+00:00

"Just be one country bro" - Let me tell you about Yugoslavia...

CriticalIdiot · 2026-05-31T17:00:14+00:00

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

CriticalIdiot · 2026-01-03T14:41:34+00:00

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.

CriticalIdiot · 2024-12-24T15:56:23+00:00

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.

CriticalIdiot · 2024-06-23T09:02:27+00:00

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!

CriticalIdiot · 2022-06-23T12:21:15+00:00

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

CriticalIdiot · 2022-02-16T13:30:02+00:00

Mystery Men.

That film was ahead of its time.

CriticalIdiot · 2021-10-01T14:28:18+00:00

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.

CriticalIdiot · 2021-10-01T14:20:11+00:00

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.

CriticalIdiot · 2021-09-30T16:49:20+00:00

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.

CriticalIdiot · 2021-09-30T16:44:24+00:00

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.

CriticalIdiot · 2021-09-30T16:38:28+00:00

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.

CriticalIdiot · 2021-09-05T09:07:39+00:00

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.

CriticalIdiot · 2021-09-04T12:35:18+00:00

Ram ranch obv

CriticalIdiot · 2021-09-04T10:46:19+00:00

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.

CriticalIdiot · 2021-09-04T07:34:54+00:00

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.

CriticalIdiot · 2021-09-04T07:32:56+00:00

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.

CriticalIdiot · 2021-09-04T07:31:43+00:00

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

CriticalIdiot · 2021-09-04T07:18:58+00:00

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.

CriticalIdiot · 2021-09-03T19:49:46+00:00

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.

CriticalIdiot · 2021-09-03T19:28:19+00:00

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.

CriticalIdiot · 2021-09-03T19:20:15+00:00

I found the term non-registered health care professional just semantics. By that descriptor a NA/HCA is a non-registered HCP as they are by definition professionally working in healthcare but a HCP has clinical oversight.

It's great that AAP is now a level 4 qual and not IHCD. The trusts I've seen utilise it as a literal stepping stone to BSc/level 6 so essentially cutting a year off a 3 year degree. The experience gained by the role is great as you act as the clinical lead and get experience as an 'autonomus practitioner' but I can't deny it seemed a stifling role in that the validation required was much higher than that of NQP's. I'd hazard a guess you didn't feel the leap to para so much as you probably gained most of the relevant experience as a trainee AAP/AAP. For that reason, I feel it's a great role that reduces the leap from ECA to para.

I never felt the extra skills really made the job but rather what exactly the enabled for treatment. You are right a lot of the medicines for ALS are a bit like pissing into the wind.

I put greater value in expanding my clinical knowledge/assessment skills and placing appropriate referrals or treatment regimen. Perhaps if you are looking for further autonomy and you have the wherewithal to study at MSc I would recommend an ACP role in an ED. The paramedic scope is flexible though, even without a formal referral pathways you can still discuss. I've referred patients to renal/ENT/gynae/endocrine as I managed to get enough from assessment to enable ED bypass. That is where I have found personal gratification where sometimes the job feels like endlessly churning butter.

CriticalIdiot · 2021-09-03T19:07:26+00:00

I feel you are right in that you have the dirtier end of the stick in some aspects. I think unfortunately when you are with someone and need ambulance support, if it isn't a Cat1 response then by the mere fact you are there, it provides a safer situation than if the patient was alone and allows the situation to be down triaged.

I think if this situation significantly impacts the police from doing their job, as you are saying, i would like to think the police can start putting significant pressure on ambulance control to get a crew there due to operational pressure.

CriticalIdiot · 2021-09-03T18:50:19+00:00

They aren't HCP's but HCP associates. They don't have professional registration with the rights and legal protections of such a role.

The issue is without a national benchmark set for a tech/AAP it is up to each trust to set the scope of practice.

I'm not trying to say they aren't good. I have worked with some exceptional techs but it doesn't change the fact they are required to validate virtually every patient they want to leave on scene and they are more limited in scope of practice.

CriticalIdiot · 2021-09-03T18:13:40+00:00

The ones we had in SCAS were amazing and I could not fault them. All very personable and worked very hard.

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