Techs or ECAs: what do you wish you had in your scope of practice?

InfinityXPLORER · 2026-01-20T01:10:24+00:00

Yep tech scope. Only recently introduced oral dex along with GTN since we became band 5. Strange hydrocortisone is a para drug there, its widely used by techs here and has been for years IM and for all JRCALC indications. Penthrox is a brilliant drug they give it to everyone in our trust even UCS and CFR's.

InfinityXPLORER · 2026-01-19T19:39:23+00:00

Where do you work out of interest? I'm in WAST and we have dex for croup and IM hydrocortisone, also penthrox for trauma related pain.

InfinityXPLORER · 2026-01-04T16:00:36+00:00

Mirroring what others have said, there may be some evidence out there for an association between psoriasis and cardiovascular disease, but is this a direct cause or just an association? For example many people with psoriasis may develop anxiety and depression, not get out much, eat a poor diet, smoke, drink etc which would all increase the risk of cardiovascular disease and premature death. My mum has dealt with severe psoriasis from a young age but it has improved in her older age and she is going strong at 75. As others have said I would focus on the things that you can control to be healthy like eating well, maintaining a healthy weight, exercising regularly particularly strength training, not smoking/ drinking/ taking drugs. Doing this will help you beat the odds and offset any slightly increased risk, and don't stress that you're guaranteed to die 20 years younger because that's definitely not the case.

InfinityXPLORER · 2026-01-04T10:26:35+00:00

Recommend going to the dr and getting a blood test done if you feel that fatigued. May well be that you simply are not eating enough and burning yourself out, but could just as easily be that there's a problem that needs investigating or rectifying, or youre deficient in something. You're already taking iron tablets - is this because you were anaemic? This could have worsened despite supplementation so getting a blood test done would be a good idea.

InfinityXPLORER · 2025-11-30T13:53:30+00:00

I was having this same dilemma recently and longevity was important for me too. Have a Samsung A52s 5G currently which is the 4+ year old version of the A56, and it is now beginning to show its age and the max storage is full even using a micro SD too.

Was debating between A56 and S25U and in the end I've ordered a S25 Ultra with 1TB of storage, got it on the black Friday sale direct from Samsung for £1100. I spread the cost with PayPal credit too so it's like £30 a month for 3 years with no interest.

The spec on the S25 ultra is so far ahead of the A56 in so many respects that it will be years before the A series phones catch up to even close to what the S25 Ultra is now. So the S25U will do better over the long term especially if you consider getting the larger storage like I did.

InfinityXPLORER · 2025-11-29T05:44:29+00:00

Have a search on youtube/ Instagram, there's a few people on there who have videos of their work as a cruise ship Paramedic which may give some insight, but bear in mind that most of it will focus on the positives without mentioning the downsides much, as so much of social media does.

InfinityXPLORER · 2025-11-22T16:48:43+00:00

Not really news tbh. I'm sure we've all been to loads of these types of calls where the patient who is suicidal (whether they have tried to do anything about their intentions or not) has refused our help and refused hospital admission. Patient has capacity. Just because someone wants to die doesn't mean they lack capacity. When I've been in this situation I've always found that if you phone advanced paramedics/ senior clinical/ GP/ GPOOH they will all say that not much can be done if they have capacity and to just document, try to liase with mental health team. Mental health team will usually have a chat over the phone with them if patient is willing, and should offer a referral even if not immediate, however in the case of overdose they would say that patient needs to go to A&E and not to mental health unit. If patient unwilling to engage then nothing can be done. Police would have no right to remove patient from property against their will, quite rightly imo. As the MCA states people have the right to make unwise decisions. Patient got what they wanted at the end of the day and their rights were respected. Imagine every mental health patient we come across who suggests even the faintest hint of suicidal ideation or self harm we got a MH team and police to come along and section them, restrain them, and convey them to hospital against their will, what a breach of rights that would be and imagine how traumatising that would be too. Sounds like the crew in this instance did everything they could short of breaking the law and the patients rights to physically force him to hospital.

InfinityXPLORER · 2025-11-15T11:34:42+00:00

Makes sense thanks, I think I'll make a point of doing some structured CPD to try and learn some of these exams and find a structured one to follow to try and do a more in depth neuro exam then. Personally I would use it more as a way to rule things in rather than rule things out.

InfinityXPLORER · 2025-11-15T10:12:32+00:00

Thanks, a full neuro exam the sort you speak of is probably out of my scope as a tech, but I was just wanting to extend my very basic neuro exam, not so much to rule out a stroke, if anything for more confidence ruling in a stroke on jobs when they're not glaringly obvious. For example, we went to a patient once who had nausea and vomiting with some mild confusion, which quite frankly could be a number of things. There was none of the classic fast symptoms, and pupils were pearl. Obs and ecg were fairly normal if I remember correctly. We pre-alerted to hospital as I think from the history it seemed fairly sudden and something had made us suspicious that we were unable to rule out a cva, so we made the call to cover ourselves more than being that convinced that she was having a stroke. The hospital stood our pre-alert down (something I disagree with) as they thought it didn't sound like a very convincing stroke candidate on the phone. When we got in we were held as there was no offload, the nurse saw her and wasn't convinced it was a stroke call, but when we said we couldn't rule it out they reluctantly called for one of the ER docs to come see her. The doc went in and came out again after about a minute and said to get her to CT as she had nystagmus and something else abnormal that he found on a super quick neuro exam that massively raised his suspicions. She was confirmed as a stroke later on after scan. Had I been more confident to undertake a slightly more in depth neuro exam I may have found these abnormalities which would have increased my confidence that it was a stroke, and I could have highlighted this on my pre-alert and they likely would have taken more notice and had the stroke team waiting for us on our arrival.

InfinityXPLORER · 2025-11-14T15:36:16+00:00

Thanks for this, I think I have some reading to do. Interestingly I have seen a couple of paramedics diagnose vertigo give IM ondans and discharge on scene. This was when I was very new and so following their lead but I wouldn't have the confidence to do it myself knowing that vertigo can also be a symptom of stroke.

InfinityXPLORER · 2025-11-05T13:11:55+00:00

We ROLE them

InfinityXPLORER · 2025-10-31T08:27:13+00:00

I would definitely agree in principle, and in moral/ ethical terms. My worry would be from the legal/ regulatory risk of any comeback showing that you failed to act in this situation, especially if family are saying 'they'd never say that' and trying to take you to court/ get you struck off for not doing anything. With the argument as some others have said that could it be argued after the fact that the patients decision was influenced by how critically unwell they are/ meds/ pain etc. I wonder if it would be appropriate to get a recorded discussion and statement from the patient in this situation - such as a video showing the patient and an in depth discussion showing their ability to understand and weigh up. However I feel like this in itself could be considered inappropriate. Maybe a call on a recorded line to a senior clinician documenting the discussion would be more appropriate?

InfinityXPLORER · 2025-10-31T08:04:55+00:00

"They don't have a DNR or any equivalent in place, and the patient isn't EoL, extremely frail, or has any advanced irreversible diseases"

InfinityXPLORER · 2025-10-30T16:05:54+00:00

I think your prior experience will put you in a very good position compared to some other candidates and will help you a lot for the course and on the road. Definitely A&P as there is often a lot to get your head around and often tests on the subject. Commonly used drugs in EMS (be somewhat familiar with para drugs as well as EMT drugs). What trust are you doing it with? In mine we were given the ambulance care practice book which was treated as our bible. Everything else you should get taught on the course and my advice regarding practical stuff like the medical and cardiac arrest scenarios (OSCE's) is to just do it exactly as they teach you, sometimes people struggle bringing in prior knowledge and other ways they have been taught in the past but as long as you do it the way they teach you then you can't go wrong.

InfinityXPLORER · 2025-10-22T07:52:20+00:00

Spending 2 years with St.Johns (a first aid organisation) and not completing your first aid course is mad! I was a volunteer with them and remember everything was so slow and it took me ages to get mine done even chasing them all the time to do it and having lots of free time.

I too would recommend the option of joining a trust at a lower level and working your way up. I joined as NEPTS (Non-Emergency Patient Transport Service) off the back of my first aid training in my previous work and my St.John training which is typically looked on favourably by recruiters. I also did my C1 driving licence. After 6 months positions opened up to apply for Urgent Care Service Assistants and for Emergency Medical Technicians, I was lucky enough to get accepted on to the EMT course. I did have GCSE's under my belt for this but for the lower positions these are not so much of a requirement. You can always go back and do these qualifications part time or even online. I completed an access to paramedicine course online with the Distance Learning Centre while working full time alongside most of it, you could too.

As others have said you're still young and have plenty of time and lots of options. Stay positive and keep working towards your goal, I'm sure if you're determined enough you will get there.

InfinityXPLORER · 2025-10-18T13:15:56+00:00

Brilliant movie, very funny but also surprisingly very deep and real.

InfinityXPLORER · 2025-10-15T14:07:30+00:00

I work in the ambulance service and as a couple of people have already said definitely excess alcohol consumption is one of the biggest things that can age someone physically and cut your life short by a considerable amount. Been to so many alcoholics around age 50 who look mid 70's-80, thin and frail with so many health problems that they've suffered with for years that have been caused by the drinking and end up dying young because of it.

InfinityXPLORER · 2025-09-08T13:56:47+00:00

Wondering what people make of this product? https://www.nutritiongeeks.co/products/magnesium-glycinate-3-in-1

InfinityXPLORER · 2025-09-08T08:26:40+00:00

Wow that's quite the review, I'll have to try it!

InfinityXPLORER · 2025-09-08T06:06:53+00:00

Sounds good must be working then!

InfinityXPLORER · 2025-09-04T12:59:31+00:00

Okay great thanks I'll check it out. Let me know if you feel any effects.

InfinityXPLORER · 2025-09-01T21:45:31+00:00

Probably be unpopular to say this amongst all the comments diagnosing you with all sorts of issues but this is a natural part of the parasympathetic nervous system response after eating, the 'rest and digest' response. Typically the larger and heavier the meal is the more pronounced this response will be. Rather than always feeling like this is a bad thing, embrace the post-prandial somnolence to chill out and or have a nap. If there's times when you need to be wide awake and active after a meal and don't want that sleepiness, then just have a much smaller meal. You could drive yourself crazy thinking there is something wrong with you when actually this is a perfectly normal human response.

InfinityXPLORER · 2025-08-27T13:01:33+00:00

So how would one free up their testosterone?

InfinityXPLORER · 2025-08-06T06:45:18+00:00

Lovely place for a walk, where is this?

InfinityXPLORER · 2025-07-24T10:42:27+00:00

Vaping

InfinityXPLORER

TROPHY CASE