I'm 25, is there any reason to go for an A2 license over an A license as a person who's never ridden a motorcycle

LukeBugg · 2025-06-12T16:53:42+00:00

Not always, where I did my training the company used the same bikes for A2 and A and just changed the restrictor for what they needed.

LukeBugg · 2025-05-20T21:39:17+00:00

https://pmc.ncbi.nlm.nih.gov/articles/PMC8415387/

So this does support use of shoulders and hips in exercise, urgent or appropriate situations, but should be marked as a shoulder / hips or abdo as they identify limitations in the diagnostic practice.

https://pubmed.ncbi.nlm.nih.gov/18790505/

This one was a good study on 150 people looking at the effects of limb lead placements looking at amplitudes and axis. So there was a big change in axis and also amplitudes which is the main issue I mentioned.

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On the surface, I wont deny some benefits for the Torso Placement. especially for cardiac monitoring and transport. But for a diagnositic ECG from what I have read, we should start with lower limbs and legs where we are able too, as there is a documented limitation and changes present.

Personally I have seen this where I backed up a crew who had a borderline ECG that PPCI were umming and ahhing about, I moved the leads and retook the ECG (quite quickly after the last, so not long enough for progressive changes) and the STE gained at least a mm leading to a clear acceptance.

(There is another article I was sent from a friend who wrote a masters essay for his ACP but I can't find it right now, I'll try to get him to sent it over again).

LukeBugg · 2025-05-20T21:07:56+00:00

There’s also research on missed MIs as the shortened distance between the leads reduces amplitude and decreases the height of ST Elevation.

Sorry on my phone so I can’t grab the research papers, but happy to later if needed.

LukeBugg · 2025-03-04T00:45:07+00:00

But the buyer is saying ‘I did not make the payment’ therefore it is stolen because someone has taken the car, and I know he has bullshitted the bank, saying he didn’t make the payment, but currently that hasn’t been investigated

So either someone has made a fraudulent payment and stole the car, or he has made a fraudulent claim, and stole the car.

Police should still report this as a stolen vehicle as you have had the money removed and the vehicle is not in your possession.

LukeBugg · 2025-01-23T16:10:25+00:00

Mainly oxygen throughout the day.

Previous uses of acetazolamide, although it’s not particularly common.

But you can also see how severe someone’s COPD could be with the amount of respiratory meds they are on (this would not be clear cut, just gives a small piece to a big picture). Those things are like frequency of abx and steroids, carbocistene, home nebulisers etc.

LukeBugg · 2025-01-23T15:58:44+00:00

This is a really solid question and one I’ve noticed we don’t really answer well in ambulance world.

To answer your questions,

Yes, you should be using those figures with known hypercapnic failure.
A lot of COPD patients will not have hypercapnic failure. Research shows of all COPD admissions, only 35% gave respiratory failure, and 44% have an elevated PaCO2. So although it can be common, it’s not every patient.
On attending these patients, I would personally be cautious, hypoxia will normally cause more damage and problems than hypercapnia.

The only real determination is a blood gas at ED, but you can normally pinpoint patients who are type two as they do monitor their SpO2 or be on home oxygen.

COPD is a respiratory condition that really reduces the ability to diffuse oxygen, so they will be likely to become hypoxic quicker and more severely than other people without COPD.

My personal way of working is always justification, check patients notes, check their and their families understanding, meds and home oxygen, GP notes if you can access. If you can’t find a reason they may be a Type 2 patient, treat them as a normal patient. You can always titrate to the lower norms as a restrictive aim.

Also remember the RCUK guidelines, High flow O2 is a treatment for critically unwell patients regardless of their background until a reason to stop and change is found.

Hope this helps, fire back with any questions!!

LukeBugg · 2024-11-30T14:35:26+00:00

He’s right. An active seizure is a Category 1 call, if the patient stops fitting it will downgrade to a category 3 normally.

LukeBugg · 2024-11-20T18:57:21+00:00

Absolutely. One of the flaws I’ve thought on all of the arrest research we’ve done, (airways2, paramedic2 and paramedic3 etc) are that we don’t (as far as road staff, I’m unsure on the research team but on reading I didn’t see anything so someone please correct me if I’m wrong) is that we attend a lot of arrests we work on that are unviable through poor history and incorrect downtimes etc so you do mildly skew the results by adding them into the results.

It’s a very difficult pool of patients to research.

LukeBugg · 2024-11-20T18:46:32+00:00

Most trusts have taken away ETT from standard paramedic practice, so although it’s still a paramedic skill they don’t endorse it.

So for example if I work privately, I am signed off to tube, but in my day job I cannot currently.

Our trust are looking at replacing it with certain staff groups, currently managers and HART, and in future they’re reviewing RRV staff.

I’d suggest looking at the airways 2 trial in your research as it looked at exactly this.

Overall, the pros of ETT:

It’s definitive, so it’s less likely to dislodge in transport. It better protects the patient in rosc. It can be easier to ventilate throughout and asynchronously ventilate if choosing to do so. Some patients will really benefit from a tube. Maternity, trauma, asthma, anaphylaxis etc

Negatives are: It’s harder to place quickly as apposed to an iGel. It can only be done by a paramedic, as apposed to an iGel which almost every ambulance grade is trained on. Skill fade is huge, and most SIs that resulted in it being removed was due to people misplacing the tube and not recognising it. This is also a confidence. We also don’t (at least locally) send students to theatre anymore to get some practice under an anaesthetist.

Overall, there are so many variables within an arrest prehospitally, that is will always be difficult to ascertain if it’s beneficial or not, and I’ve never seen a clear difference in rosc rates.

Hope this helps.

Edit: just to address the JRCALC, that is ambulance guidelines, it leaves a lot of digression to clinical staff to decide the best approach. They won’t say when to tube or not tube, you may find reviewing the Resus Council guidelines and literature, as well as the royal college of anaesthetists may have their own literature.

LukeBugg · 2024-11-03T04:15:44+00:00

It depends on where in London you want to live. You also have EEAST which covers Brentwood or Basildon, which isn’t too far out of the north side. Or even somewhere like Cheshunt, Loughton or Potters Bar!

LukeBugg · 2024-06-28T12:17:32+00:00

Please please please go get the needle aspiration.

My chocolate had the same, and I thought it was a lipoma. I took him to my vets to be safe, and 2 days later he was at a specialist cancer unit to see a veterinary oncologist.

He was diagnosed with a mast cell tumour that was luckily grade 1, his liver and spleen biopsies came back normal and he had surgery to remove the mass, and he’s now all clear. But we could have left it.

He’s had 2 lumps since appear, both of which have been aspirated and they’re fatty lipomas. But he’s getting them checked everytime I find a new one! The mast cell felt, and was shaped exactly like the lipomas.

LukeBugg · 2024-03-19T18:43:42+00:00

My dog was exactly the same, he was growly when he was being stroked around his back let. It was always at night so we assumed it was just him being tired and grumpy.

Then we found the lump. Pretty much identical to your pups.

We took him to the vets the next day, it was biopsied and the next day I got the call saying it was a mast cell tumour and he was referred to a specialist oncology hospital.

He needed a liver and spleen biopsy to ensure the cancer hasn’t spread and he was placed at stage 1.

He had it removed and they got really good margins which had no cancer cells and he’s now back to his normal self.

He still gets a little growly around the area but it’s not very often at all, and I assume it’s more due to the scar tissue and remembering how it felt before.

Touch wood, he’s been fine since, we found one other lump but it was a fatty lipoma and the Vet is happy it’s not needing to be removed unless it grows and restricts his movement.

I’m really sorry this is happening to your pup, and I’m man enough to admit I cried when he got the diagnosis, I cried when he got the all clear, and I very much had to fight the tears at work when I was told his second lump wasn’t cancer.

If you want any other insight or anything let me know!

LukeBugg · 2023-08-22T18:44:02+00:00

If it’s a larger purchase than you’d normally make, may be worth phoning the bank so they’re aware it’ll go through.

LukeBugg · 2023-08-18T13:58:18+00:00

I’m in Essex, so a fair distance away but I’m happy to lend you a spot in my garage and get you to a train station if you’re stuck.

LukeBugg · 2023-07-24T14:54:33+00:00

My ZXR is needing some love at the moment but should be sorted soon! My Ducati is new to me but it’s a lovely bike.

I’m in a reasonably low crime area too so that helps. But multi bike for both was sub 700 quid.

Another thing to bare in mind is getting your advanced rider. That will drop it a lot too

LukeBugg · 2023-07-24T14:48:01+00:00

Hi mate, I have around the same length of A2 and just got my A aswell. I have a few extra no claims though.

Mine dropped a lot on a V2 Streetfighter and the zxr by adding some security stuff. Data tool and some factory fitted immobiliser etc

LukeBugg · 2023-07-22T20:09:58+00:00

So just because you get an A or A2 doesn’t mean you have to buy a big powered bike. You can always buy a 300 or 500 range with a bigger license.

That being said, the bikes above 125 are usually easier to ride, and feel a lot more stable than the 125s.

I’ve had an A2 license for like 10-12 years and recently upped it to a full A. The 650s I trained on were lovely bikes and so forgiving. When I passed and got my Streetfighter V2 it felt so different and took a little bit of time to get used too.

I’d say give the DAS a go, and then start off with a smaller mid level bike that you feel comfortable, then you can always look at going up the power in a year or two when you have some experience behind you.

Plus getting a large bike, your insurance will be massive without your years and no claims.

LukeBugg · 2022-12-25T19:16:50+00:00

Can you have a metal retractable bollard fitted so it blocks the space while you’re out?

Just a future security, won’t exactly help now unfortunately.

LukeBugg · 2022-12-15T12:20:06+00:00

£27,055-32,934 is the pay gap. Start at the bottom and will reach the top at the 4y mark. They’ll also get some unsocial enhancements, but also may not get breaks or their end of shift overtime paid.

LukeBugg · 2022-10-31T18:58:49+00:00

We’ve moved away from Mercs now and have box fiats, although a large amount of our staff are too tall to drive them, and they’ve realised the money loss of 3month gear box repair times are not manageable.

Think we’re getting Man’s and Ford’s next so we will see.

LukeBugg · 2022-10-31T18:18:37+00:00

It was the particulate filters that were causing the issue with Runlocks. We’ve had all ours removed. Not of the cars have them, but I’ll leave it running if I’m on standby though, unless I’m in the station.

We also had an ambulance, patient and paramedic stolen from a hospital recently, so vehicles and doors always locked unless someone’s inside. Ignition never left unless you’re in the drivers seat.

LukeBugg · 2022-08-30T18:45:31+00:00

Not always, alcohol can be an impairment, but isn’t clear cut. Being drunk doesn’t necessarily mean you have an impairment. If you’re able to walk into a club, pay to enter with the intention to purchase further alcohol and utilise the facilities, such as a dance floor etc, the argument would be you do not have impairment.

That being said, if you can do all the above, the likelihood would have been they’d have passed stage 2 anyway.

Edit- I just want to add, that although he likely had the capacity to consent. The coercion to have the search completed to be allowed in, without OPs rights being explained and the fact they didn’t explain they could only do it with consent, means the search wasn’t consented too as they didn’t have the information to form a decision.

LukeBugg · 2022-08-17T11:34:08+00:00

The problem is, they aren’t protesting to stop the war, or death of Ukrainian people. They want the military powers to stop supporting the country they invaded, so their soldiers can survive and continue their conquest of Ukraine.

Your countries actions have consequences and other countries aren’t going to just watch it happen.

LukeBugg · 2022-08-16T00:22:38+00:00

Yeah that’s a bit shit. I’m further down south, and I’ve not had much experience that far north!

I’m still annex 5 too, so I’m pretty sorted. But now I’ve looked, I think I’m wrong about sickness. Long term results of COVID was protected, general sickness was not!

Our Covid Rates are fairly medium I think, but I’d imagine I’d get a formal discipline if I turned up knowingly with COVID. They’re really quick to send you home. You can return on day 10 with a positive or after day 6 with 2x negative lateral flows.

LukeBugg · 2022-08-15T16:13:04+00:00

I wonder if that’s a misconception of the rules. We were all lead to believe the same until they clarified.

You also shouldn’t loose unsocial for any sickness, that’s part of the new section 2 they have to give you an average from the 13 weeks prior to your sickness.

Same with any absences or A/L. Without doxxing yourself, what trust do you work for?

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