Charlie

@DrOKaneAgain Hi Dr Okane, what are your views on the fact that before being seen by an ambulance crew a doctor was involved in this patients care and also did not suggest hospital?

Let’s go back to ambulances which take patients to hospital to see doctors rather than paramedics who use their discretion. bbc.co.uk/news/articles/…

@LDNairamb @JoeChappell2608

Our team demonstrating how they can now deliver pre-hospital ECMO 🩺🫀

@PaulRad29 @RadMasterclass Please could you explain? I’m still learning but was taught you can’t assess this on AP as it will magnify the heart and create a false size.

@Charlie_A_A @RadMasterclass Yes you can

CHEST X-RAY 58: What medical device is in place and what has gone wrong? Answer bit.ly/3ynO0iy

@PaulRad29 @RadMasterclass Can you assess the heart shadow with it being an AP film?

@RadMasterclass Wire fracture And enlarged heart shadow with enlarged upper zone blood vessels due to pulmonary venous hypertension

@NatashaMDay link.springer.com/article/10.100… cmaj.ca/content/193/40…

@NatashaMDay It depends on the antithrombin therapy the patient is on. Research would suggest that aspirin/clopi monotherapy and DOACs e.g. apixaban DO NOT need scan. Meanwhile dual therapy aspirin + clopi or warfarin or heparin DO require scan. Happy to share the evidence :)

@maluki_f @emmajayaddie Very exciting to see Nurse Paramedics in the vision!

It’s the way forward ⁦@emmajayaddie⁩ showcasing how we support each other to find alternatives ways of working across the public and private sector #sharingiscaringconference

@simontutt88 @NurseStandard Can you justify paying one nurse more just because their patients are more unwell? Acuity is often proportional to quantity.

@simontutt88 @NurseStandard However, even though an ITU nurse may have to make these complex decisions, they have less patients and are heavily supported. Nurses in other areas make numerous decisions for numerous patients. Outpatient nursing for example you often find a staff nurse leading a whole unit…

Should newly registered nurses begin their careers on band 6? To improve nurse recruitment, the RCN wants to see NRNs enter the NHS at band 6, with a starting salary of more than £37,000. Find out what our readers’ panel thinks about the proposal. rcni.com/nursing-standa…

@ParaAndy90 HOTT principles and withhold CPR. Leaving in and CPR would mean potentially causing further injury. Removing and CPR would exacerbate hypvolaemic cause.

@CarolineJAbbott @fino_emily Well done guys!

@DrNeenaJha When did Nurse Associates begin to exam and diagnose complex conditions, and prescribe!? Pretty sure this isn’t an RN skill Nevermind RNA

“It’s a GP Practice thing” campaign from this trust - encouraging patients to see: ✅ Physician Associates ✅ Pharmacists ✅ Physiotherapists ✅ Care Navigators ✅ Health Visitors ✅ Practice Nurses ✅ Advances Nurse Practitioners ✅ Social Prescribers ✅ Mental Health Workee ✅ Nursing Associatsa ✅ Heakth & well-being coach ✅ Care Navigators ❌ Anyone missing?….an actual GP?! 🚨 Why are NHS trusts campaigning to convince the public they don’t need a doctor?! 🚨

@AriErcole @andymoz78 Is this for NRM though as opposed to water circuits?

@andymoz78 @Charlie_A_A bmjopen.bmj.com/content/bmjope…

Pre-oxygenation devices, a quick thread Good. Bad.

@andymoz78 Thanks

@Charlie_A_A BVM with a self-reinflating bag is really hard for the patient to breath in through (one way valve is designed for positive driving pressure from bag not negative from the patient, and the bag is quite rigid). Also without a PEEP valve easy to hyperventilate after apnea onset.

@MedRegoncall1 @nmcnews The long term plan is to have B4 RNAs complete the current B5 RN duties. And each ward will have 1x RN who will be responsible for care planning and escalation so I’ve heard. Currently the only difference between RNA and RN in SoP is care planning.

☢️I haven’t come across any nurse on Twitter (so far) who is concerned about Nursing associates. However, they are gradually replacing band 5 nurses with band 4 NAs. Even your agency market will be dead soon. @nmcnews

@MichaelGagaHale Is that salary reflective of such a highly skilled professional?

Vacancy for an EMERGENCY MEDICAL TECHNICIAN (ILS) 🚑 Come and work in Saint Helena - a remote island. sainthelena.gov.sh/government/vac…

@chriscraigCCC My ED has a GP room (not UTC) and they will see patients who they deem appropriate 😊 it’s pretty effective

If there is a plethora of GPs that can’t get jobs - is there a way AE could employ them? Like the “walk-in” centres but more within AE but still within their remit of being a GP? I’ve no idea Just wool gathering…..

@DRIISYD @FrankCoffey26 I see your point but lots of AHP manage undifferentiated patients as part of their practice. I think most AHPs all have a fairly unique role to play, and I can understand that when moving outside of that area it can become questionable with regards to undifferentiated pts.

@FrankCoffey26 Put an “associate” after or “Advance” in front of of your name, you will get on with your job daily with out a fuss. It comes with negligible to zero accountability. I do see a supportive role for ACPs in some niche area of nhs but never with un differentiated pts.

While the mind-numbingly repetitive narrative continues, thousands of ACPs & PAs get on with the job daily, without fuss, often in stressed environments, contributing hugely to patient care, education & service improvement. The dire state of the NHS is not of their making.

@ParaAndy90 @TheResusRoom pubmed.ncbi.nlm.nih.gov/34669565/ American study, I’m very aware they have a different approach to things. But interesting. Can definitely see the approach that less is more though. When involved in an in-hospital CA I often find it more disorganised than OHCA due to the amount of people.