Dave Nicholson

📢 New National Pre-Alert Guideline RCEM and @AACE_org have released a new national guideline to standardise pre-alert calls between ambulance services and EDs. 📄 Full guideline available now: tinyurl.com/rcemAACE ✅ Updated criteria for pre-alerts ✅ Use of ATMIST format ✅ Concise communication ✅ Importance of training for all staff This is about improving collaborative working to create safe patient handovers. Please share with your colleagues and teams! All position and advisory statements: rcem.ac.uk/rcem-position-…

Just finished reading this. An incredible and absolutely insane story of pre-hospital amputation in extreme circumstances... abc.net.au/news/2025-06-2…

@rachelgemma90 That story is utterly astounding, what a read, what an outcome.

@rachelgemma90 @ThomasBurton12 @SeanHarris999 one to share with @metpoliceuk colleagues?

Myself & @ThomasBurton12 are carrying out research into the short & long term psychological impact on police officers of witnessing prehospital resuscitative thoracotomy. Please re-tweet, share & send to anyone you think it might be relevant to.

I don't often get job jealousy, but damn that's a cool shot...

Secamb folks FYI!

@EMDocJB @bradgander_ @Junaid_APP Losing the situational awareness is tough when in a solo practitioner role as there's so much to do to ensure the marginal gains of a well run OHCA implemented. We do SPEAR in my hems role when part of a team however different kettle of fish as a solo CCP sadly, lots to do!

@bradgander_ @Junaid_APP @DavidRNicholson It’s definitely doable! It does require a shift in workflow and change in role, certainly you will be “eyes in” during cannulation so will lose SA of the overall management of OHCA Would be great to see SPEAR implemented into your service though

@DrRJWebb @RupertLowe10 Funny how I knew which political party this MP was from without even having to look it up...

So @RupertLowe10, genuine question. Non-English speaking parents come to ED with unwell baby, they don’t have family or friends locally. Can’t get history in English. You’re happy for me to let the child come to harm because you’ve scrapped all interpreters?

@aaronhillmedic @bradgander_ Agreed, have used before, technically challenging and hard in the patient with a large body habitus but valid point! We use the vScan air and it has a large cardiac probe so getting a sub-xiphoid can be tricky.. Maybe Doppler one day with some evidence/tech advancement

@DavidRNicholson @bradgander_ It is possible albeit technically difficult to get a subxiphoid view with a butterfly probe to monitor LV contraction during CPR… which can be useful to guide hand/LUCAS position

Do you have knowledge/experience in out of hospital cardiac arrest and Bystander CPR? I am looking for ‘experts’, ‘specialists’ and ‘informed individuals’ to contribute to a Delphi study to establish criteria of quality for bystander CPR in OHCA. Registration link in thread.

A visual of the venturi effect

@HowdonC @rachelgemma90 You quite literally double survival in a paediatric OHCA population if you stay and get good, definitive ALS established before conveying to hospital. Scoop and run is a thing of the past. 5% survival <10mins. 10% survival 10-35 mins. pmc.ncbi.nlm.nih.gov/articles/PMC45…

@rachelgemma90 Really good questions since the on scene times in LAS are already very long

Have only just come across this but I love it. Would be interesting to know whether since it's implementation there's been less 'scoop & run' and longer on-scene times whilst ALS is established. Any difference in outcomes? Has it been audited since it was introduced?

@beifahrer_to_be @bradgander_ Can only speak for @HIOWAA , but our model is Dr/CCP. Rarely, if ever, do we go CCP/CCP and only due to short notice sickness. We deploy solo CCP cars as well as do DSAA but these are in addition to the main teams.

@bradgander_ @DavidRNicholson do HIOWAA and Dorset AA only deploy CCP/physician teams? or are there CCP teams only?

Great to see some @HIOWAA data and research come to fruition.

@bradgander_ Hahaha needs to be marked first 😉

@AaronTuNZ Love that diagram on the opening slide and the ethos of the talk, will try and tune in!

With the second International Critical Care symposium fast approaching I guess I’d better start work on the presentation Error in critical care. Something that cannot be ignored Book your space at theiccpg.org Some awesome speakers in the lineup! #CriticalCare #EMS

The advert for Trainee CCP roles with @SECAmbulance @SECAmb_CCP is now live. careers.secamb.nhs.uk/all-vacancies/…

Nature put on some fireworks for us last night #NewYear2025

The annual rural new years escape and recharge 🔋 📌Senja, Norway.