@TM5006941 @nhsswipecard Agreed but I would imagine this is being taught in all paramedic BSc courses.
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Ben Mays
5.4K posts
Ben Mays
@HullStrength
Paramedic, RCEM credentialed ACP, CEMS ACP
Katılım Ağustos 2010
1.6K Takip Edilen1K Takipçiler
@HullStrength @nhsswipecard But it’s also true that there can be a huge variation in the quality of Para BSc courses, whatever the HCPC or CoP think or do 😔
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Can I ask physios, OTs and paramedics who have completed the ACP course and are working at EM ST3 level to show me where in their curriculum they are taught about
the renin–angiotensin–aldosterone system which regulates blood pressure?
Anon Anaesthetist@anaesthetic_spr
Someone spent more than 15 minutes explaining to the ACP in ED why they needed to give IV hydrocortisone to a drowsy, hypotensive, and hypoglycaemic patient who was not responding to IV fluids and was at risk of an Addisonian crisis. ACPs know nothing about niche presentations and tend to treat everything as sepsis/dehydration.
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@TM5006941 @nhsswipecard Was going to say, taught in my undergraduate…
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@nhsswipecard I’m not an ACP but was taught that year 1 on a paramedic BSc at St George’s Uni London 🤷🏼♂️
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@DrSdeG @PsychLiaisonCL It’s 6 months universally to my knowledge although I’m happy for you to show me a course that is 2 months and I’ll hold my hands up
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@PsychLiaisonCL Have just helped someone through it, it’s not long
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When ACPs do their prescribing training (a couple of months of training) they are instantly allowed to independently prescribe.
When drs go through med school, supervised heavily for a year on qualifying and as a GP trainee, have a year of people checking things. (1/n)
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@maffygirl RSI/Drug assisted intubation/PHEA, what ever you want to call it
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@maffygirl Paramedics deliver pre hospital emergency anaesthesia in Australia don’t they?
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@LeechCaroline The fact that a charity which holds £36 million in reserve can’t afford to pay for a position like this is somewhat underwhelming
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TAAS are advertising 2 new development posts for regional ST3+ doctors who would like to explore or kickstart a career in PHEM. 🤗
Full JD is via the link ⬇️ …ambulanceservice.talosats-careers.com/job/762065
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@DrLKVaughan You don’t know they’ve failed to show that though do you, you’ve by your own admission not read the paper. You’re argument doesn’t appear to be in good faith, I’ll leave you to your very entrenched views
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@HullStrength Is the ONLY measure? Of course not.
But failure to show whether results are by chance or not condemns the paper right off the bat.
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Article on the performance of ACPs vs 'all other clinicians' in EDs.
I can't see the text (paywall) but the abstract appears to be an outright comparison of ACPs with doctors.
No apparent modifier for case-mix or acuity. Which might be important.
1/
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@DrLKVaughan P values are the only measure of a papers scientific worth? I’m fairly sure that rule number one of critical appraisal is never interpret a paper without reading the full text.
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@HullStrength Because the P values would be reported in the abstract. Or the word 'significant' would be used in some form.
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@anaesthetic_spr @PhilipSteart Presumably you’ve read the full text and can tell us the answer?
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ACPs were introduced to ‘support’ junior doctors.
They then felt insulted to be equated with JDs and got the RCEM to sort out a credentialing pathway to get them onto the registrar and consultant rotas in EM.
Now they have conducted research to show that their care is safer than that of doctors 🤡
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@DrLKVaughan How do you know there are no “proper stats”? you’ve literally acknowledged you’ve not read the full text
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No 'proper stats'. I would be surprised if the 0.8% difference in outcome was actually statistically significant.
This type of 'research' creates the illusion of parity. When there is NONE.
At least they didn't claim that ACPs are safer...
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@AntNorthgraves @DanLittle180 But how would we know we’re repeating it acun has been proven to be a serial liar. next time he says things are fine how can you believe him?
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@DanLittle180 He lied, but we all knew he probably was. Main thing is that we don’t repeat it
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“The breaches were not the product of administrative error” is the telling line I reckon.
Club messed up, we’ve been punished accordingly. Accept it, learn from it, move on and don’t repeat it 🤝🏻
#hcafc
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@DrLKVaughan @LEADACP @ollieburtonmed @BeAwesomeBeAdam Can you provide a link to this reference? It’s the only evidence used to prove harm in the whole report and I can’t find the original paper anywhere.
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@LEADACP @ollieburtonmed @BeAwesomeBeAdam You will to
a) read what we actually wrote
And then
b) take it up with the NMC
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Yes actually.
More doctors on good pay with decent conditions IS the solution.
Except no British Govt over the last 40 yrs has wanted to pay for this.
Workforce substitution is inferior care on the cheap.
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@parthaskar @FrankCoffey26 @Xeon4f145d96s1 @OcoRory I’ll also nibble, but can you provide any evidence of causation between those 2 statements, I.e. the nhs is less safe because doctors jobs are done by others? And that it’s not related to the myriad of other issues the NHS has had for the last 15 years, namely its underfunding
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@FrankCoffey26 @Xeon4f145d96s1 @OcoRory in the end it’s less about beliefs and more about outcomes
Is the NHS more or less efficient /safe / got improved outcomes since doctor jobs are done by others?
That’s where it boils down to .
The rest? Beliefs
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I fear the “4 pillars of advanced practice” is the “medical model” version of advanced practice…
Frank Coffey@FrankCoffey26
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@DrJ_Haddock @TheSnoozeDoctor That’s lovely, I’ll wait for you to provide some verifiable evidence that can be discussed in good faith, otherwise this conversation is over.
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@HullStrength @TheSnoozeDoctor Just apply Occam's razor.
Creating conspiracy theories (a qualified doctor made the intricate anecdote up) to insulate your position is a failure in critical thinking.
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@DrJ_Haddock @TheSnoozeDoctor Can you explain to me how you have verified that this anecdote a)happened? b) represents an accurate account of events should it have happened? For someone who cares so much about EBM you’re very happy to believe something that has absolutely no evidence it even happened.
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@HullStrength @TheSnoozeDoctor This response misunderstands EBM. The burden of proof in safety-critical change lies with those implementing it. Anecdotes about systemic risks are signals, not noise — and no one who cares about patient safety should dismiss them.
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@TigerBitez1904 He also said it at a point where neither ndala or gelhardt were in our squad so the point still stands
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@HullStrength Squad value and resale value are two completely different things. They're both in our squad for this season. Therefore, count towards the value of the squad this season. If Acun would have said our players could be sold for 100 million your point would be valid. But he didn't
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People laughed at Acun when he said the squad had 100 million potential. Pandur has to be worth 4-5 million, Drameh 2-3 Giles back looking like 4-5 million, Hughes could be a 20 million pound player by the end of the season, Kamara worth 4-5 Belloumi and Millar must be 7+ #hcafc
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@HullStrength Ndala could easily be 20 million of that. Look how much Man City sell their academy players for. Gelhardt a good season becomes a 5+ million pound player. Matazo, has a high celling. Our Youth players could bring in a bit with a few good season look at KLP and Bowen (I know)
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@davidwheldrake Yes, he has proved himself to be serially dishonest and his financial recklessness could potentially have risked the future of this football club, he can leave for me.
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So.... are some still calling for the owner to sell up, or have we calmed down now? 🤔 #hcafc
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