QME
Mark Jadav
80 posts
Had a brilliant weekend training with the CFT, SWAST and Primary Care healthcare staff on St Mary's.
#wereinthistogether
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Who's going to raise the funds? St Mary's need to have bedside ultrasound to help with: pneumothorax, pleural effusion, iv access, AAA, peritoneal fluid detection, foreign body localisation, and so much more! #POCUS
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Great discussions on the need for shared decision making in medical evacuation. Time for us to collaborate and help make robust decisions about this critical but resource-intensive and risk-laden activity.
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Some great local learning on pediatric drug dosing using the Watch drug sheet, second line agents for epilepsy and asthma, the need for early joint aspiration in acute monoarthritis, and navigating the minor head injury on anticoag/ antipatelet.
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Simulations and small group discussions: Acute abdomen, Poisoning, SVT, Asthma, Arterial bleeding, Hot red joint, Knee examination, Chest wall injury, Head injury and the new NICE guidance, PE, Collapse?cause.... Just a small selection of a typical working week in urgent care
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Mark Jadav retweetledi
There is a structural problem with Anaesthetics here too (and several others).
The requirement to effectively apply twice to progress (at entry and at ST4) as opposed to run through training supports this bottle neck for trainees who have already committed to the speciality.
Shaun Lintern@ShaunLintern
🚨 It's crazy that the NHS has told 350 doctors training in anaesthesia that the NHS has no job for them after 3 years training. At the same time we have massive shortages of, you guessed it, anaesthetists. These self-defeating bottlenecks defy logic. Statement from @RCoANews
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Mark Jadav retweetledi
@alibulman @JoSouthcott16 A very good point, Ali. This was about where to create capacity. When asked to open more capacity, our system can employ more ambulances, open more ED beds, increase the size of the acute medical unit, expand a specialist ward or unlock a social care package. The impact alters.
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@JoSouthcott16 Surely that should be the same for all discharges and not just moving people to long term bedded care…..why not home and why not today!
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Mark Jadav retweetledi
theguardian.com/society/2023/j…. Bit grim, but many of us will recognise this
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Where we create capacity matters as we have a mainly hierarchical structure to emergency admissions, with conversion rates between. Make an ED space and offload 2 ambulances before it is the limiting factor. Make a social care bed and offload 200.
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@stephen_t_webb @WinnMatthew @Thea_Stein @RishiSunak @Helen_Whately @LCHNHSTrust @WYpartnership @NHS_RobW @JennyKeaneNHS @SJM_NHS @BBCRadio4 I'd like to hear that. Which programme was it on?
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@WinnMatthew @Thea_Stein @RishiSunak @Helen_Whately @LCHNHSTrust @WYpartnership @NHS_RobW @JennyKeaneNHS @SJM_NHS And a strong interview with @Thea_Stein on @BBCRadio4 this evening explaining the virtual ward approach in Leeds and the importance of admission avoidance 👍👏
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Great that @RishiSunak and @Helen_Whately were visiting an #intermediatecare unit in @LCHNHSTrust @WYpartnership today - sustainable model of care to solve our current transfer of care blockages in hospitals @Thea_Stein @NHS_RobW @JennyKeaneNHS @SJM_NHS
Rishi Sunak@RishiSunak
Last week I promised that patients will get the care they need quicker. This morning I saw how we are doing that at Leeds Community Healthcare by providing intermediate care for patients and reducing the time people spend in hospitals. Thanks to the team for welcoming me.
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@jim_crawfurd @davehartin @clifford0584 This was worth listening to. I don't agree with all the 5 policy points of the EveryDoctor campaign, and clearly they are coming from a medical workforce standpoint Vs a royal college standpoint... But this was a good interview.
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@davehartin @clifford0584 I listened for a bit but my attention span is painfully short these days 😬
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She should not be on the news. She has no mandate. I can’t say more but it’s terrible she is given a voice
Dr Andrew Meyerson@AndrewMeyerson
🚨This is @EveryDoctorUK's @JujuliaGrace on BBC News. She's a tireless advocate for the NHS and this is an excellent interview. Please watch! #SOSNHS #ReviveTheNHS
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Mark Jadav retweetledi
Unprecedented? The NHS crisis in emergency care was entirely predictable | The BMJ bmj.com/content/380/bm…
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Mark Jadav retweetledi
“I don’t think I heard quite the grasp of the fact that this is a really, really difficult situation”
King’s College Hospital CEO Prof Clive Kay tells #BBCLauraK that he doesn’t think PM Rishi Sunak seems to understand the level of problems in the NHS
bbc.in/3inz2Vi
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@Foweydoc @RCHTWeCare Oh no, I missed the therapy dog visit! We need to advertise them on the locum chat - we'd be falling over ourselves to come to work!
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@tajekbhassan @RCEMpresident @NickTriggle It was a brilliant article, Taj. It recognised that labour couldn't have spent any more than the Tories immediately after the 2008 financial crash. But the ongoing underfunding and the active defunding of social care: this has been Tory policy.
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Great work Adrian in taking agenda and issues to top table in land
We know this is a ‘hole’ taken 12-15years to dig. See @NickTriggle article & his excellent graphic.
Investment in our NHS workforce is the major requirement but the ‘perfect storm’ may take few yrs to fix
Ian Higginson@RCEMpresident
Thank you @RishiSunak , @SteveBarclay @willquince and @Helen_Whately for inviting @RCollEM to this meeting. We are pleased that emergency care is recognised as a priority. This is fixable.
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Mark Jadav retweetledi
This is Aintree Hospital where sockets have now been installed in the corridors, with signs marking out different bed spaces
This is the new normal for hospitals and no one sees it ending any time soon
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@DrChrisMoulton @RCollEM Completely agree, Chris. Don't want to distract from the inadequate funds in the current model. But we need to change what we use our health services for, and get more health and life wisdom into society at large.
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The NHS enters 2023 in its most precarious state ever. Some more fiddling with targets and pathways will not prevent patient harm or staff disillusionment. We need a complete new paradigm of healthcare, if the NHS is ever going to be the envy of the world again. @RCollEM
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@DrLindaDykes Excellent question, Linda! I've slept on the floor many nights and my Indian family sleep on the floor every night. None of us ever tested for rhabdo! My own practice is to examine for evidence of pressure damage and dehydration. None=you're ok.
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Can anyone on #MedTwitter save me an evening on Pubmed & tell me if there's an official definition of a "long lie", and after what time on the ground do risks of complications such as rhabdo & pressure area damage become significant? Anyone got evidence-based guidelines?
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