Stephen Loftus
267 posts
Stephen Loftus
@StephenJLoftus
Irish living and working in the UK, Paramedic @SECAmb, MSc Student @Resusmasters, Army Reserve Officer, Adventure and fitness addict.
Woking, UK Katılım Aralık 2016
789 Takip Edilen349 Takipçiler
@StephenJLoftus Hi @StephenJLoftus. There are links to ROSPA (Royal Society for the Prevention of Accidents) self-mobilisation video embedded within the EOC Clinician Fallers Advice Flowchart, which is saved on Teams under Integrated Care Clinical Team > Clinical Resources 😊
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Still a huge assumption that an older person who has fallen will automatically need a face-to-face ‘response’ (e.g. ambulance or community service) to get them off the floor. Very appropriate to consider suitability for coaching over the phone 📞💬 #EnablePatients #ReduceLongLie
The STAB:LE Program@stable_program
Physios… teach your clients to get off the floor. Even if they’re 90. No, ESPECIALLY if they’re 90. This is Bill. Bill is 97. Be like Bill.
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@LizzyFerret 2/2 If you want to improve PT safety, focus on building people and professions up positively, not admonishing and undermining public confidence in them. My profession is lucky in that I've never experienced the volume of toxicity and unhappiness that medtwitter exhibits
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All over Twitter there are shouts of “be kind” from Nurses and other AHPs about this topic.
As someone who was well on the road to a forever career as an ECP pre medicine I feel entirely qualified to say this kind of thing ⬇️ IS NOT OK and shouldn’t be happening.
If those in
Dr Done@Dr_Done_
Posted without comment 💵
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@LizzyFerret 1/2 Umbrella statements questioning the competency of well established and regulated HCP roles, based off an anecdotal case, is quite saddening. All AHP roles differ in their autonomy but we're all one big team.
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@teddyhla Absolutely! NHS understands metrics-change to Amb Resp Prog to incl AED on scene w/in 6 min to encourage services to engage w/ local stakeholders. Encourage innovation eg high mobility deliveroo drivers urban / amazon rural to get AED to scene, pay company if 6 min target met
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@StephenJLoftus Yeh. I think the kss experience has shown that we really need to engage low level first (which is what happens in Minnesota) - and that’s fire / police carrying AED , BLS teaching in schools etc. the hospital economic argument isn’t bad if patient has full neuro recovery
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Hybrid Model by Dr David Ransley
- Getting to arrest is HARD, ARREST 7 mins, Prague 8 min, reality is over 10 mins.
- Getting OHCA pt to hosp is hard
- CHEER 45 to 73 mins, 2CHEER : 21 to 35 mins. Prague 44- 60 mins.
#UKECPR23 @MLScourse
@Novicelearner9
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@teddyhla As a system, shouldnt we be aiming to improve the basics in the chain of survival for all before we allocate funding (asides from research setting) for a very costly treatment that has such a small subset of patients who would benefit?
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@StephenJLoftus I think those are all great points. But even with all of that - 15 mins on scene time ; flight time is jsur crazy. Perhaps rural model
Need to be on scene PHeM ECPR
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@teddyhla Great 🧵s! Cost to treat per OOHCA ECMO PT? KSS observational data suggest no OOHCA rural subset would benefit? Would funding be better invested where there's a great evidence base, free public cpr training / public access defibrillators / first responder schemes?
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Did you know our SASC Weapon Collection is open for business??
Take a walk through time with one of our trustees or familiarise your troops with foreign weapon systems.
Contact Mike on 01985 222487 to guide you through the booking process.
#thecorps #thecollection #since1853
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@EducationPara 2/2 High acuity time critical require familiarity and speed, eg shoulder dystocia management. Greater risk carried by underperformance in time critical patients vs urgent care where there's time and bandwidth to research / discuss on scene during decision making.
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@EducationPara 1/2 Even though high acuity is small %, management needs to be familiar. Also the jobs that thought of cause most anxiety. Urgent care can be developed over time, with patient safety during learning phase mitigated by discussions with senior colleagues re referral etc.
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@neilorpen @DrHannahBB Everyone completes the same 4 weeks advanced driving course before driving an emergency vehicle. In any field age does not equal experience. Would you rather a 40yo that has only had their licence a year vs a 24 year old who has had theirs 6 years?
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@DrHannahBB In fairness though , I would still be worried about a driver this inexperienced being involved in driving an emergency vehicle
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@MaskedAMHP 2) when conveyed, ED often not being set up optimally for MH pts, they will be sat in a waiting room for hours, away from their home environment where they feel safe. Would pt need b better met (where little imminent risk) with a commissioned specialist emergency MH service?
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I'm not disputing that the dire state of the NHS and lack of mental health beds contributes to those hours, but the Mental Health Act Code of Practice does stipulate that people assessed under the Act requiring admission to hospital should be transported by ambulance.
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@MaskedAMHP 1) Agreed, but % requiring ED conveyance rather than just assessment and referral in the community is changing. It's more challenging for us, with little hx or knowledge of the patient, to liase with the local crisis line for hx and / or referral.
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@georgebellstarr Tbf, the mess is the home of living in service personnel, imagine a dress code to dress up to eat dinner at your kitchen table. Discussion above to allow people to dress comfortably to switch off when not at work and ensuring female dress equivalent essential for inclusively 👌
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@DavidRNicholson Have you shrunk or is that just a really tall truck? 😂
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@simontutt88 OA=primary survey & environmental factors noted. Paint picture of the scene and whose there for those reading the paperwork. Has been the most useful part of my paperwork for police/coroner/trials/complaints. In hospital and OOH different beasts & ultimately clinician preference
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I've never understood the need for ambulance documentation to use on arrival (o/a) I'm yet to see an example where that information isn't better placed in HPC, O/E, social hx sections etc. Anyone got examples to change my mind? Trying to teach SPs clerking? They use it on road?
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@Paramedtweeter @ParamedicBarry @Ed_CritCare_On Absolutely agreed David but this context, when volume resuscitation is required, is often when I see small octopus on large bore. Can be an easy fix as you said, but it's one bandwidth occupier that can be eliminated in advance with awareness and education 🙌
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Teaching my new student about cannula flow rates today, special thanks to @Ed_CritCare_On for this one.
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@aaronhillmedic Maintenace of momentum and concurrent activity for patients pathway towards definitive care
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Ambulance Staff (of all grades!) 👋🏼
When seeking support from HEMS/Critical Care Teams, other than technical skills - what are you often hoping they will provide and bring to scene? What non-technical skills do you think are important in these roles?
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@josephmooney @Potgieter_V @DeScoite @EDinthehome @PathfinderACP Excellent, great to hear of things moving forward 🙌
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@StephenJLoftus @Potgieter_V @DeScoite @EDinthehome @PathfinderACP I think the plan is CPs throughout Ireland...at present we have 3 CPs in Dublin and hopefully more in the future
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This point needs to be screamed from the rooftops.... going to hospital by ambulance DOES NOT mean you will be seen faster
National Ambulance Service@AmbulanceNAS
We get asked a lot if being taken to hospital by an ambulance means you get seen to faster in the hospital. The answer is no. Please only call 112/999 in cases of emergencies.
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