Alex Mc

@SianyCross @NMTNGUK @MikeSheffy sure someone will have tagged you already

📣ED Nurses and AHPs in the UK! Another plug for my research study survey evaluating the @NMTNGUK ED nurse/AHP trauma competencies. It takes less than 10mins to complete, please do it now! Share with all of your colleagues as well 😃 qmul.onlinesurveys.ac.uk/emergency-depa…

@MidoriOtoko1 @geeky_gillon It becomes why a question of why are we doing it, can we do it safely, can we manage the post reduction if needed/any complications, what about follow up etc.

@MidoriOtoko1 @geeky_gillon Reduced dislocated elbows with penthrox in the ED, some including fractures but that was obviously post x-ray. The reality is that, if there is the underlying fracture, you may find that elbow is unstable post reduction and you will need someway of securing (POP)

Ambo & ED folks - what are your thoughts on reducing a dislocated elbow on the ambo? Pros - often very difficult to move people w/ outward rotated elbow - pain relieved & easier to manage#l Cons - can’t rule out fracture - chances of nerve damage - lack of training / familiarity

@georgebellstarr Than changing an already robust gem path. Two separate professional groups that work together in the right setting with the right support in place, each bringing something different. In the ED I belonged to, our ACP's worked like "f3's".imho, it was the right level to work at.

@georgebellstarr I'm an ACP, sister's a GP, we've had a similar discussion. Just do GEM if you want to be a doctor. All this talk about foundation years etc, let's be honest, doctors a shit life until you're a consultant. Focus should be on improving their training pathway rather for retention/..

@lesyoung01 @wmcareteam Hoping one day there'll be a similar scheme up my way! Best of luck with the recruiting!!

We are recruiting folks for @wmcareteam If your interested in joining us as a volunteer check out the poster and our website. If your interested then get your application in early as we are expecting high demand. #MD099 #wmcareteam #PHEM

@donotcallmemike @Mat_J_B This was also likely written for ED patients, not speciality patients stuck in ED waiting for beds. My experience, iv paracetamol/iv morphine for analgesia initially and then PRN codeine/oramorph if pain managed in the admitted patient awaiting a bed.

@Mat_J_B I read it as oral morphine has a slower onset of action compared to IV, so give IV. I guess speed is more importance in ED. Although depends how long it takes to get IV access and blah blah blah. Maybe we need a...what's the word....race...to see. 100 ptn needing analgesia. Go.

In acute settings like ED, why is codeine used preferentially to morphine? My pharmacology understanding is admittedly limited, but are you not essentially just giving a less predictable morphine proxy? And if already cannulated, why give oramorph over IV morphine?

@georgebellstarr There's a magic clothes shrinking wardrobe in my house.

@Chris_medicpara Big call without knowing that history though 😂

@al_mce_89 I’d gone with the first, as it was the same as previous presentations and has been managed that way in ICU 😅 Very extensive care plan in place!

Went to an idiopathic anaphylaxis pt the other day and prior to arrival parents had given an air driven neb with adrenaline in. I’ve read in RCUK that you can do this but is more of a ‘may be effective’ and isn’t included in the new updated algorithm. 1/3

@RichM83 Is it more money or better job plans that would keep people in these type of services do you think? Motivation for leaving needs to be assessed properly at the leaving stage.

So many colleagues saying that the Ambulance is not somewhere you can now do a 20-30 year career anymore due to the rapid burnout. We need to change the way we recruit and retain staff with this in mind.

@mfann90 @theRCN Or is it because we've pushed this Florence Nightingale-esque "angels" nonsense for generations and now can't understand why the public/politicians don't understand the varied nursing rules?

@drgandalf52 Agreed. If everyone digs out covering for a couple of days, it lessens the impact of these groups not being there. Therefore reducing the overall effect of the strike. But easy for me to say as I don't have any horses in the race. The obvious being patient safety etc

Unpopular opinion. GPs and other doctors / clinicians shouldn't cover for nurses and paramedics going on strike. What do you think?

@jfletch2012 @lesyoung01 I'm the same! North West seems to be a difficult place to get into it so would be great to see what opportunities there are!

@lesyoung01 this is something ive always inspired to do as part of my nursing goals, but failed due to a severe lack of opportunities in this field esp in the north west

Nurses if you work in the prehospital setting then shout up, let us know where you are & what you do & use the hashtag #PHEN (Prehospital Emergency Nursing) You may inspire other nurses starting out as they can see potential #PrehospitalNursing roles available to them 👇🏻

@thegradmedic This poster reads like a twitter outrage which isn't what you'd expect from a formal body. Can't fault the message, just the manner in which it's being passed.

@kelvmackenzie "ambulance drivers"?? Good work on understanding medical professionals. What kind of creep are you? What have you done for this society outside of spreading absolute shit in your dross rag that you call a newspaper

@RNSuperHero As an ED nurse, that's a good handover that 😂 and I'll throw in some obs leads and iv lines that look like a snakes wedding

My favorite types of report “they’ve got an ET it’s a something at a number. And they’ve got some gage of IV in the right side” ok sir thank you 😂😂😂

@NGParkes83 @Pipes_n_pumps @WelshGasDoc @cliffreid Seen in the CANLEAD trial. Better off leaving the algorithmic approach to ALS with someone else as the clever stuff happens separately. Improved time for defib, drugs etc

@Pipes_n_pumps @WelshGasDoc @cliffreid In the words of Mark Whitbread you need the thinkers and the doers. So Nurse to run the doing part, going though the algorithm. And I’d say Anaesthesist/EM/ICM to run the thinking part.

If there is a cardiac arrest in the operating theatre, who should team lead? A. Surgeon/proceduralist B. Anaesthetist C. Operating theatre nurse D. EM or ICM physician E. Don't care but blame Anaesthesia

@georgebellstarr Tbh I did a dissertation and it was garbage. Have ended up going back to do different modules in areas I feel my clinical knowledge is lacking. Think dissertation and the likes is great if you're looking at further academics, but taught modules are better if clinically focussed

@georgebellstarr Not 100%, but all the MSc peeps I know have had to do a research module and dissertation. And modules/dissertation were specific to that MSc aswell.