Andrew Blackmore

“A positive CTPA in a PERC negative patient is more likely to be...” @EmergencyHull

@Microbedoc2 That depends on what you mean by “respond”. “Ctrl A + Del” is a pretty quick response I guess…

When you have annual leave and come back to an inbox of emails - how long do you take to respond upon return?

@JPGK_MD @fuqekgs Fuck off. Not every resident will be doing out of hours surgery- they will find their niche. We need doctors in public health roles or day time outpatient roles.

Oh? So you admit that medicine is not inclusive???? which is why you are failing thousands of students and residents who could have better outcomes, especially in their mental health, if they received support and proper accomodations We NEED more disabled and ND doctors

@DrDiGiorgio Fuck off. Not all doctors operate at 2am. We need doctors who fill primary care roles, public health roles, community roles, secondary care roles, which might be more in alignment with neurodivergent minds.

Students claim disability to get extra time on tests. Those students become doctors and claim disability to avoid night shift. Are they going to claim disability when they are full attending doctors and they kill someone because they don’t know how to operate at 2am?

Time for the live in situ simulation exercise now led by Dr Andrew Blackmore and live in our ED with Dr Chris Srinivasan #SPARK24

@clare_eliza Fuuck. This is awful to read. Made more awful by the shame of having thought and said some of these things a long time ago myself. I hope that a lot of the people commenting are as junior as I was. And that they have the role models I did.

@jd220323 @TavernFootball Not many people know this but West Ham were his childhood team

@TavernFootball That didn’t happen.

He played for them???? Did he?! No 1. Steffen Iversen. Crystal Palace. 2011-2012.

An absolutely elite red card for Kevin Mac Allister against Anderlecht this evening.

@AlexNevard As Ben has said, current advice against them. If I recall (when local schools looked at getting them), what little evidence the company put forward was in stroke/ MND patients with food boluses in pharynx occluding the laryngeal inlet, not in the larynx like a kid would. Avoid

Nursery has just bought one of these lifevac.uk I've only ever had Facebook ads for them. Anyone used them in real life? Pre-hospital? Aware of evidence they work? I'd hate for a fad to take away from more traditional first aid

@FFAFrances @armyemdoc I was going to say that yours is my favourite response to this clown, but this takes some beating:

@armyemdoc You have some incredibly dangerous practices. You need investigating. I wouldn’t trust you to put a plaster on my family member without doing it in a dodgy way.

When it comes to naloxone opioid reversal, there are 2 schools of thought - give them just enough to increase their RR or totally reverse and wake them up. I'm in the latter. I rarely start with <4mg. There's a theoretical risk that their opioid could outlast the naloxone, they wake up, refuse transport or leave the ED, and then drop dead. That's another myth. In a study of 542 patients completely reversed by EMS followed by refusal of transport, there were 0 deaths within 48 hours. So, the moral of the story is that either method is likely acceptable and safe. pubmed.ncbi.nlm.nih.gov/21612385/ #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #prehospital #ems #medic #meded #heroin #opioid #epidemic #medx #medtwitter

@clifford0584 twitter.com/andy_bmore/sta…

Anyone do this?

@DrJSherrington I don’t give big doses of naloxone, not because I’m worried about them waking up and leaving but because around one in fifty will go into flash pulmonary oedema. And there’s just no need for big doses when titrating works so well.

@PaulAshYoung I remodelled the reg rota when I was a reg, then herded cats getting everyone into slots each rotation and helped those LTFT to drop a fair number of shifts. For that I got time back - taken as additional shifts dropped when I did my 80% LTFT schedule - 2h per week IIRC

@doctorcaldwell The ticking clock of the thrombolysis window led an otherwise good clinician to dismiss concerns raised by the radiographer as it didn’t fit their diagnosis in this young, healthy patient who came to the hospital because their arm was numb and hand was weak.

@doctorcaldwell “…I told the reg but they didn’t listen” The radiologist agreed to scan the thorax while we were on table and it showed an aortic dissection with contained rupture into the mediastinum. We were in a non-tertiary centre and the patient died on the ICU less than an hour later.

What episode of avoidable harm to a patient had the greatest impact on you as hands on, observer or Investigator? What did you learn? I was in a team when new Doctor mixed antibiotic with potassium not sodium chloride & injected into central line, patient died. Systems matter.

@HMRCcustomers They’ve done their bit but on my personal tax account it hasn’t been updated after more than a month. What’s the timescale that I should expect the change to show in my GOV.uk tax account?

@HMRCcustomers My employer was underpaying me and when the matter was resolved, I received the payment as a single arrears payment in Oct 2022. My employer then told me that they would update pension records and HMRC so that the tax was due in the years it should have been paid.

Good morning, @HMRCcustomers are here until 8pm to answer your general queries on Twitter. Please don't post any personal details.

@Xeon4f145d96s1 I don’t know the bloke or his motivations, but I read the “consultant PAs” bit differently. Doesn’t it refer to the job planned time needed to organise/supervise the staff in the lines above? 1-2 programmed activities? Might be me being generous 🤷‍♂️

The use of PAs in EM in the near future, told by Paul Kennedy, senior EM consultant and shared and supported by HEE. 2040 vision: to have consultant PAs and to start migrating PAs onto middle grade rotas Can you really say they wouldn’t be taking up an SpR slot?

Everything from patient experience, to safety and quality improvement: Expanding Reach with Dave Wright, Director @HullSimulation #SPARKConference23

@WelshGasDoc <Loudly> “Are you okay in there? That was a BIG poo” -Sophie Blackmore, aged 4