Graham Pacey

@NWAmb_Caroline @JanBarnesOrme @NWAmb_F2SU @NWAmbulance @MarkEvans1208 @RhondaStanger @lisat4_lisa @NWAmb_Caroline So glad you could find everyone else

@JanBarnesOrme @NWAmb_F2SU @NWAmbulance @MarkEvans1208 It’s been a fantastic day met interviewing graduate paramedics and welcome our new recruits to the our green family #NWAS 🚑 Thank you to @RhondaStanger @lisat4_lisa and the HR hub for all your help today #teamnwas.

@DrLucyMcCracken @AprilLochhead @laramitchdr @Jak673 Also depends if local community services have a way monitor CK in a timely fashion

@DrLucyMcCracken @AprilLochhead @laramitchdr @Jak673 I think its really difficult to have a cut off for long lie, depends on so many factors that often 🚑 crews can't guage, normal kidney function, meds, muscle mass, amount of movement on floor etc.

Falls enthusiasts / SAS.. We are looking at non conveyance of fallers.. Does anyone have a guidance out there regarding those who have had a long lie and does anyone have a cut off for acceptable long lie to be kept at home? @AprilLochhead @laramitchdr @Jak673

@SisterScrappy @mswenman It's amazing I love mine

Lads… we’ve finally got an allotment. I am giddy! 🌱

@DrChrisGrant @NWAmbulance @NWAmb_Vinny @NWAmb_simwal @DrChrisGrant please try not to find as many patients as Liverpool

We serve a broad and diverse set of communities and today @NWAmbulance is at Appleby Fair. As per the sign - we have all been warned !

@NWAmb_Jon That was not a good day

#throwbackThursday to 2020, mid lockdown when not only did ⁦@grahamP36⁩ and I get utterly soaked, a bolt of lightning struck just a few metres from where we were stood…..

@NWAmb_Jon Totally agree but swap dog for 6 year old and fresh air for the smell of oil and burning rubber

Another beautiful day, so another dog walk, hardly a cloud in the sky and the fresh air and clear sky is very welcome!!

@NWAmb_Jon I don't know what your saying about us

Sometimes, my team make me smile, and sometimes, for the right reasons 😂👍

@Ste_Story @NWAmb_Jon @DrLindaDykes @AirwayVigilante Perhaps, but a confirmed PPCI trfr is still a CAT2 so now the patient goes to the bottom of the CAT2 stack. There will never be a right answer unfortunately,a change in the culture of HCPs to be less risk averse would be a start

@NWAmb_Jon @grahamP36 @DrLindaDykes @AirwayVigilante But in reality if waits are that long which they often are and people can make their own way, being in the wrong hospital is better than not being in any hospital if it is a true STEMI/CVA...

Ambulance delays are problematic across the whole country, but why aren’t we pointing out to the public that if they live a mile from hospital & have access to a car, then - unless CPR ongoing or injury precludes - they’ll likely get there quicker than a Cat 1 on a good day? 🤔

@DrLindaDykes @riversampler Again and this is not in any way taking anything away from CFRs bit we send our least qualified to our most complex patients, yet we send our most qualified to algorithm led patients in a vain attempt to hit government targets that are not evidence based

@riversampler … intruiging… but also I hadn’t realised CFRs were being deployed in such a way that you get to recognise frequent callers. Sadly can’t explore more here as could be identifiable to px concerned.

@DrLindaDykes @AirwayVigilante And I think it is not just paramedics, surely there has to be a realisation the Urgent and Emergency care are two different things. The lines between what is primary and urgent are blurred causing us confusion. If we are confused how can we expect patients to get it right

@grahamP36 @AirwayVigilante Yes: it’s a fundamentally different job to what paramedics were invented for…

@garychaplin @DrLindaDykes @AirwayVigilante I think it has been made clear in lots of reports we are wanted to be a mobile treatment and assessment service. Some of our 🚑 organisations are still led by ambulance men who can't see how up skilling staff, changing practice and culture can change the system.

@grahamP36 @DrLindaDykes @AirwayVigilante We do very well at assessing but we are not doctors ,what do we want of our ambulance service we must not forget it has 'Accident and Emergency service' on the side of the van.

@DrLindaDykes @AirwayVigilante Absolutely, it also means an acceptance by the paramedic profession in general that our role ahs changed from that in which many trained, I qualified 7ush years ago and still most of my training was ALS based as opposed to the 95% of our actual workload

@grahamP36 @AirwayVigilante I’d agree with that - it means organisational acceptance of ambulance services being mobile urgent healthcare providers, though, not just “proper emergencies”. Does ⬆️ demand esp if (like ED) perceived as way to get a F2F assessment.

@paddy1111111111 @DrLindaDykes The issue is some paramedics will then convey across the road validating all the failings within that scenario

@DrLindaDykes @AirwayVigilante Does that not just move the problem. Patients end up in the wrong hospitals delaying life saving treatment. The answer for me is to up skill paramedics, adopt a new response model and become the mobile treatment and assessment service the public and NHS deserve

@AirwayVigilante Yup, but I was thinking even for serious scary stuff - if hospital is half a mile away, and you can get the patient into the car, why do people sit and wait for an ambulance, worried sick & calling repeatedly, when they could be there in a couple of minutes? Sunk cost fallacy?

@NWAmb_Research @ParamedicBen @NWAmbulance Can't believe you have poached him from me

Super to catch up with @ParamedicBen today Lovely to hear about your research interests and experience and to see the passion you have for your new role as Research Paramedic with us in R&D @NWAmbulance Great to meet you in person at last Welcome to the team! 👋🏾

@pandaclare I often ask and document what a patient wants, but more importantly ask about CPR

Really useful illustration of how advance care for planning is a process, not a one off event. It needs an individualised approach, often supported by multiple professionals across the whole health and social care system.

@ScouseMedic30 Doh

Volunteering on a night shift and then realising the clocks go back 🙈😂👮‍♂️

@NWAmb_Steve Doesn't recognise my ID so I can't wear one

Had a meeting with the Body Worn Video Camera Project Board today discussing how we can improve confidence in staff to wear them. The BWVC are there as a deterrent to reduce verbal & physical violence to our staff. If you have access to BWVC please wear them just like Sara 👍

@sueclough1970 @LancashireCC It's a shocking menu. Trying to encourage children to eat a variety of foods as long as it's a sandwich or jacket potato. @MarcusRashford

@LancashireCC Just had notification of delivery issues impacting school lunches in my sons school. I don't think a menu of either jkt potato or soup/sandwich is acceptable, surely a much limited menu, but not just those 2 choices could be delivered?