r/ParamedicsUK

Be careful and thorough out there.

What are you thought in cannulation by technician? I am so far critical towards is as a cannula is useless without the drugs to give, and there is see a bit the issue of technician skill increasing far higher than the training should allow.

Your thoughts?

One of my irks at work is seeing people administer this by telling patients to swallow it rather than keep it in the lining of the mouth. Thinking about it, I don't think I've seen anyone use it correctly. Annoyingly when I've given it, I can't actually say I've seen a massive difference in the rate of BM rising for patients who I have told to administer it buccally rather than when others have told them to swallow it.

Thoughts?

Hey all! I am a paramedic with Addison's Disease and I have been working with the ADSHG to further education on treating adrenal crisis in the pre-hospital environment.

Though Addison's Disease is rare, other types of adrenal insufficiency are more common, and thus adrenal crisis may be a more likely diagnosis for your patient than you first believed! As such, it is important for us (as clinicians) to understand the signs and symptoms and the appropriate treatment plan for these patients.

The ADSHG run pre-hospital focused sessions on treating adrenal crisis, which are available for ANY pre-hospital emergency clinicians across the UK! This includes student paramedics, technicians, paramedics, CCPs, etc as well as tutors/lecturers.

There are 3 more sessions booked for this year:

June 23rd

September 9th

November 19th

All sessions are free, JRCALC/AACE accredited, online (via Zoom), and a certificate will be sent upon completion.

The sessions are presented by Philippa, the ADSHG's Communication and Health Liason Manager, alongside me (Lottie), Paramedic and ADSHG volunteer, and Alison, ADSHG Enquiries and Conferences Volunteer. All three of us have Addison's Disease personally and have our own individual experiences with adrenal crisis.

Questions are accepted throughout in the Q&A chat at the bottom of the screen, and that's where you will find me answering them all! There are no stupid questions, and every session opens new discussions to further knowledge on adrenal crisis.

I have linked the ADSHG page to sign up for your desired session. If you have any questions, feel free to ask away below!

Question as in title, seems like a pretty simple intervention that should well be within paramedic scope. Could be life saving in certain situations if you work somewhere with long transfers. I understand from older threads on here we can legally do it but para's have had the book thrown at them for not working within guidelines after having done so. Why not just put it in JRCALC?

Despite the BMA raising the ACP issue, I’m not optimistic about anything being done about it in the NHS.

Currently it seems that every nurse and paramedic and their grandmothers want to skip medical school and become GPs via primary care ‘advanced practice.’

And why wouldn’t they? It’s a gravy train where they get to take all the simple cases leaving the salaried GPs to deal with all the complex and risky cases in 10 minute slots (without a compensating increase in consultation time for these cases).

In other words ACPs not only take jobs away from GPs but make working conditions for GPs worse too by increasing said complexity-risk load on GPs.

Even though we were told they were supposed to help relieve the increasing pressure on GPs by helping with work load (lol).

If GP were to go the way of dentistry then the market will naturally introduce compensatory mechanisms to correct this absurd situation we’re in.

Sure patients might prefer to pay £40 instead of £80 to see an ACP instead of a doctor for their foot corn but most will go to a GP for any real medical issue. Similar to how people will pay to see a dental hygienist for routine cleaning but will go to the dentist for any actual dental problem.

Like in dentistry, there will be a time price linkage mechanism where complex patients would have to be seen in longer consultations and be charged higher prices for that consultation.

Second, there will be demand filtering because most rational patients won’t pay to go see anyone about their toe corn to begin with which will reduce the overall volume of consultations demanded from GP.

This would generally lead to better working conditions for salaried GPs. Private GPs in London already enjoy much better working conditions compared to NHS salaried GPs.

Now I anticipate I’ll get moralistic outrage mongering from the usual suspects about how this will lead to poor people being unable to afford to see a doctor or how big, bad private equity corporations will eat up general practice, but the dentists made it work and from what I can see they enjoy better working conditions than the government serfdom called NHS model GP.

And sorry but I’m CCTing and fleeing to Australia if working conditions do not improve.

Just read about this crew in Kent being reunited with a patient they treated for an eclamptic seizure. 1 in 3,000 pregnancies is a proper "once-in-a-career" call for most of us. For the veterans here, what’s the rarest clinical presentation you’ve actually had to manage on a blue-light call?

Hi guys,

What’s everyone’s honest opinion on the DS Medical Premier Response Bag? It’s the green body with an orange face, and it’s looking like a strong contender but thought I’d get. Some opinions from here and there.

Thanks in advance all 💚

I just got bollocked for sending out an advice to a client with a bunch of track changes unresolved.

Can you all make me feel a bit better and share the disasters you’ve all had?

Hello everyone. I’m a USA paramedic for the past 5 years moving to the UK later this year. I’m looking for any advice on what to expect and or what to prepare for in my employment searches in the UK.

I’ve already obtained my HCPC paramedic registration, and I won’t need an employer sponsorship.

I’ve spoken to a few paramedics in different ambulance trusts and they’ve said most recruitment comes from university graduates etc so there not sure how it will be for someone moving from abroad. Any advice is appreciated.

I’ve also been wondering what other certificates and or classes I’ll need besides my HCPC registration? I’m used to ACLS, PALS, PHTLS, BLS etc.

Again any advice or recommendations are greatly appreciated! Thank you very much!

Hello all,
I unfortunately didn’t get accepted into Uni to do Paramedic Science this year but have every intention on reapplying next year. I have a leading Mental Health First Aid Qualification (St Andrews), FREC3 (Amvale) and about to finish my HNC Healthcare Practice in the next few weeks.

There was an ECG course getting run but I wasn’t sure if it would be beneficial for my application next year or just a waste of money at this stage.

I was also wondering if there was anything else that could be beneficial for my application for next cohort. I am also currently working for Amvale for first aid cover at events.

Thanks!

Bit of a naive student question following a recent placement experience:

Our crew attended a care home for an elderly patient with an unwitnessed fall. An experienced and somewhat embarrassed carer explained that their new management rules now requires staff to call 999 for all unwitnessed falls, regardless of injury or anticoagulant status.

The patient was assessed and did not require conveyance. The carer was clearly frustrated with the policy, and the crew suggested feeding this back to management, warning that repeated low-acuity calls to their facility could risk de-prioritisation by our dispatchers.

From a care home management perspective, it feels like there’s little to lose by defaulting to ambulance attendance. Clinical escalation decisions are effectively handed over to the ambulance service, and lifting patients becomes the crew’s responsibility rather than the care home’s. I’m sure most of you have encountered patients being left on the floor in care homes for prolonged periods while awaiting a crew, even when the care homes have hoists and staff available (how that isn’t considered neglect is beyond me).

Would it be appropriate to fine organisations when policy-driven reliance on ambulance services replaces core care functions (like falls or organising OOH GP referrals)?

I appreciate that we’re the healthcare service of least resistance (especially outside of normal hours) but the cost and inefficiency associated with these calls has to be staggering (not to mention reduced coverage while responding to these calls). Is there any realistic mechanism to address this?

Hi everyone,

New CFR here, absolutely love doing this and I have the utmost respect for what you all do. During jobs I often find handing over to be the scariest part - in some cases I wonder if I'm rambling too much while in others I don't feel like I've given enough.

Would love to know what you guys are looking for in a handover that makes your life easier! Thanks in advance.

Hi everyone,

I believe I was subject to professional misconduct in regards to a paramedic that recently attended my home address. I am also considering reporting a criminal offence to the police regarding to this individual. At the moment, all I have is the ambulance report, and her PIN number. How do I get further details? I have complained, but further details of the person in question has been omitted from the response, quite intentionally I suspect.

Sincere thanks.

The clinical stuff you train for. The protocols you learn. Nobody really teaches you what it costs to hold it together in a room, drive back, and then immediately go to the next one. And the next one. And keep being present for every single person like it is the first call of the day. Years in and I still think this is the hardest part and I still do not think it gets talked about properly.

Interested because there’s definitely equipment I paid almost no attention to initially that now seems far more important in practice.

I can't seem to find any info online.

I'm due to start soon with NWAS as an EMT1. Seems like EMT1s have a pretty limited scope of practice (even more limited than ECAs in my current Trust in some regards)

Does NWAS have ECAs/ECSWs?
Is there a such thing as an EMT2? Do they have additional scope? Do they have additional pay? How does one become an EMT2?

On paper most trusts now have more provision than they did five years ago. Peer support programmes, occupational health pathways, counselling referral routes. In practice the culture of the job means a significant number of people are not using these things either because there is not enough time, because of stigma that still exists regardless of what gets said officially, or because previous experience of seeking support was not good enough to make it worth trying again. What has actually worked for people here and what do people think the job still gets completely wrong about looking after its staff.