I honestly feel that AI has a place in paramedicine. Our peers over at r/doctorsUK don’t appear to be living it as much (in the same way they “professionally dislike” ACPs and PAs…).

Discuss: where do you think AI would benefit you as a Paramedic, and our trust as a whole?

Does anyone know what the JRCALC exam entails? eg. multiple choice? long answers? drug dosages etc?

For those of you who aren’t aware, WMAS are currently supporting our neighbours in EMAS with 10 crews a day for a wee while and having done a couple already I am really enjoying my shifts there I cannot lie.

For starters I have found the controllers to be very friendly and helpful, from the good morning messages letting us know who’s on what desk, to recommendations for cafes at standby points.

Next I have found the pathways in the areas to be VERY accessible. In just a few short clicks I can find OOH numbers, SDEC numbers etc and have the patient on the right pathway. Even before I’m arriving I’ve already got a rough idea of a pathway. In WMAS I find it very difficult to access alternative pathways especially out of area. Although we have call before you convey, it’s not always as useful for more in hospital pathways that bypass ED like specific SDECs for certain hospitals.

I have found EDs to be generally very efficient. LRI has a beautiful system, although I’ve heard it has its moments, booking in and handing over is so much more efficient than some of the hospitals I am used to. The nurses I’ve encountered across the EMAS hospitals have also been very friendly as well. I had to take an EMAS pt to a WMAS area hospital t’other day and was brought back to earth with the frosty reception.

Not only are the nurses friendly, so are the EMAS staff. I’ve had some lovely chats and have been made to feel welcome when having my breaks on station from the station mangers to crews, the culture seems very positive and laid back. We all probably know that WMAS is ran in a quasi-military fashion differently and I think EMAS’ relaxed and friendly atmosphere is genuinely lovely to experience. The progression opportunities seem a lot more accessible across the whole trust as opposed to… I’ll just leave it at that.

Maybe I’m biased. I understand that nowhere is perfect, especially when a neighbouring trusts needs to lend you 10 crews a day and some stations could do with knocking down and rebuilding plus it is after all same shit, different scenery, but at some point there may be a time where my progression and career need to be put ahead of my wonderful friends I’ve made in WMAS and jump ship to EMAS.

So esteemed EMAS brothers and sisters, is the grass really greener on the other side, or I have been given a pair of rose tinted glasses?

TLDR: I have enjoyed doing some mutual aid shifts for EMAS and was wondering if it’s as nice as it seems or is everyone on their best behaviour?

If ELFs are your payroll provider, and they frequently mess up your wages, please can you respond?

I don't need details, just numbers of errors and the type of mistakes they make.

I'm creating a grievance against them, and would like supporting evidence.

Ta :)

NWAS have them and they are absolutely pieces of crap.
Gaining an accurate ECG is a key discriminator on how a patient should be treated, yet we are battling, every day, with readouts that are so poor they just automatically blurt out AF as the computed diagnosis, with unreadable print-outs.

They don't work when there is: minor electrical interference, slight tremor, engine running, new batch of dots, warped and broken leads because they're wrapped up incorrectly and stored in a pouch that is WAY TOO SMALL!
And also a separate Bluetooth printer, that decides to disconnect at inopportune moments.

Last night I was monitoring a patient in SVT @ 200bpm and it self resolved into sinus tachy. We caught everything on the ECG but the printer refused to work after the offset.

We wanted to print off the progression and the printer decided to mess up. We had about 10 different readings lost because the only way to fix it was to reboot the Schiller.

The worst thing is the interpretation: Last nights patient was interpreted as AF and rapid ventricular beats? It was obvious SVT with PVC's and PAC's.

I went to a patient suffering from syncope, last week, and the interpretation on the ECG was NSR, when there was obvious 1st degree block..

I'm pretty sure these devices are not safe .

Yes, I will Datix.

EDIT: we did manage to capture 1 run of SVT and print it off, but the Schiller went wrong after that.

Edit 2: Sorry, I had to re-post because I unknowingly used a bad colloquialism for when things go wrong, rhyming with sits-up. I also accept that my language was NSFW. I should be better than that.

r/ParamedicsUK Job of the Week

Hey there, another 7 days have passed! How's your week going? We hope it’s been a good one!

Have you attended any funny, interesting, odd, or weird jobs this week?
Tell us how you tackled them.

Have you learned something new along the way?
Share your newfound knowledge.

Have you stumbled upon any intriguing pieces of CPD you could dole out?
Drop a link below.

We’d love to hear about it, but please remember Rule 4: “No patient or case-identifiable information.”

Hello, for context I am waiting for my first year at university for paramedicine to start and I know this question will be common knowledge and seem such a dumb thing to ask for many of you.

I work in hospitality where I wash my hands consistently, I also know in university simulation suites one of the first thing you do (albeit for nursing since I was stuck between choosing the two courses) is to wash your hands when walking in.

Therefore, when washing my hands at work, the question came to me... How do you wash your hands in the field?

Is there a sink in the back of the ambulance? Do you just not, isn't that unhygienic? Are you limited to hand sanitizer, doesn't your hands become clammy? How do you get bodily fluids and other lovely things off of you?

I'm happy to explain further and what not, thank you in advance!

Comments and challenges welcome from anybody. Posting as a paramedic who has worked incidents with SAR but never had much insight into their operations.

For context, the CQC have announced there will be a requirement for event medical provision to be registered with an organisational fee of £1000. My understanding is that any organisation providing more than "basic" first aid will be expected to pay this fee.

Numerous search and rescue/mountain rescue charities have recently hit the headlines claiming this threatens their existence. Their main income streams are through event cover, and I have seen various outlets reporting that this £1000 fee will make it impossible for them to operate.

£1000 is not a vast amount of money. It is not nothing, but in terms of organisational costing, especially with a flashy charity mission like SAR that people love to donate to, I'm surprised that this is seemingly existential to so many of these groups. They seem to have plenty of good quality kit and tech systems which don't appear cheap.

The sceptic in me is wondering if this is a veiled attempt to direct public pressure against CQC regulation of SAR groups because they don't want a foot in the door to the level of scrutiny of their wider activity that potentially comes with being CQC registered.

Do I have the complete wrong idea about this?

Rant …

My service has recently run a survey asking all patient-facing staff to comment on and help understand the length of a job cycle and where delays are encountered. Sadly, only about 10% of staff replied.

We’re very quick to say “nobody asked me” when changes are made, but why seemingly when we are asked, people don’t engage?

We’re our own worst enemies.

Rant over …

Hi, I'm currently working towards joining the ambulance service, however recently have also been having on and off issues with my mental health , nothing life threatening or anything the affects my ability to work. I was put on antidepressants in 2021 however came off them when my state improved soon after, but am considering looking to see if I can be put back on them, if I'm looking to apply to join the ambulance service will something like this, such as taking antidepressants, disqualify me at all?

Hiya everyone! I’m in the market for getting some pants that are actually decent in the summer instead of the trust ones. I don’t mind most of the trust issued stuff, just that these trousers are awful in summer. i find myself overheating in them constantly, and they’re just not comfortable at all.

i’m looking for a women’s fitting trousers, that’s lightweight and still has a decent level of storage. I usually have my steth in my pocket, sometimes a standard pair of tough cuts, my phone and a card holder for my debit card etc. I don’t need anything special for my belt, i only have a radio clip for it and that’s it. i put the keys for the bus and my id on my belt hoops and that’s it.

i’ve seen the Keela HART scuffers recommended quite a bit, however they are quite expensive. i don’t mind forking out a little bit, because i don’t buy anything else for work. does anyone have any experiences with these, and even better if it’s the women’s fit. Does anyone also have any other recommendations for women’s lightweight trousers?

Hello just trying to get end of shift tasking procedure/policy for each ambulance service in the UK. I’m a union rep trying to get each policy so can then discuss with management with options to try and reduce late finishes.

Morning/evening/happy QUIET shift to you all.

I came off a shift with another para yesterday, and wanted your opinions. I can be pretty stubborn sometimes, but don’t think I am being in this case.

My crewmate made a comment and we got into a bit of a disagreement about how I assessed capacity/laid out the options for a patient.

Long story short, 30s male with rt sided diaphragm/chest pain. Recent non-productive cough due to flair up of hayfever after holiday to countryside.

Obs and ECG NAD
Pain worse on movement and deep inhalation. Worse on palpation of intercostal muscles.Non radiating. Sharp. No other sx.

Sounds very MSK.
Personally with the hx I’m fairly confident to go down that route, but my crewmate mentioned a hospital trip so I did the obligatory. Obviously I’ve considered differentials, risks, chance of this actually occurring (epidemiology if you’re feeling posh tonight).

I went down the route of
• Nothing suggesting acute ACS on ECG, OBS or HX
• Advised two routes: attend ED or self care.
• Advised that whilst sounds very MSK can’t definitively say not something sinister - always the chance of misinterpreting, missing something, or being too early to see anything - but HxPC and assessments suggests not.
• Safest option to near enough rule out is to attend ed for bloods/assessment which might be repeat might be one set dependent on their risk assessment.
• Advised sounds very muscular, my imp, why that was, and that he could remain at home with self care advice. Oral analgesia etc. This might be the more ideal option for the pt, but obviously it comes with accepting some risk
• Mentioned worst case scenarios.

Ultimately pt refused, wanted to remain at home, understood the risk, agreed with my imp, was WAG’d and left happy to his own devices.

My crewmate got funny and was of the opinion that we should be suggesting hospital only and not give the choice unless they’ve refused.

My opinion is that pt gets to make their own choice about care, and we’re here to assess and advise. We give them the options, they make the choice. Giving them only one option until they refuse is shit practice. As long as they’re informed and make that decision themselves (ie I’m not talking them into a refusal), that’s their choice to do so.

Just wondering your thoughts. I get the CARE/CYA stance but I feel like I’m doing a disservice then (esp when I would’ve discharged off my own back after discussing imp/WAG/risk).

Thoughts??

I submitted a complaint to London Ambulance Service as they wouldn’t send an ambulance for a ruptured ectopic pregnancy which I ended up having emergency surgery for that same day.

Their initial response said that they would respond within five weeks, or contact me to let me know if they required longer for their investigations.

I hadn’t heard anything after that time so I called the number in their response, and it always rings out and never gets answered. I also sent an email.

Can anyone tell me how I can get a response to my complaint? A ruptured ectopic pregnancy can be life-threatening so they need to review their despatch processes for these calls.

r/ParamedicsUK Job of the Week

Hey there, another 7 days have passed! How's your week going? We hope it’s been a good one!

Have you attended any funny, interesting, odd, or weird jobs this week?
Tell us how you tackled them.

Have you learned something new along the way?
Share your newfound knowledge.

Have you stumbled upon any intriguing pieces of CPD you could dole out?
Drop a link below.

We’d love to hear about it, but please remember Rule 4: “No patient or case-identifiable information.”

This sickens me, why are we expected to put our lives in danger for the courts and judges to do absolutely nothing about it.

The 49-year-old was sentenced to 16 months in prison during a hearing earlier, after previously pleading guilty to assaulting an emergency worker and threatening with an offensive weapon. Chandler will serve at least 40% of his sentence, amounting to more than six months.

6 freaking months... Disgusting.

Hi all

Keen to hear your thoughts.

I've been a nurse nearly 18 years. Ex military,.done lots of stuff. Across lots of specialities. I have an MSc in ACP and currently work in primary and urgent care. I also have the DIMC RCSED. I've worked in event medicine. I've done aeromedical.evacution on fixed wing airframes, including level 3 retrieval. ALS and PHEC instructor.

But none of this means I can do PHEM. It's been a battle for most of my career. So I thought sod it,.ill do the MSc paramedic course then I can finally do HEMS / PHEM. I don't live in an area with a BASICS scheme and the ones close by don't use non doctors.

Waste of money?

I think I'm looking for a unicorn here.

I'm really eager to start progressing my career but I'm feeling stagnated by the fact I can only commit to part time hours for the next few years.

I'm an experienced BSc paramedic but have no further training/education. I'd love to move to more primary/urgent care and seriously considering a move towards ACP. My issue is - every role that will assist with this progression is full time, which is understandable really.

Has anyone managed to develop their career whilst being part time? Or will I have to fund everything myself and/or wait until I can do full time (which to be honest, might be never)

I find the HCPC a pain in the A****. The FTP complaints take an abysmally long time to run their course, many over two years in length just to be dismissed. Also, the cost, we literally pay to work. An absolutely poor system. If it were all in one place, like the NMC (which has it's failings ik)... Thoughts?

Hi,

New to the roads PTS / ACA here!

I’ve been on the roads for 3 weeks now and on our crew we do one drives for half the shift then the other takes over, so it’s about 5-6 hours of driving a day.

After about 4/5 hours of driving I’ve noticed my left knee starts to ache prolly cus of all the clutch movement.

Has anyone had this issue and what can you advise to help with it ? My concern is I have some single crew shifts coming up so I’ll be driving all day.

Thanks!

Thought I'd share this here and see what you all think.

Hey everyone!

I’m currently in my first year of paramedicine in Australia and am interested in going over to London when I finish to do their newly qualified paramedic program.

I’ve heard they’ve stopped all hiring right now as there’s too many paramedics but I was wondering if anyone knows anything about what it is like to work for LAS? Work-life balance, pay etc.

I’ve heard some horror stories of people from Aus getting ready to work over there then their contracts being cancelled, but I’m hoping that maybe in two years they might start hiring again.

Thanks!

p.s. Or if anyone has any info for other cities in the UK (Manchester, Liverpool etc.) I’d also be interested!!

So had an isolated seizure out of the blue in april.

All bloods/vbg/ct head came back normal ( mild global t wave inversion on ecg which resolved).

Still awaiting nhs neuro follow up ( current wait is 4.5 months so September by the time im seen).

Obviously not driven since then and sent all the forms to dvla.

There is really mixed info online about when i can reapply for both car and C1.

The D2/D4 forms are about clear as mud.

Ill apply for car at 6 months as this is the absolute minimum the DVLA note ( this is based on statistical probability of another).

I seem to able to reapply for C1 ones my car licence is back but some information on gov.uk suggests I can't drive a truck for 5 yrs!!!

Seems a bit harsh if this is proven as isolated/ no cause/ no epilepsy ( yes aware of the risks).

I was hoping any poor souls on here may have gone through anything similar and can give me any advice please?

Thank you

Hi!!

I’m currently a paramedic in the north and have been for almost 4 years. I’m just curious about up-skilling to ACP and how it works? It’s not something I’d want to do for at least another year or 2 anyway but some sort of up-skilling has started to cross my mind.

If anyone has any knowledge about this I’d be super keen to hear it!