Scott's Spiel

Maybe I’m just a trauma buff (which sounds horribly morbid and quite unwelcoming, I agree) but I would expect most 2nd year medics to know what is meant by intubation. Apparently not, as I found out the other day when a friend was stumped by the word, apparently taking it to be a typo of incubate.

I don’t know about anyone else, but I’d rather not be incubated when I needed intubated!

This might seem like a simple slip up and I was quick to correct him. However, it highlights a much more worrying aspect of our acute clinical knowledge.

I’d maybe be extending my ego slightly but I feel that if someone were to collapse in the middle of Morrisons (or wherever) I’d be able to assess them, assist them and maybe even take a stab at a possible differential. Ignoring the last, how many of my colleagues would be able to do so, competently if not confidently? Probably not very many and I know a few that would panic.

I feel there is a general lack of very basic acute training in the course (at least, so far). We’ve had 30 minutes, at a push, of CPR in year 1. This is examinable in our year 2 OSCE (which makes a lot of people worried!) but other than that we’ll receive nothing more till our final year when we are expected to deal with Advanced Life Support.

There is a course, Immediate Life Support, run in conjunction with the UK Resuscitation Council – which I’m trying (with minimal success) to get on – that provides an intermediate between BLS and ALS.

This, or something similar, should be taught to junior medical students at some point. Not only would it possibly save someone’s life but would also mean the medical student who’s always telling first aiders on duty what to do, actually has a clue of what they should be doing.

The beauty of it all is that whether I get to sit this course or not is completely irrelevant by St Andrew’s. They (unlike BRC) don’t recognise external courses and still wouldn’t let me take an AED course until I’d been a member for a year.

This then begs the question: if a situation arose where I was faced with using a defib or not, understanding the potential benefits and unlikely consequences, would I do so?

Honestly, I just don’t know. But if St Andrew’s aren’t happy to use me, I’m sure BRC would be!

I’ll agree with the subject of this article, which is much too political for my poor blog, but I dislike the wording. Isn’t Scotland part of the UK?

Source (BBC news)

Disclaimer – This is not meant to offend anyone and should not be taken as such. It is simply observations I’m making about my first 2-3 months as a member. My views my change over time or I may end up correcting some of these myself in the future (who knows?). I do enjoy it, regardless of what’s here

Around the start of November in my 1st year (06) I finally discovered the existence of the voluntary first aid societies (applicable to me were the British Red Cross (BRC) and St Andrews Ambulance Association (StAAA)). I’ve still got my initial email enquiries to firstly StAAA HQ trying to sell myself to them and desperate for further information. After a while (over a month of getting sent from HQ -> Exec -> Company) I got an offer to come to some room in Caledonia University on a Monday night. By this point I was home or going home for Christmas so I didn’t go. I’m a pretty shy person and was really looking for information, not being invited to some strange place.

In the end I tried the Red Cross. They scared me asking for references, birth certificates and more for an interview (in some far away location) by the end of a week. I apologies, explained the difficulties, and left it at that. March became August before I got round to trying to find out more. This was a combination of exam and summer holidays, but I wish I’d got my finger out earlier, I really do.

I got another invitation to come to some night. I didn’t want to do this, I wanted to know more first. The same people giving my the invitation were holding a public first aid class for 4 Sundays which I would finish just before going back for 2nd year. After a few more emails and cheque problems I got on the course and met some pretty decent people. I was still terrified going into the first class but the difference here was a hotel in the middle of the city and I knew the area reasonably well, instead of a office in the south of Glasgow or a Uni towards the north(ish).

After the 4 weeks I probed into joining the company. I’d already met a number of the members (though I knew it not) and all I had to do was get a Disclosure and some references….simple! The Disclosure was a major cock-up. I handed it in at the start of September and finally got in back in November, only because I phoned and found out it hadn’t been received. It was well over a year now than when I first contacted someone to volunteer before being considered a member.

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My aim here was to show the very negative impression I got out of these people. Why should volunteering be a chore for the potential volunteer? If I’d been given a standard reply to my enquiry providing my with information potential recruits would need, such as:

• What volunteering would required
• The structure of StAAA
• The contacts of exec’s and companies (which is available in the members section of the website, for some confusing reason)
• A general welcoming reply, without being ignored for a month in an email inbox

This would be a short document, kept accessible publicly on their website. How many potential volunteers are lost because of lack of information or by not being as persevering as myself?

But that’s all in the past. I’m here now. Boy, was my selling myself not required.

Being honest, and polite, I can only call what I’ve seen and heard so far as a bureaucratic mess. At the shop floor level things are pretty dandy – we attend, we treat, we leave. The problem comes higher up. A sample of problems:

• After ~3 months of being a fully Disclosed, uniformed member I still have no equipment or bag. I would buy my own but it needs to match everyone else’s. I’ve bought my own belt, cool packs, torch, face mask, gloves, etc but can’t do anything as I’ve nowhere to put them.
• I was never, ever, properly told about who does what in the company. What I know stems from the website and StAAA regulations (which I haven’t been given, found them in the lost pages of another company).
• Company training nights very rarely involve any training.
• There is a general attitude that you can’t “fail” at First Aid. I disagree. If you can’t perform basic clinical tasks you should not be allowed on duty.
• Things are far too hidden and secret, both at a company, exec and national level. Council meets regularly (I can now see dates!). Surely these meetings are recorded as minutes? Why aren’t they available? There is a distinct lack of any communication from above the company tier. Arguments at a company level are unresolved, left to brew until they spill over into public view.
• I only just got access to the member pages in the last 2 weeks. It takes that long to come up with an ID number and badge?
• I want someone please to show me how to claim expenses…
• I want someone please to tell me radio protocol (although I’ve read all about it in the regulations…which I don’t have)
• I want someone please to explain why I need to be a member for a year before being put on a training course for a machine designed for people without training.
• I want someone (please?) to show me how to put someone on a scoop.
• I want to feel as confident as people seem to think I am when I go on duty.

At lot of this could be addressed by having 2 or 3 of the training nights separating new members and running through a quick session. Nothing explicitly formal but things that are relevant and not included in a standard first aid course. We get new members all the time (about 3 since I’ve been in, most following a public class). This could be developed into a small handbook available for them to read. I may even prepare my own if I see new members struggling to work out what’s going on.

I have other, wider concerns about fitness for members on a duty. I won’t lengthen this post any longer by putting them in here so they’ll be later.

I have no idea if anyone interested will ever find this post, but that’s not really the point. If you do though and are wondering whether to join StAAA/BRC or have joined and are major confused, please feel free to contact me (up to date email address on about page). I won’t bite and might be able to answer some questions.

Above all I do enjoy the work, however much the above might not suggest it.

I seem to have failed already to try and keep this a little more updated. Oh well, lets see what I can remember.

I got back to Uni with my rather shiny bike in tow. It’s not quite as shiny any longer but still pretty useful. Every time I use it and go up an even moderately steep hill I realise just how unfit I am. I’ve also not been running yet this year, which I’m sure can be classed as a failure. The weather’s been pretty terribly, if I can use that as an excuse.

The actual course itself is coming along nicely. Not too fond of my new PBL group – it’s by far the quietest one I’ve ever had. It contains a couple resitting and another with many years of higher education behind them. The plus side is that it’s quite a focused group (when we speak) and we get the PBL done to the letter with time to spare. Another plus side is that I’m only with them for 5 weeks, which since I’ve taken so long to post this gives me another 3.

So in no time at all I’ll be doing my first SSM. This is possibly the most exciting thing on the course this year and I’m really looking forward to it. I have two opposing views of what it might consist of. The negative one being a lot of science and limited, strict clinical sessions once or twice. The positive would be a few science based days with an unlimited number of supervised, educational but not too strict clinical sessions. Chances are it’ll fit somewhere in between, not quite sure where though.

I was sorely tempted by Queen’s Belfast’s Emergency Medicine Conference, which features:

• talks on acute medicine, trauma and major incident management
• workshops on data and imaging interpretation
• undergraduate research & poster presentations,
• the opportunity to gain valuable hands-on experience through the use of simulators for clinical procedures and acute medical emergency scenarios!

Sadly, it’s timetable at the end of the last week of the SSM (I think) which will probably consist of essay writing and presentation. The other downside is the lack of guaranteed accommodation and I’d have to sort out travel myself too. I’m hoping that next year I’ll be able to go though – whether it’ll be worth it then or not I don’t know.

The strangest thing happened recently – I found one of my best friends from primary school (Edinburgh, before I moved) on facebook. It gets even stranger when I found out he met someone from my school in South America! It gets just plain freaky when he replies and asks if I know one of my ex’s. (Oh dear!). We’re hopefully going to meet up in the next week or so. I don’t really know how to start filling in 10 years of non-contact. Guess we’ll just see what happens.

I’ve also found a pretty decent blog – Blog St John – which is an excellent insight into the background of St John’s Ambulance. Whilst St Andrew’s is quite different (it’s a lot smaller for a start), we seem to share common problems. I wish I could find one on the British Red Cross too, it would be nice to see which society really is falling to bits the most.

Maybe I’m being short sighted. I’ve not been in for long and I’m still getting used to how things work. Either way though, it’s not exactly a model organisation. I was tempted to start a similar blog, fully anonymous, so I could write similar stuff about St Andrews. The truth is though, I wouldn’t keep it up. Instead I’ll just have to post here my rants (one is coming soon, I’m sure) and hope that noone takes offence.

This is reasonably anonymous, but not very much so. I don’t imagine anyone who wanted to find out who was behind this blog would struggle much. I also don’t really see the need. This is perhaps best in a post of its own but very few bloggers have stuck to their pseudonym and I’m quite happy to qualify my postings if need be. Perhaps those who are intent on covering their identity consider themselves in a position where there background would cause problems of various kinds. Either way, I have very little to hide.

So here it is, the start of another year. I decided to spend a bit of time changing the blog since it’s probably the only time this year that i’ll be bothered to do so. The most obvious is the new photo gallery which gathers albums from my Picasa account. This is rather empty at the moment, but I’ll try and keep it updated.

As for hogmanay itself, I did manage to get to the castle to watch the Proclaimers. They were pretty good, although I will admit to not knowing too many of their songs. I was wondering whether they’d finish before the bells since they started their final song (I’m Gonna Be, obviously) just minutes before midnight. They then went and confused me by playing through Big Ben immediately after – making me think it was new year – before starting a countdown. Here’s a small clip of one of their songs:

[soon, it wasn't such a successful post]

Quality is nothing spectacular because a) it’s pretty dark, b) my camera’s pretty poor, c) I must’ve had my hand over the mic for a bit, d) some idiot is waving a Scotland flag around and e) i’ve compressed the file – but it’s better than nothing.The fireworks following, however, were pretty spectacular. Unfortunately it was quite a misty night so despite being very close we couldn’t see much. I’ve strung together this very amateur video of what I managed to record though:

Finally, here’s a stream of still photos from the night:

I’m terribly proud of this post although it’s probably going to be a rare one.New Year also made me wonder about whether it’s just me that notices the first aiders on duty, so that’s my new poll.

Only a few days to go now before I start on some cardiovascular work, not exactly looking forward to the “work” part…