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Posts Tagged ‘emergency medicine’

A&E so far

July 6th, 2009 No comments

I’m now into my second week of my A&E elective. So far I’ve seen a nice mix of things from painful hands, shoulders, ribs, knees, ankles and feet to COPD, DVTs, falls, chest and abdo pain to a cardiac arrest we were sadly unable to resuscitate. Quite a lot for just over a week of starting.

Last week was particularly warm outside but despite this the heating remained on for reasons that escape me. This turned the department into a sauna and I was struggling to cope. Now that we’re back to rain, the heating has been turned off and I’m almost feeling cold!

The attitude from staff has been excellent, everyone is happy for us to get involved. I’ve had the chance to practice some cannulation and blood gases. I’ve also done a fair number of venepuncture but this doesn’t quite excite me to the same extent. Indeed for the start of this week I’ll be working as a phleb from 7-9am and then in A&E from 9 till 4ish pm. Quite a long day! To top it off I plan to cycle in on those days so I should be fairly fit by the end of this (and shattered!).

The hospital is one of the few with a helicopter landing pad. Twice now I have been out with the brightly coloured jacket to receive the patient. As yet none has been terribly serious and I’ve just been happy to familiarise myself with procedures. It is probably only a matter of time though before we get something a little bit scary coming in and it’ll be interesting to see how it’s managed. I have take two of my own helicopter trip this Saturday which I’m looking forward to.

I plan on spending the Saturday night in the department to see what the infamous Glasgow population can get up to. That also happens to be T in the Park weekend (which I’m sadly not attending) so maybe it’ll be a little more tame than normal. We’ll see.

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Channel 4 – The Hospital

April 14th, 2009 No comments
A&E in the UK

A&E in the UK

This is a 3 part documentary on the effect of young adults on the NHS. The first part was on last week and was excellent. The second, regarding teenage pregnancy, is on tonight at 9. Recommended watching for all those thinking of working in the NHS.

Will chip in my views about it all after I’ve seen all 3.

A&E anybody?

August 13th, 2008 2 comments

I got an email yesterday replying to an enquiry about spending my 3rd year (junior) elective in the Southern General Accident and Emergency Department. Happily I’m all booked up for July next year! Why that choice?

A&E because:

  • It may actually be my future career. May be nice to get some experience as early as possible.
  • I will see a variety of people, hopefully consolidating a lot of what I’ve learned already and will learn by the end of 3rd yr.
  • It’s not an area that we’ll cover in the course for a while (if at all?)
  • It’s a busy place and I’ll hopefully be able to get involved at some level

The Southern becase:

  • I know where it is!
  • I can live in the area without spending too much money. I can save more for my senior elective (where i’ll probably go abroad).
  • It’s a busy hospital, lots to do
  • It even has a helipad (the only one in Glasgow).
  • Probably a few more.

So, basically, if anyone is planning on being injured near the Southern in July 2009 (I’m sure people plan it…) then you might just see me looking after you.

…I feel your pain.

Voluntary services in the thick of it

May 2nd, 2008 No comments

I’m a regular reader of The Paramedic’s Diary and couldn’t help but notice the new poll question – Should the voluntary services support the ambulance service on frontline duties?

This likely comes from a recent diary post of his and I felt compelled to write just a bit about it.

Firstly, I’m commenting on this as it would be under usual circumstances – in the event of a major incident (London bombings, etc) then things are obviously different. I’m also basing this mainly on experience in St Andrew’s. I’ll be the first to admit St John’s are quite different on a number of aspects although I’ve tried to come at it from a combined VAS point of view.

The problem with this is how the definition of “support” is taken. If it means relying on a VAS crew attending any type of 999 call then I’d have to say no. Whilst training for some of the St John’s advanced courses (say Emergency Transport Attendant) is undoubtedly tough it is still nowhere near the level required for technicians and paramedics. A VAS crew turning up at a large RTC would, I feel, be quite overwhelmed and wouldn’t have the experience to help them.

Taking another situation, lets say a complication in late pregnancy, would possibly be worse still. Not only is there the medical condition to deal with but there is also a highly emotional situation that a number of professionals would probably not like to be in.

Further, what if there were complications in relation to the actions of the VAS crew? Insurance exists, yes, but to what level? What about regulation? A registered paramedic could face being struck off in a serious situation, but what would happen to a voluntary member? Would communication be effective enough to impose levels of discipline?

These may seem a bit far-fetched, but are foreseeable problems.

On the other hand if we take the situation where a patient is assessed by a technician/paramedic and that professional requests and is confident allowing the care to pass to the voluntary crew then that really is a different matter. Transporting a stable patient doesn’t carry quite the same risk as attending an unknown.

But in the event of a cardiac arrest when even basic lifesaving skills can help, this doesn’t really apply. I might even go as far to pick a VAS crew over a number of GPs I’ve met, basic lifesaving having long since left them.

I guess my point then is that VAS crews might have a use, particularly in busy or definite emergencies. The problems will start when they become preferential to qualified professions which, in today’s cost-effective health service, seems all too likely.

I often comment on St Andrew’s rather slow expansion capacity but if we ever get to the point of covering 999 calls I’d want to be damn sure we covered all the bases.

I’d be interested to hear other views on this and I’ll happily admit I’m not totally knowledgeable about the current policies.

Read more…

Failed…

January 19th, 2008 No comments

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.

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