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Ambulance: More on Shape and well done Tom Dolphin

Written by RSS Poster Garth Marenghi
  Anyone who reads this blog will be aware of the Shape of Training review, irrelevant of this I would strongly advise you have a glance at this excellent piece in the BMJ exposing several critical flaws of the review.  It is worth reiterating that Shape's critical flaws include its methodology, its lack of transparency, its flimsy evidence base and its dangerous recommendations. It is easy

Ambulance: The Butler Did It

Written by RSS Poster Medic ScribeMedic Scribe

There are any number of different ways to give a verbal handover report at the ED. All sorts of mnemonics. What form you use may depend on what your hospital expects. I try to tell a story. But I don’t tell a story in the same way I would write one. A written story takes you from point A to point Z with all the twists and turns, ending with the Da Dumm! The Butler Did it.

The other day I was listening to a new paramedic tell a triage nurse a great story of a very interesting call. Lots of the above mentioned twists and turns. It started with “We were called for…” It could just as well have started with “It was a dark and stormy night…” The problem was even though it was a great story the triage nurse was getting very impatient, not to mention she was interrupted by other nurses, doctors and her phone during the course of the medic’s novella.

My suggestion to the paramedic was when giving an EMS report to a triage nurse, you have to start with the last line. Begin with “The butler did it,” and then you...

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Ambulance: The straw men of the 'Shape of Training'

Written by RSS Poster Garth Marenghi
  So many straw man have been put forward in an attempt to justify the potentially disastrous 'Shape of Training' (ShOT) review's recommendations, that it is slightly tricky to know where to start.  It is also important to acknowledge from the start that it is impossible to discuss these issues logically with some people, much in the same way that it is impossible to debate religion with

Ambulance: Please sign on and support high quality medical training!

Written by RSS Poster Garth Marenghi
  The Shape of Training was an 'independent' review of medical training chaired by an economist, Professor Greenaway, which reported at the end of 2013 is currently in the process of being implemented by government.The review was less than fully transparent in revealing the potential influence of government during the review process.  There are a number of other problems with the review

Ambulance: Gifts

Written by RSS Poster Medic ScribeMedic Scribe

I just hit my 20 year mark with the company. For this, I received my choice of anniversary gift. You go to a link and they have various gifts you can get depending on which anniversary it is. 10 years ago, I got a set of Henkels knives. 5 years ago, I got a GPS which I gave to my now wife because she was always calling me asking for directions. She lost the GPS so it was a bit of a wasted gift. This time around I got another set of knives. While I got 13 the last time, this time I only got 7, but these are larger and a higher quality of knife. Included was a steel to sharpen the knives with and a pair of kitchen shears. The same set sells on Amazon for $299.95. If I make it to 25, I get an even fancier and higher quality set.

In my younger years I worked as a line cook for a year when I lived in Iowa. The Chef taught me the value of a good Chef’s knife. If there is only one knife you are going to get, it should be the Chef’s knife. You can cut, chop, slice, dice, whatever you need. It is a tool of the trade, what...

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Ambulance: Practice (Revisited)

Written by RSS Poster Medic ScribeMedic Scribe

A comment and discussion on my previous post sparked me to revisit a post I wrote 9 years ago about the issue of working a body for the practice.


Here’s what I wrote back then:

My preceptee needs a code. He probably needs a couple. He hasn’t done one as a medic yet. He’s intubated Fred the Head, but mannequins just aren’t the real McCoy. While managing a cardiac arrest is about more than just intubating, a medic needs at least one intubation to get cut loose to practice on his own.

A week ago we were called for “a fall, not breathing,” then updated that it was a dead body with no one doing CPR. When we got there, we found a four hundred plus pound woman face down on the carpet in front of her motorized lark. She was just a big blob of flesh. You couldn’t even see her face. It took a moment to make out where it was. We rolled her over, and quickly assessed her. She was in the gray area between being dead and workable by protocol and being dead and not workable by protocol. In either case, she was...

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Ambulance: AHA 2015 Guidelines: A Preview

Written by RSS Poster Medic ScribeMedic Scribe

On October 15, the new American Heart Association Guidelines for CPR and ECG will be published. Then we will get the answers to the big questions many of us have wondered about?

1. Has epinephrine in cardiac arrest seen its last days?

2. Should paramedics continue to intubate cardiac arrest patients?

3. Will traditional CPR be abandoned for cardiocerebral Resuscitation (CCR)?

Yesterday, the ILCOR Scientific Evidence Evaluation and Review System, in conjunction with the American Heart Association, published draft statements for public comment that shed light on the likely direction of at least some of these and other care questions.

The statements are available for public comment at the following link:

ILCOR Scientific Evidence Evaluation and Review System

Curiously the statements open for public comment do not seem to cover the full gamut of issues. There is only one statement on stroke care and no statement on continuous cardiac compressions (CCR).

Here are the answers to two of the above...

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Ambulance: Elephants

Written by RSS Poster Xf
It has been a long time since my last post but my family and career must come first and if anything I write threatens them, I need to temper my emotions; thus less to say of pertinence.

This week I was invited to sit on a panel during a live national television debate on the 'NHS Crisis' and so, after four busy night shifts in a row, I appeared, bleary-eyed, in front of the nation, along with other healthcare professionals and an assortment of politicians, celebrities and members of the public with a story to tell.

The programme, called 'NHS in crisis - the live debate', which you can see here, discussed the failings of our great healthcare system - the strain it is under and the possible causes. It ran for an hour and I sat, for the most part, in the audience, whilst waiting to take my seat in front of the cameras to say my piece.

I watched the audience and I listened to the panels that came before mine and it became clear that there was an awful lot of hatred for the Government and its policies. Fair enough, there is indeed a major problem with the...

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Ambulance: Iufenamun

Written by RSS Poster Trauma Queen

Ambulance: *No title*

Written by RSS Poster Trauma Queen

The difference between me and you is that I’m eating left over Mexican for lunch.
Regardless of your situation, I win.

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