Archive for the ‘Web & Journal Watch’ Category

The great old lady GCS.

This post was written by Matthew Harris (HarrisCPD) , Monday, November 30th, 2015

1960sBeetleWaterShe has been around for almost as long as I have, and in 2014 she had her 40th birthday. Yes, she might have fall out of favour every now and then but that’s only because she has not been giving  the respect she is due. The Glasgow coma scale is a great old lady and the only scoring tool that has stood a test of time. If properly used she will answer the question she was designed for . . .  “is your patients head injury getting worse?”. Why use her for anything else? (more…)

Paris responds

This post was written by Matthew Harris (HarrisCPD) , Friday, November 27th, 2015

Jean-Jullien_illustration_Peace-for-Paris_attacks_dezeen_squareIn a macabre and twisted way the only thing military conflicts in Afghanistan, Iraqi and Jordan has offered the western world is new insight into the management of ballistic injuries. Injuries of such severity where once confined to the dusty realms of a military theatre,  inflicted on those bodies of fatigue clad, fully armoured soldiers. Now these same horrific injuries puncture the bodies of Friday night revellers dressed  in evening gowns and suits. The battle lines have been redefined and now runs through the middle of every  late night district in every western city.  (more…)

High altitude Extreme medicine.

This post was written by Matthew Harris (HarrisCPD) , Monday, November 9th, 2015

everestI had the opportunity to attend another fantastic update by the West Midlands PHEM team who continue to provide interesting itinerary packed days, filled with diverse topics in emergency medicine. Of note was the presentation by Dr Suzy Stoke (@drsuzystokes) on providing emergency medicine from a single tent on the side of Mount Everest’s first base camp during the 2014 spring climbing season. Suzy, at the time was employed by the Himalayan Rescue Association and was one of a handful of emergency physicians and medics providing care 5 kilometres above sea level. (more…)

Wanted: Australian Paramedic seeking greener pasture?

This post was written by Matthew Harris (HarrisCPD) , Saturday, November 7th, 2015

cc Chris Sampson (HHA124L) Flikr

Journal Article Review: The grass is greener on the other side and the water always warmer. If this is the case then why are Australian Paramedics leaving the surf of Bondi beach to work the cold, damp and dark shores of these British Isles?  If the Paramedic qualification is becoming more and more transferable why would the Australian paramedic want to work in the UK  and how does the qualification rate against the UK? (more…)

Having a Heatwave

This post was written by Matthew Harris (HarrisCPD) , Wednesday, July 1st, 2015

cc Flikr Jim Legans, JrCan you suffer a heat related emergency indoors? On the hottest day of the year most Paramedics already know that the emergency 999 call volume will steadily climb in direct relation to the outside temperature. A mini heat wave means health agencies issuing warnings to stay hydrated and the sales of factor 50 suntan lotion rocketing. For the average Paramedics the day is a long drawn out shift in the back of a vehicle with poor or no air conditioning at all. Unlike most of the “normal” working population in their climate controlled office, the Paramedic does feel the heat. But what about that elderly population, insulated in their small poorly ventilated one bedroom boxed room, the thermostat routinely stuck on high.   (more…)

Can Paramedics differentiate between Asthma and COPD?

This post was written by Matthew Harris (HarrisCPD) , Wednesday, March 4th, 2015

nebuliser

Can Paramedics differentiate between the individual  presentations of Asthma or COPD ? Here in the UK, each of these two condition has it’s own clinical management plan, set out by the JRCALC, a Paramedic  guideline for clinical practice. Having two separate guidelines would be practical only if the Paramedic clinicians can differentiate between the two, but how well do they do? Can you tell your Asthma from your COPD? I’ve found a journal article abstract that asks this same question.

(more…)

Do Dogs Bite?

This post was written by Matthew Harris (HarrisCPD) , Monday, February 2nd, 2015

cc S Carter (flikr)During my time on the road I have seen some viscous dog bites. Chunks of flesh pulled from the bone by the friendly family pet or clothes shredded to tatters by an angry police dog. Most needing vascular surgery or some form of repair. All needing long term antibiotics.  Animal bites are synonymous with infection and for decades there has been the tendency to keep puncture wounds open when treating, to only irrigate and de bride with minimal closing by suture where possible. In this journal article I’ve found, [Meg Tabake et al (2015) "Predictors of infection from Dog bite wounds: which patients may benefit from prophylactic antibiotics?" EMJ BMJ Online First] the authors look at the rates of infection occurring in animal bites and suggest it’s lower than initially thought. However they did observe an increase in infection rate where the wound had been closed [by suture]. This would make sense as there has always been a preference to close wounds to the neck or face for cosmetic reasons I would imagine. (more…)

I’m not nuts about mental health!

This post was written by Matthew Harris (HarrisCPD) , Saturday, October 11th, 2014

“Paramedics don’t get enough mental health training!”, it’s a cry that has been banded about for ages. The reality is, it’s probably true, highlighted by the frontline Paramedics general poor perceptions of mental health patients. In a journal abstract I found this week, these sentiments are echo’d in the Journal of Psychosomatic Research with a systematic literature review by the authors studying perceptions and experiences behind treating self harm patients.

You can find the abstract here. Registration may be required. (more…)

Mental health Act 1983

This post was written by Matthew Harris (HarrisCPD) , Wednesday, May 7th, 2014

Mental health champion Michael Brown of (@MentalHealthCop) has penned an article for the Journal of Paramedic Practice that asks the question as to how robust is the current Mental Health act? Revisited in 1983, it would appear that little has changed since it was first introduced in 1959. Is it a tool that has remained current with our modern day emergency service workplace? The most telling statement in this piece is that UK emergency care providers, both ambulance or police, have no non-criminalising laws to ensure the immediate well-being of people who may be at risk. Does this need to be addressed? Like myself, many paramedics have been frustrated by the “legality” around providing what we think to be in the best interest of our patients. We might be clammering for a new act, but more importantly this needs to be a robust law that protects the patient and in turn . . . “ourselves from ourselves”.

Here is a journal abstract/article I spotted with some more background and detail. (more…)

Cricoid Pressure, a piece of cake.

This post was written by Matthew Harris (HarrisCPD) , Tuesday, April 29th, 2014

The last piece of cakeDo I perform cricoid pressure or not? Answering this question is much like standing up and admitting you like to eat cake. This goes down great at your local WI cake baking sale, not so great at a weight watchers convention. If you’re not aware, there are two distinct and vocally vociferous camps in this regard. Those that think that cricoid pressure has a role to play in airway management and those who do not like cake. And then there are those that sit on the fence eating cake, something at which I’m very good at ( . . . cake eating that is). Over the years I have heard the debate , for and against cricoid pressure, nothing has convinced me to adopt or discontinue this practice yet. (more…)