#MedChat Transcript
Healthcare social media transcript of the #MedChat hashtag.
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See #MedChat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Jack Tulloch @jack_tulloch97 @MedicNow exanguinating haemmorhage is first concern surely? control any obvious bleeding from injuries such as a possible open fracture from the fall? open femur fracture? #medchat |
 | Emily Wragg @ewragg90 @MedicNow Primary survey, secondary survey including neck/hip/back/abdo ax Also consider likely b/l calcaneum #'s #medchat |
 | Elliot Sutcliffe @elliot203 @MedicNow Following a CatABCDE approach, with focus on getting on a pelvic binder and watching vitals for signs of significant abdominal/pelvic internal haemorrhage #MedChat |
| Emily Wragg @ewragg90 RT @Elliot203: @MedicNow Following a CatABCDE approach, with focus on getting on a pelvic binder and watching vitals for signs of significant abdominal/pelvic internal haemorrhage #MedChat |
| Emily Wragg @ewragg90 @Elliot203 @MedicNow Second that, especially when you can bleed almost your entire blood volume into your pelvis #medchat |
| Elliot Sutcliffe @elliot203 @MedicNow @josephfra Bi-Lateral IV access would be first port of call, with IO in the proximal humerus being a good alternative if pt becomes shut down due to hypotension. Critical care teams with blood products would be useful, as standard fluid resus may cause a dilutional coagulopathy #Medchat |
| Emily Wragg @ewragg90 @MedicNow @josephfra Fluids - paramedic (crystalloid) physicians (blood) ??poor evidence for colloid for resuscitation #medchat |
| Jack Tulloch @jack_tulloch97 forgot to #medchat https://t.co/tO0txGXxVY |
| Emily Wragg @ewragg90 RT @Elliot203: @MedicNow @josephfra Bi-Lateral IV access would be first port of call, with IO in the proximal humerus being a good alternative if pt becomes shut down due to hypotension. Critical care teams with blood products would be useful, as standard fluid resus may cause a dilutional coagulopathy #Medchat |
 | CR Barley @_crbarley Can anyone tell big fat juicy Trauma is not my field of expertise? #medchat #timetolearn |
| CR Barley @_crbarley RT @Elliot203: @MedicNow @josephfra Bi-Lateral IV access would be first port of call, with IO in the proximal humerus being a good alternative if pt becomes shut down due to hypotension. Critical care teams with blood products would be useful, as standard fluid resus may cause a dilutional coagulopathy #Medchat |
 | Billy Roskell @billyroskell @MedicNow @josephfra IV IO give TXA good pelvic immobilization. Fluid in 250ml reassess max 2ltr #medchat |
| Jack Tulloch @jack_tulloch97 @MedicNow @CalebOwomoyela @Elliot203 @CalebOwomoyela and myself are currently sat in the same room reading, learning and contributing #learning #medchat #motivation |
| CR Barley @_crbarley @MedicNow @josephfra Interested for answers on this! I personally really struggle with hot debrief as I can’t remember what happened immediately after. Maybe the debrief should include a recap of what actually happened as well as what went well and what could reasonably be done to improve? #medchat |
| CR Barley @_crbarley @MedicNow @josephfra I also really struggle with the phrase “So, how do you think that went?” It’s so open-ended and is often sprung on you without warning. Maybe we should say “Shall we have a debrief? Let’s go over what happened.... What do you think we did well/can be improved?” #medchat |
| Emily Wragg @ewragg90 @MedicNow @josephfra Start positive, highlight main areas, transparency is also key #medchat |
 | Tomide Owomoyela @a_caleb_o #medchat https://t.co/pF5JFOg7Kz |
| CR Barley @_crbarley @mlg1611 @MedicNow I think debrief can be great opportunity to act on holes in a service. Not only medically but for psychological support of staff. Perhaps it will also help to acknowledge in this debrief, as you’ve said, how slight the chances of survival were initially? #medchat |
| Billy Roskell @billyroskell @MedicNow @josephfra Never had a Service debriefing in 25yrs no matter how distressing. Asked how are you over the radio but nothing more. However I attended a police hot debriefing following a fatal RTC,very well constructed. All expressing how they felt at the time and now. #medchat |
| Elliot Sutcliffe @elliot203 @MedicNow @josephfra Without experience it's hard to weigh in, but I think being open about what went well, and things that could have be improved for the next time, but also understanding that not everyone can be saved, so it's important to allow people to just discuss their feelings too #MedChat |
| Tomide Owomoyela @a_caleb_o @josephfra @mlg1611 @MedicNow @BASICS_HQ @PHEM_cast Also very important to have a break between call outs. All health care professionals are always under time pressures during a shift but time must be taken to just refresh! #medchat |
| CR Barley @_crbarley @mlg1611 @MedicNow As I say, I struggle with hot debriefs anyway. In a cold debrief I’d feel as though I’d had time to consider questions and digest what has happened. By then I may be ready to tell you what I needed in the incident clinically and need now emotionally. #medchat |
| Jack Tulloch @jack_tulloch97 @MedicNow @CalebOwomoyela @Elliot203 #medchat 🔥 https://t.co/2hPIipDGSz |
| CR Barley @_crbarley @MedicNow @josephfra I am going to leech off everyone else’s answers for number three! #NoShame #MedChat 🤗 |
| Elliot Sutcliffe @elliot203 @MedicNow @josephfra Establishing airway and breathing with the thought of intubating if expertise available, then using HOTT as the major reversible causes of traumatic cardiac arrest, pelvic binder for potential pelvic haemorrhage. CPR is devalued, until the other causes can be managed. #MedChat |
| Billy Roskell @billyroskell @LivEaTraveLove @MedicNow @josephfra @SECAmb_CCP My Trust could well be very good at it. I'm speaking from personal point of view. Think if your asked if your ok at the time, have a think before replying I'm ok. #medchat |
| Emily Wragg @ewragg90 @MedicNow @josephfra Safety, update control, try to manage major reversible causes - tension pneumo, haemorrhage etc - emerging evidence for no CPR in traumatic arrest #medchat |
| Jack Tulloch @jack_tulloch97 @MedicNow @CalebOwomoyela @Elliot203 sorry just constantly thinking about my ABCDE approach and the HOTT principles.... #medchat |
| CR Barley @_crbarley RT @Elliot203: @MedicNow @josephfra Establishing airway and breathing with the thought of intubating if expertise available, then using HOTT as the major reversible causes of traumatic cardiac arrest, pelvic binder for potential pelvic haemorrhage. CPR is devalued, until the other causes can be managed. #MedChat |
| Tomide Owomoyela @a_caleb_o @MedicNow @josephfra This scenario raises the very likely possiblity of blunt trauma as the cause of this patient's cardiac arrest. After securing airway and obtaining a tripod, key to follow the HOTT principle to treat the reversible causes a traumatic cardiac arrest #medchat |
| Jack Tulloch @jack_tulloch97 @Elliot203 @MedicNow @josephfra yeah completely agree, HOTT principles would be high on my list! #medchat |
| CR Barley @_crbarley @COwomoyela @MedicNow @josephfra Here comes a stupid question! Forgive me, what is a tripod? #medchat |
| Billy Roskell @billyroskell @MedicNow @josephfra Control claret, think of reversible causes Tension pneumo decompress, Airway & ventilate defib on, cpr. #medchat |
| Tomide Owomoyela @a_caleb_o @MedicNow @josephfra Would feel very awkward not starting chest compressions on a cardiac arrest patient though. What were all those competencies for? #BLS #LUCAS3 #medchat |
| Jack Tulloch @jack_tulloch97 @__Barley @COwomoyela @MedicNow @josephfra The use of an oropharyngeal airway and bilateral nasopharyngeal airways :) #medchat |
| CR Barley @_crbarley @Jack_Tulloch97 @COwomoyela @MedicNow @josephfra Oooh, I actually use this but have never known it has a special name... thanks! #medchat |
| Tomide Owomoyela @a_caleb_o @__Barley @Jack_Tulloch97 @MedicNow @josephfra Only learnt it this week as well! #medchat |
 | RePHILL @RePHILL_trial RT @mlg1611: |
| Billy Roskell @billyroskell @MedicNow @josephfra 🤔 be assertive but calm. Explain that to reverse the cause is better than treating the result. #medchat |
| CR Barley @_crbarley @MedicNow @josephfra God, this sort of confrontation is my worst nightmare as a young, baby-faced, University-educated Paramedic. Someone older and with more experience disagreeing with the clinical care I know to be best for the patient... grateful for tips #medchat |
| Jack Tulloch @jack_tulloch97 @MedicNow @josephfra I would say, whilst its been seen recently to be less important to do CPR in this situation, if the team is that uncomfortable not starting CPR then it can always be done as long as it doesnt interfere and get in the way of the team still managing the HOTT principles? #medchat |
| Emily Wragg @ewragg90 @MedicNow @josephfra Be confident in your approach, this should help others trust in your decisions to hopefully encourage them to negate CPR. #medchat |
| Elliot Sutcliffe @elliot203 @MedicNow @josephfra I think briefly explaining the rationale behind why CPR is ineffective in traumatic cardiac arrest, and that once HOTT has been addressed, CPR can commence with a higher success rate? #MedChat |
| Jack Tulloch @jack_tulloch97 @Elliot203 @MedicNow @josephfra Some people do feel really uncomfortable dealing with situations like this without using CPR! do you think it be better to try and convince yuour team to abandon CPR completely or allow it if its not going to stop you managing the HOTT principles? #interesting #medchat |
 | Oli Smith @OliSmith91 @MedicNow @josephfra Taking the time to explain can be beneficial - you may impact the practitioner with their future practice which is far more beneficial. If there enough hands on deck - CPR won't hurt but volume preservation and HOTT principles take priority. #medchat @josephfra |
| CR Barley @_crbarley @josephfra @MedicNow No, agreed. I think being from Uni background can be seen in a negative light by some ambulance crews though 🤔 or is that me being insecure? #medchat |
| Elliot Sutcliffe @elliot203 @Jack_Tulloch97 @MedicNow @josephfra Ultimately team cohesion is important, and depending on how many people are available, will depend on if CPR will interfere with effective HOTT management. If 3 people, then CPR takes too many away from the main focus, if theres 7 of you, then I think CPR would be useful #MedChat |
| Jack Tulloch @jack_tulloch97 RT @Elliot203: @Jack_Tulloch97 @MedicNow @josephfra Ultimately team cohesion is important, and depending on how many people are available, will depend on if CPR will interfere with effective HOTT management. If 3 people, then CPR takes too many away from the main focus, if theres 7 of you, then I think CPR would be useful #MedChat |
| Emily Wragg @ewragg90 RT @Jack_Tulloch97: @MedicNow @josephfra I would say, whilst its been seen recently to be less important to do CPR in this situation, if the team is that uncomfortable not starting CPR then it can always be done as long as it doesnt interfere and get in the way of the team still managing the HOTT principles? #medchat |
| Tomide Owomoyela @a_caleb_o @MedicNow @SPServicesUK @Jack_Tulloch97 @CalebOwomoyela @Elliot203 Big shout out to the great people of Treliske for providing us with some sound education. Massive thanks to the big man @josephfra #WeWantMore #IOuntilprovenotherwise #MedChat |
| CornwallChatter @CornwallChatter RT @MedicNow: | |
| Jack Tulloch @jack_tulloch97 @josephfra thank you for all the teaching! https://t.co/8Ea3gc7jGl |
#MedChat content from Twitter.