Dave Quirk
@2Quirk
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NWAS Clinical Support Manager & APP🚨| Developing our frontline clinicians | Occasional lecturer | #RapidRecap 📚 | ...& away from work, the outdoors 🏔
North West, England
Joined October 2018
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🚑🚨 Rhabdomyolysis can occur as a consequence of crush injury (and other causes). October
#RapidRecap
looks at recognising the cause, pathophysiology, and patients at increased risk 🚨🚑. Thank you for supporting
#RapidRecap
- please continue to share and provide feedback.
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🚑 The prehospital assessment of abdo pain can be challenging, with multiple pt streaming options available. How can we enhance our assessment?
1. Comprehensive and structured hx-taking.
2. Thorough physical exam.
3. An underpinning knowledge of potential causes.
Links below 👌
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🚑🚨Moving past "mechanical fall". With the introduction of an "Older Adults Falls" Ambulance Quality Indicator, this month's Rapid Recap focuses on exactly that. How do we determine intrinsic vs extrinsic, and do we frequently perform orthostatic BP assessments or ECGs?🚨🚑
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🚨Our latest
#RapidRecap
. Water-related incidents have increased - so this month, we look at drowning. A quick 2-minute read for frontline ambulance clinicians & students, looking to recap core knowledge🚨
@NWAmbulance
@NWAmb_learning
@sgtee
. Feedback and ideas are welcomed!
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🚑🚨
#RapidRecap
, this time looking at
#asthma
and aimed is towards
#ambulance
clinicians. Remember to add RapidRecap and a short reflective piece to your
#CPD
evidence portfolio
#paramedic
#NQP
#studentparamedic
#nurse
#studentnurse
.
#JRCALC
. 🚨🚑
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🚨🚑December's
#RapidRecap
looks at Psychogenic Non-Epileptic Seizures
#PNES
, helping us move past the historical pejorative term "pseudo-seizures". Distinguishing between epileptic seizures and PNES is often challenging and with caution - see
#JRCALC
for further guidance. 🚑🚨
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🚨🚑 "We should assess all patients >65 years of age for frailty" -
#rapidrecap
frailty and the 5 frailty syndromes. Contributed to by
@NWAmb_Sara
🚑🚨
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🥶 🚑🚨Winter is fast approaching!
#RapidRecap
is staying topical, and this month explores
#hypothermia
. We packed in lots of information to
#rapidrecap
the basics - I'll post further CPD sessions below and see your
@JRCALCPlus
for more.🚨🚑🥶
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We wanted a platform to 'rapidly' communicate 'headline' clinical info⏳. After seeing great examples across multiple care sectors, RapidRecap was born. Soon linked with the local ParaPass app for quizzes and further reading. Plus, our paramedics&EMTs contribute to each RR✏📚
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🚑🚨
#RapidRecap
, looking at pre-eclampsia, one of the most dangerous complications of pregnancy. See
#JRCALC
for further information. Add RapidRecap and a short reflective piece to your
#CPD
portfolio
#NWAS
#paramedic
#NQP
#studentparamedic
.
RR Library:
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Yesterday, we had the pleasure of training 22 East Lancashire
@NWAmbulance
paramedics at the difficult airway CPD day, with our new training kit. A&P, equipment preparation, airway optimisation,
#SALAD
technique (i-gel&ET), and neonate inflation/ventilation.
#CPD
@NWAmb_learning
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🚨 Our latest
#RapidRecap
, this month looks at Diabetic Ketoacidosis. A 2-minute read for frontline ambulance clinicians looking to recap core knowledge 🚑🚨
@NWAmbulance
. Feedback or ideas are welcomed!
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🚑🚨
#RapidRecap
STEMI. Early diagnosis and prompt transfer to PPCI are crucial. Minimising our on-scene time can positively influence patient outcomes, especially those with cardiogenic shock. Women may experience 10% longer at scene; consider STEMI early. &...prepare for VF.🚑🚨
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🚨🚑 In keeping with the pregnancy-related complications theme of our last
#RapidRecap
, this month, we explore bleeding🩸. Scan the QR for the RR library and QR for bleeding CPD🚑🚨
#paramedic
#JRCALC
#studentparamedic
#ambulance
@SusanRhind1
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3 Peaks - Complete! ...and nearly killed us in this heat ☀️☀️☀️. Thanks to everyone who's donated to support our fundraising and thank you to Amy, our amazing support driver & carer. Lots of pictures and videos to follow, but for now we need this pizza-and let our joints recover!
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Our
#AMBULANCE
teams have been exceptionally busy. This morning we were lucky to have 10mins team time on station. We supported our team by offering donning & doffing training, along with scenario discussions.
#nhs
#ipc
#nhsfrontline
@NWAmbulance
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And so it begins...we start the national three peaks challenge this morning 🏔⛰️⛰️ - let's do it 💪. Thanks for supporting us so far 👌
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Another well-delivered CPD session in East Lancs,
@NWAmbulance
- we explored respiratory illness and how staff can maximise safe referrals to community urgent care providers. Thanks,
@Fran_1x
, UC2R ACP, for joining and helping show the vast capability of community services 👏
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We are definitely being looked after! Thank you ‘A right royal tea party’ Crawshawbooth, East Lancashire. The team loved them!
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Making the most of this morning with simulation. Life-threatening asthma management followed by debriefing, helping crews identify good practices and areas for further learning - 👌
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On the rare occasion that I'm not trying to steal the lime light, my dad does a good job of it...and manages to get some great action shots 😂. Proud son moment 👌
@NWAmbulance
@HuffPostUK
@NWAmb_Alice
#nwas
#ambulance
#paramedic
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Myself and two colleagues, Chris and Pete, have set a challenge to fundraise for two great charities. The challenge is to summit the three highest peaks in the UK🏔️🏔️🏔️, all within 24hrs! Check out which charities we chose and why, and help us fundraise if you can - link below
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18 EMTs attended our
#ECG
foundation course yesterday in East Lancashire,
@NWAmbulance
. Plenty of other
#CPD
courses planned for the future.
@NWAmb_learning
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A weekend away in the lakes is exactly what was needed - although ice on the tent might suggest it was a bit cold for camping 😂❄️ 🏔 ⛺️
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Looking after our ambulance crews welfare at Blackburn ED
@NWAmb_Wellbeing
@NWAmbulance
courtesy of E.Lancs NWAS leadership team.... and powered by
@AldiUK
by the looks of it 👌🏻😂
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We’re going to see some exceptional paramedics coming out of
@UCLanParamedics
next year
#studentparamedic
Great example of teamwork and communication, Developing competency in advanced airway management with
@NWAmbulance
EMTs on their paramedic programme.
#NU2114
#FutureParamedic
#StudentParamedic
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Wednesday night? Must be an opportunity for CPD: closed chest compressions in traumatic cardiac arrest. In summary, the evidence finds we need blood products ASAP; ever thankful for our HEMS DR team
@NWAirAmbulance
#traumacare2020
#cpdme
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A truly well-deserved nomination, recognising your dedication to last year's
@NWAmbulance
flu campaign in North Cumbria. Needless to say
@NWAmb_Mia
, I need you on the team again this year 😉
🌟 lovely little end to the day today to receive an email informing me that I was nominated for an NWAS Star Award for my leadership and vaccination programme success in the 2022/23 flu campaign.. absolutely flattered for the nomination
@2Quirk
! good luck to all the finalists 🌟
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Ben Nevis completed in just over 6hrs - what a beast of a mountain 😂
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🚑 ‘To be a learning organisation we must be able to effectively facilitate debriefing with our staff’ 🚑 An outstanding educational session around the importance of debriefing. Delivered by
@sgtee
, a hugely inspirational
@NWAmbulance
advanced paramedic.
@DrChrisGrant
@cpdme
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We're so close to our £1250 target, fundraising for the Anthony Nolan Charity and NWAS Charity 🙌. Our 24hr, 3-peak challenge is nearly a week away 🏔🏔🏔... please donate if you can 💚 - thanks for supporting👌
@NWAmbCharity
@AnthonyNolan
@NWAmbulance
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Great weekend in Stoke for
#FITC2019
. A great approach to multidisiplinary learning in trauma care and refreshing those key skills.
@TraumaCareUK
@cpdme
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A great article for those working in pre-hospital care; comparing Warfarin vs NOACs in ICH. ‘Delayed Intracranial Hemorrhage in Anticoagulated Geriatric Patients After Ground Level Falls’. …
#FOAMed
#paramedic
#studentparamedic
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April is STEMI awareness month @ NWAS. We've engaged with patients to hear/showcase their positive, emotive stories. We're launching Minutes Matter - a campaign focusing on reperfusion time/patient care. And our 2024 mandatory/clinical training now incorporates STEMI ECG skills🚑
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Primary assessment can always be enhanced. This weekend I was introduced to EVALUATE within ‘E’. A key opportunity to summarise assessment, treatment, and receive team feedback before extrication. Effective clinical leadership skills.
@JoshuaBarker94
@TraumaCareUK
@d_w_connor
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@RossM_2003
Good questions. Yes, they all have pads placed once diagnosed, approx 10% will progress into an arrhythmia so best to be prepared. RCUK advocate for stack shocks if witnessed/monitored 👍
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Promoting collaborative working between our paramedics and the community care providers 👌🏻
Productive day working with Mike, paramedic to further facilitate the
@ELHTIHSS
@NWAmbulance
pathway. 5 delfections from referrals ranging from reduced GCS, fast AF, DIB and reduced urinary output.
#THINKHOME
@2Quirk
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@NWAmb_Sara
@paramatt71
@NWAmbulance
Great to have you join us and thanks for developing the teams understanding of falls and frailty!
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As far as studying goes, a couple of days in Ambleside Library isn’t too bad 👌🏻
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Feedback/ideas are welcomed to further develop the RapidRecap initiative.
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Brilliant 🙋♂️
Can your house number be easily seen in an emergency? 🏡
This Christmas, we are urging people to make their house numbers visible so that paramedics, as well as Santa Claus, can find them when it matters most.
So we brought in an expert to help! 🎅
#HelpUsFindYou
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Thanks
@jade_xtina
....I’ve added some BSL NHS basics to my communication tool kit! 👌🏻 🚑🏥
Top 10 signs for
#NHS
workers!!
Please note that signs can vary in regions, these are the signs I use.
@AccessAbilityuk
#BSL
Hope these help you all in some way! 🤟🏼
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@SarahParaNQP2
NARU have guidance on smart motorways in their ‘Guidance for Ambulance Service response to Incidents on the Motorway Network (Including Smart Motorways)’. Worth a look, especially regarding fending and also reverse access.
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@NicoleSAtkinson
@AlisonBicker
@Prehosp_care
@ParaCharlie
@LornaBailey88
Hi
@NicoleSAtkinson
. We've found our staff engage well with RR and receive great feedback. It's accessible via local ParaPass, trust CPD site, monthly bulletins, and digital wallboards. Subjects are submitted from our regional/area learning forums or from incident reviews 👌
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Quick read for resus guidelines 2021 updates - courtesy of
@heli_med_james
Whilst the new
#RESUS21
guidelines don’t introduce any significant changes, here are some take homes that I believe are worth highlighting. A thread....
#FOAMed
#FOAMems
#cardiacarrest
#resuscitation
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@h3l3na97
@RossM_2003
Defibrillators often increase joules for the first 3 shocks, 200, 300, 360... And the likelihood of reverting VF is highest at the point of arrest, then decreasing over time. Without stacked shocks, a 4-minute wait exists before 360j and there is also consequential chest trauma.
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🥶 temperature is dropping: It’s too cool to skip hypothermia school, make sure you warm up your knowledge...It’s snow joke!
Forecasted -2’c next week ❄️
Any tips, cue cards or puns? 👀
@TheResusRoom
#hypothermia
#paramedics
#studentparamedic
#FOAMed
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Following the recent panorama on smart motorways it’s worth reading the NARU guidance.
@SarahParaNQP2
NARU have guidance on smart motorways in their ‘Guidance for Ambulance Service response to Incidents on the Motorway Network (Including Smart Motorways)’. Worth a look, especially regarding fending and also reverse access.
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@RossM_2003
Definitely - it significantly improves defibrillation time and these patients are high risk of VF. From a human factors perspective, it keeps the clinician calm with good operating bandwidth as all they have to do is press shock 👌
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Brilliant idea 👌🏻
Today we’re proud to launch an initiative, in partnership with
@TheDanielBaird1
, to provide life-saving ‘Bleed Control Kits’ to over 300 late-venues in the Square Mile.
Find out more about the initiative, here:
#ControlTheBleed
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@dentjjpd1
@NWAmbulance
I can only imagine the educational session you engaged in with them. That's the problem with high acuity low occurrence incidents. Generalised information overload means things are forgotten, or, underpinning knowledge is missing - RapidRecap will support both👌
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Worth noting to avoid any confusion, this study is focussed on haemorrhagic events leading to hypovolaemic traumatic cardiac arrest.
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@GHancock2304
@ParamedicsUK
We're in a similar position as others... We have a situation whereby some paramedics intubate, some can't. We're soon to have an airway strategy to outline our future plan. Not wanting to ignite the ETT/i-gel debate, whats crucial is to optimise/practice the supported 'skill' 👌
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@gareth_j_barnes
@think_brew
2/3 but in some others, it appears the aim is to step down ambulance pre-alerts without clinical assessment or observations irrespective of capacity. Previously there was no assigned accountability and based completely on Drs intuition...which resulted in clinical incidents.
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@mols_wilson
@cpdme
Snap. It really brought home how much there is to know! I’m a fan of using case studies for each one, works well do you think?
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@ZachDavies94
@NWAmb_Sara
Great point. As you both know, the demographic of >65s attended to by ambulance clinicians likely contrasts that of the general >65 population. Bench-pressingdad isn't our regular >65 patient; yet as you've shown, concerns can be ruled out
#rapid
😂.
#frailtyawareness
👌
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@lukeingle_
Hi
@lukeingle_
. Good point about hypoC. The hyperK is directly linked to rhabdo. And the potential for sequential AKI (from myoglobin) can disrupt calcium reabsorption leading to hypoC (QT interval prolongation, ischaemic changes etc).
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@nimal_patel
@tomamedic
We still have water-gel burns dressing, but they are deemphasised. Although the gel dressings cool for a short period, they then effectively act as an insulation layer. Water works best with adequate cooling times, and then cling film sheets are placed on top 🔥 💧
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Highly recommend the podcasts coming out from
@JoshuaBarker94
and the team at
@GenBroadCAST
. Great learning for our EMTs, students & paramedics 🚑 👌🏻
Episode 6 is out now!
Find it online at:
Listen on Spotify, Itunes or your Podcatcher of choice, just search "General BroadCAST".
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Cochrane review: PPE for healthcare workers to prevent coronavirus and other highly infectious diseases: a 5 minute video....
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@mill_cam
@steve_1866
@Sheebajphilip
@CatherineCurl12
I have a trauma course planned for April 2020, but it would be great to all sit down early next year and plan a summer 2020
#Prehospital
#stroke
course? Fancy it?
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@parajon82
Thanks
@parajon82
. Great speaking with you and hearing your passion for QI for our NWAS patients 👌
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@ParaAndy90
@h3l3na97
@RossM_2003
The most crucial factor is ensuring correct pad placement, that lateral pad especially⚡️
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@katy_mama
Same for paramedics as long as you have DipHE. Might be worth doing a single level 6 module to show your ability to study at that level.
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@gareth_j_barnes
@think_brew
3/3 Because we have highly competent crews who are clinically concerned after spending an hour with pt. So now...the ‘step-down’ must be by a Dr, following a set of obs, and full clinical handover. And the Drs name is recorded on PRF, and pt is taken to front of the RAT.
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This is an interesting project to monitor from another amb trust. Will the EMDOs need support from clinicians? I wonder if advising service users of prolonged wait times will open up clinical conversations, especially if they believe they should be a higher priority?
@EdHill0
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@EdHill0
@DrLindaDykes
100% whilst driving around. Then removed prior to attending the patient 👌🏻
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@dentjjpd1
@NWAmbulance
@NWAmb_learning
I think that’s a great idea, would you be interested in getting involved with some teaching?
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All I need now is a book case, wide range of books, and a reason to call a meeting.
The vital ingredient in an authoritative Skype interview...
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Personally I think the
@NWAmbulance
stance on this contentious subject is spot on. Promote safety 👌🏻
Ecstasy pills can be extremely dangerous.
The strength is very unpredictable so if you do decide to take them, you should start by taking half or a quarter of the pill. Avoid drinking too much or too quickly (even water) and be careful not to overheat.
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Great proactive ideas from
@nwambulance
. Working with young children to educate on when to dial 999. 👌🏻👌🏻👌🏻👌🏻👌🏻👌🏻
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@Maz_zeratti
No arms and one leg. You're right, a major trauma would be more suitable...or new equipment! I'm told we have new kit arriving soon - fingers crossed.
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