RT @smithECGBlog: Potassium 6.2 with narrow QRS: any indication for calcium? @ECGcases

@EduMed_UK @Oxfordite @cannula_service @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Way more volume of opportunity for theatre vs bedside procedures I did 8/12 surgery in F1 and didn’t go to theatre once. No PAs. Its a wider cultural issue. They seem to manage where I now work (DGH) Imo should be in the curriculum, with suturing a required outcome

@Oxfordite Haha. Not exactly - picking apart the details of comfortable narratives is a habit from humanities days It’s just difficult to express and address the unspoken ideas and feelings that underlie these kinds of discussions - in the space of a tweet instead of an 800 word essay 😶

@EduMed_UK @Oxfordite @cannula_service @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Er, who was this a reply to? Me??

@DrLKVaughan @EduMed_UK @Oxfordite @cannula_service @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 I’m sure that’s true Not just shift working patterns But services - esp gen and sometimes acute medicine - full of transient locum consultants SHOs with no registrar to escalate to/learn skills from. So the cannula/LP/drain goes to anaesthetics/IR Sad state of affairs

@Oxfordite @cannula_service @EduMed_UK @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Sorry, I wasn’t meaning to swear at you! A bit of depth of feeling slipped out 😜

@Oxfordite @cannula_service @EduMed_UK @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 As a highly educated doctor, I can tell you, there is no fucking way I would perform this procedure. My medical degree did not equip me to do it. In very recent times, a posh chap with some time in the library was considered entitled to do this. I guarantee you, it was not better

@ollieburtonmed @cannula_service @EduMed_UK @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Thanks for your insight on that. One thing that surprised me is brain biopsies being done by CFs unsupervised. I got the sense that this isn’t really considered “neurosurgery.” Is a bolt EVD neurosurgery?

@cannula_service @EduMed_UK @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 I think ultimately I agree I would rather I had this done by someone who both had some persistence in the service, as well as at least a potential long term training benefit Just to make the point that I don’t think there is an ideal answer to this problem

@cannula_service @EduMed_UK @oscar89mac @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Well, that’s the it - how best to run a pyramid shaped service. ST offers a column. Who fills out the pyramid? LEDs is one way. That’s how it was done in my very very brief experience at a NS centre. Unfortunate that they largely will not be able to progress in the specialty

@NutterAlic41590 @parthaskar @Alison6123 @CareQualityComm @NHSEngland @gmcuk @DrAsifQasim @ShivaniM_KC @COPDdoc @RCSnews @doctor_oxford @ShrillaB @kidneydoc101 @DrNeilStone @DrLKVaughan @UKGastroDr Excellent priorities, truly a patient centred approach, exemplary

@EduMed_UK @oscar89mac @cannula_service @PhilipSteart @dieracg @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 There are about 20 neurosurgery ST1s every year. So, yes they should definitely be given the opportunity if they are there at the time, and not in theatre etc. But that doesn't address how to provide this service 24/7

@Billy6872463584 @ponteepon @LukeAmos__ I wanted to be a musician. Being a doctor is pretty cringe ngl

@Cray_tweets1 @oscar89mac @cannula_service @dieracg @PhilipSteart @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Well, that's an interesting point. I feel squeamish about having things shot through my brain and I'd very much prefer the surgeon. OTOH we don't have the ability to request a urologist or a doctor places a urinary catheter just because we feel vulnerable or sensitive about it 🤔

@oscar89mac @Cray_tweets1 @cannula_service @dieracg @PhilipSteart @parthaskar @CareQualityComm @NHSEnglandNMD @PSCommissioner @wesstreeting @DrAsifQasim @ShivaniM_KC @DrSelvarajah @ShrillaB @DrLKVaughan @COPDdoc @doctor_oxford @DrPhilBanfield @UKGastroDr @kidneydoc101 Well there's bedside procedures and beside procedures. Urinary catheters vs perc traches. There has to be a line somewhere. What are the complications of EVD placement? Non-trivial I believe?

@LostDazes @ollieburtonmed @agemjourney Yes - but less than half foundation doctors will end up in those specialties I agree ultrasound and seldinger techniques are transferable But I also think training should be reasonably concentrated

@ponteepon @LukeAmos__ You're saying it will happen but not that it should happen (?) If you think that is good for patients, then we can agree to disagree

@ollieburtonmed @agemjourney And more FYs go to GP and psych than medicine and anaesthetics I don't think F1s need to be doing CVCs. But FYs do *really badly* need to have a concrete sense of professional development and skill acquisition The slump of the curriculum into vague generic fluff is a disaster imo

@ponteepon @LukeAmos__ And yet here we are. Entirely self funded from a band 4 job Dose of reality - having a mortgage and children restricts your other choices in life If you own a house, you are very privileged. Take some time to appreciate the good things in your life

RT @walsh_joe: Have since discovered that EM applications have practically doubled in just one year 2024 - 2,718 2025 - 5,081 Only 17%…