The keynote panel of @SarahToddPara @helenbeau1 @Kirsty_LLR, Simon Robinson and Dr Bridget Carne are talking about pre and post registration training for Paramedics in the next 5 years.

#SWPiPC
@Kirsty_LLR mentions they are already talking about pre reg training changing in the 5th iteration of the curriculum to incorporate a larger focus on urgent care including long term condition management.
@helenbeau1 has discussed paramedics in primary care specialising in primary care.

@CoP_PrimUrgCare looking at launching a Co-badged steroid injunction course.

#SWPiPC
Simon Robinson - “it’s amazing to see so many paramedics here on a sunny Saturday.

8 years ago the #CoP told me to keep my intubation and cannula skills up - today I’m a partner of a large surgery responsible for 200 employees.

It’s great to see how far we’ve come”

#SWPiPC
GP Dr Carne admits that until she invited a paramedic into her practice, she had absolutely no idea of our skillset.

Years on, her surgery has seen a dramatic reduction in antibiotic prescribing and emergency presentations.

#SWPiPC
Dr Carne states that paramedics are experts at spotting sick and ill patients.

Paramedics in primary care incredibly valuable and without paramedics in general practice it would be broken* in Somerset

*even more broken

#SWPiPC
There are 50! paramedics working in primary care within Somerset.
@SarahToddPara - “what tips would you give to those employing new paramedics”

Dr Carne - “allow them to shadow for a while, accept that they will need lots of support at the start, bookmark30 mins everyday for a catch up and queries”

Cont…
Simon - “we have a 6 week induction, we invite perspective employees to come and spend the day with us, see what it is really like.

We then have joint clinics with a range of practitioners - inc pharmacy. This gives them time to learn what they don’t know….
…then a modified Wolverhampton grid to narrow down learning objectives. Then regular learning meetings.

We also have 2 week placements for student paramedics from the local uni”

#SWPiPC

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More from @georgebellstarr

Mar 25
Finally we end with Dr Andrew Tressider - a Somerset GP - with a specialist interest in health and self care.

Very often, we care for others, but we rarely care for ourselves.

#SWPiPC Image
It is important to take a minute, and put a dose of calm into the system.

Sitting up straight, feet flat on the floor and taking some deep breaths can activate the parasympathetic nervous system.

Look at the difference between sympathetic and parasympathetic drive.

#SWPiPC Image
Take a minute between patients, or a few times a day can really help us regulate ourselves.

Running on adrenaline (sympathetic arousal) can lead to long term negative effects on us.

These are all symptoms of other things but can strongly be related to ⬆️ stress.

#SWPiPC Image
Read 6 tweets
Mar 25
Final lightening season of the day for me, @AAndybrereton - EoL Case Studies and working as a Paramedic in EoL care.

Andy opens by explaining his route to becoming a specialist EoL paramedic.

Paramedic > EoL HCA > B5 ‘nursing role’ > Training role > Specialist role

#SWPiPC Image
A remainder before we start from @AAndybrereton - this could be emotive, if you need to take a minute, please do, remember to be kind to yourself.

#SWPiPC
Andy continues by bringing in some real (highly anonymised) cases.

In @AAndybrereton’s locality, family are trained to deliver stat doses of analgesics.
Read 9 tweets
Mar 25
Headaches and Neurology with Dr Peter Miller.

Possibly the most popular presentation of the conference so far.

Starting with some hard hitting facts:

Headache = brain tumour = 1:1,000
Likelihood of migraine diagnosis being right = 9/10

#SWPiPC Image
PT with a headache? Some 🚩

🚩>50
🚩 Pregnancy
🚩Thunderclap
🚩Hx of malignancy or immunosuppressives

Any of these could be concerning.

Thunderclap, need to be asking speed of onset and is this the worst headache ever?

Onset is likely 0 > 10 in <5 mins.

#SWPiPC
Pregnancy - can be very complex

Migraines often worse in the first 1/3, often better in 2/3.

First occurrence of aura in pregnancy is quite common due to ⬆️ esteogren.

Serious causes = preeclampsia

Compare acute BP to booking BP in pregnancy.

#SWPiPC
Read 15 tweets
Mar 25
Up next:

Dr Bridget Carne - Consultation Skills

What are they?

Communication skills
- creating a relationship
- sharing information
- picking up cues
- working out a plan together

#SWPinPC
“Consultation skills is a massive subject, so let’s focus on some some tools”

Patients often rehearse what they want to say - try introducing yourself and NOT asking a question - give the patient time to speak first.

#SWPiPC
Practice the golden minute.

Try and keep silent for 1 minute and let the patient tell you what they want to tell you - the patient will often tell you what need to know.

Try active listening (nods, yeses, mmhm etc) to encourage the patient to speak.

#SWPiPC
Read 11 tweets
Mar 25
@HosznyakRachael talking about NHS@Home and her work around keeping the frail at home.

#SWPiPC
The challenge with NHS @ Home is we are not currently working to keep patients at home.

In the #BNSSG area:

84% of patients could have left hospital earlier. With an average of 16 extra bed days per patient.
“We can do better”

➡️ frailty and increased care needs are not a surprise.

Patients aged 80+ (3% gen pop) account for 30,000 bed days annually.

#SWPiPC
Read 9 tweets

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