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Medics: Should We Delay Cord Clamping? How Long?
Photo containing quote from Resus Council about delayed cord clamping. -
The Decompensating Child: Blood Pressure Ranges to Watch
Image showing the 5th and 50th centile blood pressure ranges for children from 1 month-15 years. -
If you use an inhaler infrequently…
Woman holding asthma inhaler on color background, top view. Space for text -
Lacerations – Criteria to Inform Referral Needs in Stable Patients
In your stable patients with lacerations, who do not have any urgent or troublesome A-D problems and who have not sustained injury through any great mechanism, what else should you be looking for in your assessment of their injury? What are the risk factors, according to different guidelines or authors?
While some of these elements may not be enough to refer a patient to secondary care on their own, they should help to increase your risk assessment during safe discharges. In combination, many of these factors should raise flags.
Depth Size Risk Factors Area There is limited evidence regarding the depth of wounds. The emphasis is on the structures that deep wounds would impact. For example, vascular damage, and nerve, tendon, or bony injuries (NICE, 2021). More than 5cm (NICE, 2021). Two or more of:
– Malaise
– Fever
– Rigors
– Contamination of site with body fluids, soil, faeces, or/and pus.
– Patient older than 65 years
– Diabetes
– Jagged wound edges
– Signs of tetanus
(NICE, 2021)Any of:
– Face
– Palm – and there is a potential infection.
– Joint with cellulitis.
(NICE, 2021).Contamination from unknown object (e.g. knife/glass) (NICE, 2021). Presence of necrotic tissue or slough, which could delay healing. Granulation tissue can also delay wound healing, but all can be prevented with appropriate dressings (Wilson, 2012: 11). Wounds older than 24 hours (Newman and Mahdy, 2021). Bites (Newman and Mahdy, 2021). Lacerations: A Collection of Risk Factors and Specific Criteria to Inform Referral Needs in Stable Patients. Have you found more, or would you like to add some from your own experience? Add these in the comments below, and let us know what you think about this post.
References
Newman, R.K. and Mahdy, H. (2021) ‘Laceration’, Treasure Island. Available at: https://www.ncbi.nlm.nih.gov/books/NBK545166/ (Accessed 18/11/2021)
NICE. (2021). Lacerations. Available at: https://cks.nice.org.uk/topics/lacerations/ (Accessed 18/11/2021).
Wilson, M. (2012) ‘Understanding the basics of wound assessment’. Wounds Essentials. 2. Pp. 8-12. Available at: https://www.wounds-uk.com/resources/details/wound-essentials-72-understanding-the-basics-of-wound-assessment (Accessed 28/12/2021).
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Googling Symptoms – What to Ask
- Ask, who runs the site? Is it clear?
- Ask, who pays for the site? Does that affect its content, or the way its content makes you think?
- Ask, does the site have a specific aim? Does this affect its content, or the way its content makes you think?
- Ask, where is the information from? Is it referenced? Is it health-specific, or a generic news website or opinion blog? Is it recent?
- Ask, who has written the information? Can you trust them?
- Ask, can you compare this information with a page from a health site in your country, e.g. an NHS England site? Is it telling you the same thing?
- Ask, have you already been advised by a health-care professional to follow-up with your doctor or other professional? If yes, ensure you book this appointment sooner rather than later.
- Health information is often generic, to cover a wide range of circumstances, risk factors and eventualities. My risk of having a specific condition is not the same as yours. So, ask about your personal circumstances. This one symptom may mean you have X, but how likely is it for you age, health history (the conditions you and your family have), and other circumstances? Is what you have today a life-threatening emergency?
If you are unsure, always ask your doctor.
Based on advice provided here.
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Introducing Collaborative CPD
What is collaborative CPD? Well, it’s a way of tagging your crewmates/colleagues in specific CPD entries such as reflections on jobs, and then asking your crewmates/colleagues to answer some questions and provide some feedback on your communication and clinical management. You can then use this feedback as prompts to write – or expand – your reflective entries. Or you can export their feedback and add it to your portfolio as evidence of feedback. And your crewmates/colleagues can sync the shared CPD to their portfolios to evidence their own feedback or to prompt or expand on their own reflections. Watch the video for more:
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Video Guide/Walkthrough to Article 999’s CPD Templates, V1.6
Please note: These videos demonstrate printing/exporting the NQP portfolio. However, all portfolios (post-NQP/Non HCPC/NQP) print in the same way. There is simply more to print in the NQP version. Non NQPs can safely skip parts about printing the NQP learning outcomes.
Please also note: The settings in the templates are such to enable printing to work properly and to ensure your NQP learning outcomes are in the correct format. Please do not change the settings, unless I have specifically advised that you can. NQPs, please print your learning outcomes from the given table to ensure your portfolio is accepted. If you are unsure, please do reach out.
For more information, please see the CPD Templates main page, and the Help File.
The full walkthrough:
00:00 Intro
03:40 Logging CPD
12:50 Editing the Cover Page
14:00 Editing the Summary of Practice History (and checking the word count)
14:47 Adding more category/tag options for your CPD log – using the ‘check all fields’ tab (which is *not* for printing.
17:00 Adding/Editing Development Goals 19: 40 Editing the Statement of How I Have Met the Standards (and checking the word count)
20:10 Checking, and a second way of logging the NQP Learning Outcomes. Searching for met/not met outcomes as well. Use of the signature(s) column(s).
23:00 Checking, and a second way of logging HCPC Development Goals.
24:40 Printing/Exporting
How to print/export the:
25:10 Cover Page – Using the extensions tab
28:20 Summary of Practice History – Using the extensions tab
29:14 Dated List of CPD Activities – Checking the fields & word count before printing
32:09 Dated List of CPD Activities – Printing/Exporting the CPD Log
37:40 Evidence List 39:40 Reflections – Using the Extensions tab
41:25 Skills
42:00 Development Goals
43:00 Statement of How I Have Met the Standards
44:01 NQP Learning Outcomes
45:20 HCPC Standards of Proficiency
46:20 Merging the PDFs, Adding Page Numbers, Editing
52:06 NQPs or anyone wanting signatures – How to get your portfolio signed electronically.
54:00 Final bits of advice, references, and support options.The printing/exporting instructions only:
How to print/export the:
00:00 Cover Page
03:38 Summary of Practice History
04:38 Dated List of CPD Activities – Checking the fields & word count before printing
07:12 Dated List of CPD Activities – Printing/Exporting the CPD Log
12:45 Evidence List
15:00 Reflections
16:50 Skills
17:25 Development Goals
18:28 Statement of How I Have Met the Standards
19:39 NQP Learning Outcomes
20:45 HCPC Standards of Proficiency
22:30 Merging the PDFs, Adding Page Numbers, Editing
27:20 NQPs or anyone wanting signatures – How to get your portfolio signed electronically.
30:00 Final bits of advice, references, and how to seek support. -
Seeking Clinical Mentors
As HCPs we are used to having mentors. We are assigned them in training programmes, trained to become them as part of our progression, and some workplaces offer ‘team leader’ style roles for continued mentorship post-training. But what about when we want advice on accessing career pathways that aren’t immediately available?
What about when we are thinking of reducing hours, changing contracts, trying different Trusts and don’t know anyone currently doing the same?
LinkedIn is a great tool – if people respond, and I have said for some time that if you look for someone doing what you would like to do, you will likely find them. The problem is, that doesn’t mean you can ask them how they got there, what courses were worthwhile (or are now worthwhile amidst constantly moving barriers like Trusts previously wanting level 3 certificates now wanting level 4, and evolving career maps), or how to get anyone in your chosen line of work to answer your enquiries.
Image: Little help with those steps, please. Image shows a hand holding a wooden block in place as a stair while a wooden man steps up to it. Paramedics are now working across a variety of fields, and as I have written recently, I believe that we may soon reach a point like other professions of working a generic few years before choosing specialist paths. However, I am aware that many are trying to work out which path is most suited to them, which one isn’t a dead-end and involves a good mix of a healthy shift pattern, interesting work, and career progression. It isn’t easy to choose when many pathways are new or still being developed. Some appear in one part of the country several months before they pop up in another and as most of us have experienced, the same pathway doesn’t necessarily look or feel the same in every Trust.
I believe that it should be easier for us to find mentors and support each other to answer simple questions like those written above. I hope to soon provide Article 999 mentors who will available to answer questions and offer guidance. These mentors will be working in a variety of specialised roles. They may have specialist interests that have become part of their career. Going forward, they may be able to provide more in-depth career discussions and advice, and some of them may be interested in collaborating on projects and ideas.
What does mentoring mean to you? Image shows people trying to climb up a series of blocks, receiving help from each other in the form of hands up and ladders. We as Paramedics do have the benefit of information and support available from unions and the College of Paramedics, but we don’t have an easy to access resource of helpful, responsive, qualified mentors who are there to help you:
- Progress
- Network
- Make informed career choices
- Make informed course choices to spend your money and time effectively and efficiently
- Find guidance (and perhaps inspiration) when you are unsure where to take your career or what is next for you.
Learning and leadership – two interconnected terms relating to mentoring If you are interested in becoming a mentor for Article 999 please email me at article999uk[at]gmail.com with your name, role (and registration number if you are registered), clinical background and experience, area of specialist interest(s), and mentoring experience and qualifications. Please note this is currently voluntary, but committed mentors will be contacted in the future as this project develops and grows. Mentors will also receive a certificate that could be used for CPD portfolios.
If you are interested in being mentored then please let us know by liking this post, commenting and/or sharing it.
Motivational quote “Leadership is unlocking people’s potential to become better” appearing behind torn blue paper. “Mentoring is a brain to pick, an ear to listen, and a push in the right direction.”
John C. Crosby
(one of many quotes that describe effective mentoring)
