Episodes
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This episode has taken a little while to get sorted but I promise it is worth it... Here I am chatting again to Pete Chessum from Adprac- our fab sponsors who provide advanced practice staffing solutions to urgent, emergency and acute care settings across the UK.
Pete and I recorded a podcast a few months ago about the crux of rapid assessment or whatever name you may call it, the role of bringing a senior decision makers closer to the 'front door'. During this podcast Pete correctly identified those departments that place all their eggs in one basket or all of their focus on one aspect to 'sort the problems out' are potentially setting themselves up to fail. He then mentioned the complexity of ED and I thought we should probably record another podcast.
In this podcast we look some of the suggestions on how to improve our departments by not simply focusing on 'input, throughput and output'. We need to look inwards and try to fix what we can within our teams. We talk about safety 2 culture and habituation (this part is so useful for me as sometimes I stop and think how habituated I have become).
There are a few links that should keep you busy if you are interested in this and in improving how we do Emergency Medicine in this current climate.
Enjoy
P.S I have told Pete that it is now called the ED and not A+E but he is having none of it!!
https://resiliencecentre.org.uk/2017/06/paper-understanding-emergency-department-escalation/
https://resiliencecentre.org.uk/care-qi-handbook/
https://1vv82dtluny8l2py3ufo882r-wpengine.netdna-ssl.com/wp-content/uploads/sites/23/2019/07/1-s2.0-S0925753518321556-main.pdf
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05208-3
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Welcome to our 10th podcast and this episode is all about major bleeding in the ED and we touch on massive transfusion. I asked the nursing team in my ED what they wanted us to talk about next and this was one of the requests. I have also written a blog to accompany this podcast which may expand on some of the things we touch on in this podcast.
As always it is super important that you go back to your local policies and procedures, and also have a read of some of the associated papers below that can definitely explain some of these things a lot better than liz and I.
Main things for you to go away and have a look at, how can you recognise a patient is bleeding in your current role? Who do you need to tell and what are your immediate actions.
This links to your RCN Emergency Nursing Framework
CD2 - 2.4- The Shocked Patient
CD1 4.1.2- Recognising patients with GI bleed
Some awesome links to some very awesome people from the resus room and St Emlyns' for more study if now you have the bleeding bug!! And the sentinel paper on the use of calcium in massive transfusion based on some experience from the military.
https://www.theresusroom.co.uk/shock-in-trauma/
https://www.theresusroom.co.uk/external-haemorrhage/
www.ausmed.co.uk/cpd/articles/massive-blood-transfusion
www.emj.bmj.com/content/35/3/176
www.stemlynsblog.org/hypocalcaemia-trauma-and-major-transfusion-st-emlyns/
Why not try using the new CPD recording form that you can find on the website this week to record your learning.
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Missing episodes?
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Hey everyone two podcasts in a week- as you can see we are a regular as ever! This one we have been promising you for ages and it goes very nicely with Petes Blog which you can find here.
The landscape of ED's have changed so much on the last 5-10 years and this development of early senior clinical decision making as close to the front door as possible is still under review. Have we overtaken the role of triage nurses and amalgamated into one? Have we changed the jobs of ED clinicians? Join Pete and I to chat about this.
Pete mentions about the ECHO study and here is the link
Here are some other options for reading around RAT but as we said there isn't actually much out there...
https://emj.bmj.com/content/30/10/873.2
https://emj.bmj.com/content/32/2/112
https://journals.sagepub.com/doi/10.1177/1355819614560449
https://www.researchgate.net/profile/Mark_Sujan/publication/274313481_Translating_tensions_into_safe_practices_through_dynamic_trade-offs_the_secret_second_handover/links/551b17450cf251c35b5062ba/Translating-tensions-into-safe-practices-through-dynamic-trade-offs-the-secret-second-handover.pdf
Hope you enjoy and any comments get in touch, also if anyone has great experience of RAT or wants to get some research out there... Pete is your man!
Thanks all
Ash
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Hi All,
Liz and I just felt it was vital that we had a quick chat about what we have been up since the whole world changed earlier this year. Both of us have had huge changes, I stepped across from ACP to become the interim ED matron in my department and Liz dropped her hours in ED to take up a uni lecturer job. We chat about how this year has been.
There are a couple of areas where the sound isn't great as we were trying a new style so bear with us, its only minor.
Hope you are all surviving and doing amazing things and giving amazing patient care in ED.
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Hi Guys,
A cheeky catch up with Liz and I about the upcoming content we will be working on and also a bit about what's been going on in our respective departments. We would love to hear from you about what has been happening in your departments too.
We hope you are all staying safe and being supported by your #TeamED family.
As promised in this episode we have linked the Faculty of Emergency Nursing (FEN) webpage here
Keep doing great things and delivering amazing patient care.
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Hey #TeamED legends here it is episode 6 of our podcast and in response to your twitter votes we have chosen the assessment of the acutely unwell adult in ED and a look at ABCDE and NEWS 2 and Front door investigations. As usual we had a brief chat about the current challenges and a small debate about the front door investigations that we should or should not be doing for our patients.
We signposted a few links in the podcast and here they are;Nigel from Strata5- the website genius that is https://www.strata5.co.uk
We are now being sponsored by Adprac- A new take on the traditional agency https://www.adprac.com
We talked a lot of about end of the bed-O-grams and liz mentioned this blog and I hadn't read it until now but I can see why she mentioned it- its awesome thanks St Emlyns great read- http://www.stemlynsblog.org/when-is-a-door-not-a-door/
Royal College of Physicians NEWS 2- https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2
The resus council ABCDE approach principles- https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/
The British Thoracic Society guidelines for emergency oxygen https://www.brit-thoracic.org.uk/quality-improvement/guidelines
And as promised some hints of where to go for the rest of this section;
Check out COPD management here https://www.rcemlearning.co.uk/references/community-acquired-pneumonia/
And once you have done this go find out some stuff on type 1 and type 2 respiratory failure and diagnosis of PE. This should give you enough work for an evening of study!! And remember carry on being #TeamED legends
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Hi guys,
This is episode 5- thank you for bearing with us and we are sorry we have been so quiet, it has been a challenging year academically for Liz and I. This is a summary podcast of whats happened in 2018 both for us and the wider education/FOAMED community and what we hope for 2019.
The last 9 months have been crazy since we started this thing... we are well aware that we are not fully 'there' yet, wherever there is. We know our website and podcast sound quality needs more professional support and we are working on that. We want to make the most of next year in adding content and streamlining it more so that you can easily find what you are looking for.
That said this year has been great and we genuinely feel like the ED world and the nursing world is starting to join the conga line and realise that we need to act now from an education point of view if we are to preserve the ED nursing workforce.
SO we have pulled 10 things which have happened which are all good things associated with improving ED nurse education.
As promised some links...
The RCN- Investing in a Safe and Effective Workforce- CPD for nurses
https://www.rcn.org.uk/professional-development/publications/pdf-007028
The NTACC course- https://www.ataccgroup.com/product-category/ntacc/
Cool people to follow on Twitter- @davehartin @carrings @Hols_cat
Have a great Festive Period and if you have questions, comments, ideas then please get in touch!
Bye for now.
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This is slightly different to our previous podcasts-
Liz (@SisterScrappy) and I (@ashleighlowther) having a chat about how we got into being an ED Nurse and what the current situation is. This was sparked by a conversation I had with an amazing ED nurse talking about leaving the job and I found myself trying to convince her but with a struggle, as everything she said was completely legitimate.
Anyway in the podcast we make reference to Liz's blog so here is the link to that.
We also chatted about the absolutely fabulous presentation by @LizCrowe2 available here https://vimeo.com/188765724
We hope you enjoy and as always are very open to suggestions for future blogs or chats.
Coming soon, Liz and I + Harmony are going to chat about becoming an ACP- the future is bright!
Much love
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Hi lovely people,
Welcome to our 3rd podcast and we actually forgot to say on the podcast that we have a new jingle!! Thanks to Nigel (@Nrtaylor101) from the @RCEMLearning team for his help with that.
Ok so we are pretty chuffed with the support you guys have given us so far and we want to keep improving, this podcast does have a couple of blips- bear with me as I am still trying to get good at editing the content.
This episode is all about Pain in the ED and centered around the CCT2 part of the framework, we talk about each part although we never did quite get to what the 3 parts of pain management were so if you can help get in touch.
We also talked about Fascia Iliaca Blocks (FIB) at the end which is becoming a very common technique for the management of pain associated with fractures to the Neck of Femur (NOF). Check out this fantastic blog by the guys at St Emlyns which explains it all here
We talked about the RCEM safety alert for FIB and this can be found here
Finally we wanted to link you to the framework again but specifically what each page says about the level of competency and how you get to each level so those images are below.
The more you use the framework the more it'll become second nature to pick a subject do some self directed learning around it then return to the competency to link it.
Take home points-
Assess pain using a tool (i.e. 1 to 10)
Give appropriate analgesia
Please reassess pain after analgesia is given
Keep doing amazing thing in ED!!
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Hi everyone,
This is our second podcast and today we are discussing the cross cutting theme on patient assessment in the ED and looking at the knowledge and skills elements of that section.
We have mentioned a few documents in the podcast so they are linked below for your viewing pleasure.
We are still trying to get the audio right so please keep listening and we hope it will improve each time- thank you for supporting this and don't hesitate to get in touch!
Education is power!
RCEM Assessment standard- https://www.rcem.ac.uk/docs/SDDC%20Intial%20Assessment%20(Feb%202017).pdf
Liz's SBAR blog-https://www.ededucate.co.uk/blog/raising-the-s-bar-on-handovers...
The Manchester Triage System-
https://www.triagenet.net/classroom/
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This is our first podcast and is really an outline of what we are all about and what we want to do.
Its mostly Liz and I chatting which may feature again in future podcasts.
Enjoy!
Link to out self development blog and access to RCN competencies
https://www.ededucate.co.uk/blog/self-development-is-the-way-to-go
Link to Kirsty's blog on diagnostic bias
https://www.ededucate.co.uk/blog/casey-and-the-case-of-the-missed-diagnosis
