Archive | July 2014

Intranasal Medications Podcast

Inspired by a recent twitter conversation with a UK Paramedic I’m talking this afternoon about IN medications and their use, encompassing a case study.
A few people have been talking about IN Fentanyl on Twitter, I’ve been using it now for quite a while. So I thought I would jump in front of a microphone and have a quick chat about it.
Just a quick one here for the podcast, haven’t been able to talk about as much as I want to, a big period of study coming up in the next few weeks.

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Effectiveness of morphine, fentanyl, and methoxyflurane in the prehospital setting.

A great website covering all things Intranasal

Methoxyflurane (known as Methoxy)









Prehospital Pelvic Binding and Femoral Traction Poll

I’d like to hear about your service and Femoral Traction in the Presence of a Pelvic injury, do you have a SOP, Protocol, Guideline on the application of Femoral Traction Splints in the Presence of Pelvic injury?

This is out of Twitter, does your service have a formal recommendation on the use of Traction in pelvic fracture, if so I’d like you to enter an answer on the poll!

I’d like to see as many responses as possible!

Feel free to comment on the blog, at twitter or in the current discussion on G+

Fatigue in our workplace

While my girlfriend was looking through some resources for work she found a Fatigue Risk Assessment and Hazard wall chart presumably developed for Mines NSW, So she sent it over to me to have a read of. She’s been working on her workplace policy for fatigue and avoidance of excessive overtime. Being the wonderful person she is and knowing I spend good deals of time on twitter and here talking about various things she occasionally provides some resources.

Here’s the where you can find it

Click to access Fatigue-Risk-Management-Chart.pdf

This got me thinking about what we do, a lot of the risks identified are iatrogenic to our 24/7 365 best care out there model (IE. not readily modifiable) The points on the table where you as an individual have the most ability to affect change are the individual and non work factors

A few weeks ago I was involved in a chat on twitter about how best to do night shift.
The question from a Paramedic student, presumably in reference to up coming clinical shifts generated a number of tweets about different strategies

What I find work for me is, take as much time for my self in the preceding day as possible. As tempting as it is to go out, hang out with friends or have a bbq its going to hurt later (I have most friends well tuned into my 9 day roster).
I try to limit my caffeine intake in the AM and early PM to allow me to have a nap if the mood strikes. I try to avoid stocking up on sugar for nightshift, I find pushing back my dinner until 11 usually tides me over until the morning (this will of course be different) I try and avoid relying on the various brands of energy drink.
I find some light exercise, helps to wake me up for the shift a jog or some light cycling try to avoid muscle fatigue that won’t help.

After a shift I like to have breakfast, usually something light and wander off to bed, if its days off then I’ll have my girlfriend call around 1 or 2 so I don’t sleep through the day and wreck my sleep cycle.

Now for a Airline industry mnemonic! Because Twitter loves Aviation (and why shouldn’t we) Used by pilots to assess fitness to fly.


Now why did I start this with a story about how I found this via way of my wonderful girlfriend, because that’s what I think about when I think about fatigue, moving away from the patient safely issue we all like to talk about and bringing it back to a more personal point. The consequence of driving tired not only affects you, but loved ones, mates and other road users.
Don’t be afraid to have a nap after night shift, my lounge is often offered to paramedic students and everyone who’s a close friend knows how to get into the house where to find blankets and that they are always welcome to a kip on the lounge.
Fatigue its a huge killer on the roads. We have to operate through it by virtue of our employment. Watch this ad from Transport NSW and think about the message.

Stay safe out there

The featured photo was taken after I was coming back from a night shift that involved a long drive, after realising I was struggling I diverted to a friends house and took a nap under my jacket on the lounge, thankfully the 3 year old allowed Uncle Mitch some much needed sleep!

The cut segement from Jess’s talk on Peer Support and MH


I cut a section from the interview with Jess, with her consent because I didn’t think it it fit the tone of our talk and it was important enough that it deserves its own podcast!

Jess and I both feel really strongly about personal mental health and taking care of others around you not professionally but as a friend.

Opening a dialog with your partner/ recognising when someone is in need of a vent/chat/debrief/breakdown what ever your calling it. This is a job, but its a job that has the potential for serious harm to occur if you don’t follow the warning signs.

Thank you to those who contacted me when we were talking about this on twitter.
That’s what we need to do more, start dialog talk about whats bothering us, find a trusted friend or partner, a senior manager, even request formal peer support if you have access to that.  

You work in a sometimes terrible job, for people to expect us to absorb all that and deal with it by ourselves is lunacy, that’s old way thinking and it doesn’t work.

Next, I want to start a new trend, when ever people meet us they want to know “Whats the worst thing you have ever seen”

Please I want everyone to get their family and friends to ask “whats the best thing you’ve seen/done” I’d rather share the happy calls than the unhappy ones. 

Thank you for listening
Mitchell Thomas

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