SPICT tool useful to help identify patients whose health is deteriorating due to life-shortening admissions. #AWSEMconference #MedSky

www.spict.org.uk

Just b/c someone is recognised as actively dying in ED doesn't mean they can't go home (esp to NHS) - can be gratefully received. But does need either a slick SPOA with immediate MDT response, or, someone who know system/services/contacts/management very well. #AWSEMConference #MedSky

Personal data from one palliative care consultant going to ED 0800 handover 2-3 days a week - reduces time to first palliative care contact reduced by six days.
#AWSEMconference
#MedSky

Voting by delegates #AWSEMconference unanimous that all would prefer to be admitted in a hospital with both critical care outreach AND a call for concern service. "Everyone should be allowed to call for help - even in hospital".

Excellent by @csubbe.bsky.social
#Medsky

140 UK hospitals in survey of Call-for-concern (pt/family prompted activation of CCOT/equiv). Numbers at any given site v low; some calls more about communication failures; but some fatalities have likely been averted (e.g. parent of son whose DKA was missed). #AWSEMconference @csubbe.bsky.social

Delayed admission to ITU in critically ill patients is associated with a near doubling of mortality - possibly the single most modifiable outcome factor. @csubbe.bsky.social at #AWSEMconference on #MarthasLaw
#MedSky

Next up at #AWSEMconference is my dear friend and former colleague Dr Chris Subbe, on Martha's law. As always an engaging and inspiring presenter. n/1

Inquests - if giving evidence, give condolences at the *end* of your evidence and not at the start. n/1

#AWSEMconference

Cheeky quick run to the second day of the #AWSEMconference - next up is Rachel Knight (Asst coroner S Wales) on Work of HM Coroner

3. Document skin colour: bruises harder to spot as skin gets darker
4. NFS + sexual assault - refer SARC.
5. Asst proforma - ifas.org.uk/wp-content/u...
6. "Just because it's consensual doesn't mean it's safe" - 30-40% report NFS sexual activity in a large survey.
#AWSEMconference #MedSky #WalesEM

Non-fatal strangulation: squashing jugular vein or carotid artery takes less pressure than squashing a can of coke. Same in sports "choke hold": www.facebook.com/watch/?v=242... - (also why some victims of assault don't realise they have been choked)

#AWSEMconference #MedSky #WalesEM

2-15% (latter from a SA paper of strangulations and hangings) of non fatal strangulation have carotid aortic dissection, and some people are repeatedly subjected to strangulation (be it assault or consensual) - have low threshold for imaging.

#AWSEMConference #EMWales

Non-fatal strangulation: prevalence high & increasing. High medical/psychosocial consequences.... and this is only the second time I have seen this topic on an EM/EMS conference agenda after nearly 30 years in EM (last time was 2014 at #EMSWorldExpo, USA)
#WalesEM #AWSEMConference
ifas.org.uk