Rick Strang
@rickstrang
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Pompey, hockey, music, relentless optimism, humour (no, seriously), planes, NHS, all things emergent. Views not checked by my wife, which can only end badly...
Joined August 2011
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Last Seen Profiles
1/3 - Nod to all on/off-duty medics, nurses, paramedics & others that came forward on Saturday. A complex & challenging scenario that would’ve sorely tested a dedicated, experienced team in a prepped, pre-alerted well resourced Major Trauma Centre.
10
64
2K
6 wks ago we noted EoL patients had multiple bed moves to make beds for new patients. We acted immediately and within 24 hrs had implentmented our “Blue Ribbon” scheme. Blue Ribbon patients must NOT be moved. Since then not a single EoL patient has had a non-clinical bed move.
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1K
Here’s the thing; this is market driven. If we all start wearing neck guards, especially the elite players, then the manufacturers WILL start innovating and offering lighter, less obtrusive models. Evolution will become revolution… Adam Johnson’s legacy.
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864
If you’re a rink owner still charging ice time for games cancelled by teams today then maybe, just maybe, have a re-think?
Some things are bigger than profits.
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823
Since we stopped using the Oxford comma this morning we’ve seen:
- 24% reduction in ED attends;
- 12% improvement on the 4 hr standard;
- 100% reduction in >12 waits;
- 19% fall in Med fit for D/C;
Should have done it years ago! This is the pro-active leadership we need…
20
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3/3 - Be assured; you did your very best in what was the worst of all scenarios.
Thank you.
👏🏻👏🏻👏🏻
#mytribe
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660
Player collapses on the ice
Witnessed loss of resp effort & cardiac output
Good CPR within 10 secs
Shock delivered <45 secs
CPR resumed - ROSC at 2 mins
Helimed take at 11 mins
Straight to Cath Lab - 3 stents put in
Guy who died on the ice goes home to wife and 2 kids
Team work💚
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We’ve been campaigning hard with
@ukfallstars
to get a public access defib in every rink in the UK by July 2024.
@EIHA_Official
have been extremely supportive and donations have been generous but do we need to extend this to also have a “Catastrophic Bleed Kit” in every rink too?
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2/3 - To tackle it in the middle of an ice rink, in front of 8k people with extremely limited resources was extraordinary. You are all extraordinary. Stepping forward as others stepped back. You’ll wake-up to doubt & thoughts of what you “could” have done.
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534
@zackferguson
I suspect it’s further down in the memo but it’s important to note that trainees should only be urinating and “defecting” fluids and solids consumed during their shift. Items consumed and processed by the body out of work should subsequently be held and released out of work.
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Ambulance attends ⬇️
ED attends ⬇️
Medical Admits ⬇️
Discharge profile ⬆️
System capacity ⬆️
Social & community teams flexing criteria ✅
Respiratory bypassing ED straight to specialty ✅
Empty trollies in ED ✅
Is C19 driving the change in care/flow we’ve all been chasing?
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Does good quality, early CPR + defibrillation save lives?
Ask Craig.
He suffered a cardiac arrest during an ice hockey match on Saturday, receiving CPR + defibrillation on the ice before transfer to a cardiac centre to have 3 stents inserted.
Today he went home to his family💚
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Do we really need any hockey games anywhere at all today? Maybe take the time to pause and take stock…
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It’s intimidating on Twitter reading countless Tweets about other hospitals delivering amazing cutting edge care. It’s easy to feel left behind.
Not any more.
We now have Pringles in our vending machine IN A BAG! In a bag, people! Get in!
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@richardtill
Hopefully you’ve had sight of this. Currently promoting it on behalf of the Royal Colleges (-ish)... Malhotra Risk Matrix
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There's no excuse for being rude to NHS staff but one of the reasons we are seeing a huge increase in incidents is because strategically NHS has failed utterly and catastrophically to honestly explain the degrading of its offer to the public.
🧵 1/6
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So my worlds collided today as the tragic death of a young hockey starlet (20) brings out the "Died Suddenly" idiots.
Never have I wished so hard for real life to mirror hockey so that I could beat the crap out of some folk and just do my 2 minutes in the box.
Alex Graham 🧡
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@BadVaccineTakes
Look, these folk have got to sort this stuff out. I keep convincing my wife there's no point tidying up the garage because we're all going to be dead next week anyway and then it doesn't happen and I get absolutely battered! 🤣
Just make your minds up! This is important!
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It comes to something when the ED middle grade rota has more people on it than there are ministers left in the PM’s government…
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Significant confusion in ED this morning when we came in and saw these. A longer serving member of staff suggested they may be two empty trolleys, although she wasn’t entirely sure. Some early investigation shows that we did have something similar once in the summer of 2016.
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@RAF_Luton
This photo featuring an RAF Luton English Electric Lightning F3 aircraft was from the same night out I believe. What a night that was...
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So, anyway, this is what happens in ED when the whole hospital (and the system) really owns the emergency care pathway. Great for patients and great for the working lives of staff. It’s not easy but, y’know, just sayin’...
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12 hours stretching every risk envelope & applying every bit of creative thinking I’ve garnered in 30 years of hands on emergency care to our full ED/hospital & heartbreakingly I STILL queue ambulances knowing I’m degrading the 999 response in the process.
Why?
🧵1/7
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On my way in to an ED that’s now a 24hr short stay ward, an elective plan about to be slashed as elective beds are full of weekend emergencies, a bedded SDEC & 50% of the bed base blocked by “med fit” &/or Covid.
IMHO this entirely justifies having a Curly-Wurly for breakfast.
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@RAF_Luton
Mum Plane: What are you doing?
Little Plane: I saw one of the
@RAF_Luton
big planes doing it on Twitter...
Mum Plane: And if one of the
@RAF_Luton
big planes puts its his head in the oven are you going to do that too?
Go to bed...
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@Pandamoanimum
This banana was called “spotty” and “bendy” by apples and pears. Let’s show the world that every fruit can be beautiful. I dare you to like this Tweet and re-Tweet. I know 99% of you won’t. Let’s get to a thousand likes!
#bananastoo
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As the spring sunshine filters through the blinds, a delicious, snuggly Sunday lie in is brought to a sudden and terrifying end by your four year old calling upstairs “Don’t worry Mummy and Daddy, I’ve made my own breakfast!!”
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@keirshiels
@davehartin
Just released. Approved by the Royal Colleges (-ish). Malhotra Risk Matrix.
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@RAF_Luton
They look so much better in the anti-flash white. The camouflage was a nightmare and I understand there are still two Vulcans at
@RAF_Luton
that were left out overnight no-one’s ever found them! They’re there somewhere!
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Funny how a mug of tea brings out the Brit in me. All the beds are full. ED is full. Winter pressures are full on. We’re already in special measures and today 80 inspectors arrive for a 3 day CQC inspection. A quick sip from my tea though and I’m like “still ... could be worse”
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@Fife_Plague_Doc
"It has been highlighted during annual stock take that patients have been incorrectly portioned as 1 per bed when they should be 2 per bed. Please be aware that moving forwards, in line with other units, patients will now be portioned 2 per bed. Thank you for your understanding."
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@LivCookefs
@GaryLineker
Hi five for my son Howie (6) then
@LivCookefs
, as he did it three times in a row! Look at his face when the third one hits! 🤣
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@4000AndCounting
Cancel your game and I’ll pick-up the fee. Email me rick
@rickstrang
.co.uk
This is shameful.
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We've had some great (and not so great) crazy theories for why Sheffield Steelers are winning the EIHL so handsomely. No-one however seems to have considered that it may be that they've assembled a good team that are playing great hockey?
Just putting it out there as an idea...
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Therefore folk are very surprised & very angry to find hospitals full to the gunwhales & making difficult decisions about moving patients & managing long waits for care.
And it's the frontline staffing who are (wrongly) having to deliver the message & copping the anger
🧵 6/6
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I love the ED positivity on Twitter & am always keen to celebrate teams hitting 95% (or thereabouts) but how do we support teams not reaching those dizzy heights? The reasons can be complex. Why are we so often left with the narrative that they’re just not trying hard enough?
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On this very special day, I'd just like to apologise now for every pen I've ever stolen. I'm sorry, I couldn't help it ... I'm a nurse.
#InternationalNursesDay
#yearofthenurseandmidwife
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I very rarely swear on here but dear God, if you’re a Panthers fan and you booed your team the other night after their home loss what the f☠️🌀!%€g Hell is wrong with you?
Thank you. That completes my TED talk.
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When we take our jerseys off & take a step back we know that League titles aren’t won; they’re earned.
Devils kept it honest. No-one’s giving away the title for free. Steelers will have to earn it.
There’re no freebies.
And that’s exactly how it should be.
Go again. 👍🏻
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Leaving the Island after 8 months. Totally in love with the place. Don’t underestimate the number of “only on the Island” experiences I’ve had! The next assignment beckons but this one has been one of the best. Might need to find my way back
@IoWNHSTrust
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There are 57 ice rinks where hockey is played in the UK. I wonder if they all have a public access defibrillator?
Does your rink?
Why not check and let me know. DMs are open.
👍🏼
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@DrJSherrington
Pillows. Big trade may need the bladder scanner as collateral, although you’ll need to show you actually have it before the deal takes place…
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@RAF_Luton
As I've said before, whilst the anti-flash white is quite elegant I do prefer the Concorde in its camouflage as below...
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Now confirmed from official sources that 29 year old Adam Johnson has died following the freak injury during last night’s game.
Condolences to family, friends and everyone affected by this tragedy.
Sticks on the doorstep tonight.
Rest in peace
#47
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@Pompey
@PompeyTrust
Any of the guys want to take on Howie’s Crossbar Hattrick? He plays for the U7s...
@Burgey44
@RonanCurtis1
@SeanRaggett
@JohnMarquis09
@MarcusHarness
Worth a retweet at least!
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@Tunisia_1943
@CWGC
My granddad's (Lt. Nichol) citation for a Military Cross was personally upgraded by Auchinleck to a DSO. He has read, altered, crossed out and signed the original typed battle report. I hope this is interesting reading for folk...
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@Shayan86
@CovidRadicals
All true but let’s not allow facts to get in the way of comedy gold… 🤣
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@WindsorDebs
It’s worse than that Debs. I’ve noticed that after spraying in the morning, about 12 to 14 hours later it goes completely black and then stays like that for around 10 hours. Happens every day! 🤷♂️
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@rosieICM
TTOs ✅
D/C letter ✅
Appt in Ambulatory for ET tube removal Thurs ✅
Daughter to collect. No Oxylog at home but neighbour has antique bellows ✅
Any worries, come to ED where the on-call team will deny they've ever heard of you & ED will need to start all over again ✅
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@geriatricgiant
@gmcuk
GMC Tribunal, Question 1:
If you’re working in a corridor have you been promised a laptop to make your work there easier?
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It's also partly due to the total failure to actively and directly address truthers, anti-vaxxers & conspiracy theorists who continue to spread misinformation & disinformation to discredit the NHS and/or belittle the pressures.
🧵 4/6
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This is partly due to treating targets (standards), like 4 hour emergency care & cancer waits, not as indicators of a problem to be openly reported & discussed but instead as a political threat to a narrative of "everything's fine" that needs to be restricted or hidden.
🧵 3/6
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Grinning to myself because I found one of these in ED this morning. I think the last empty one I saw was back in October ‘21. It won’t last but for today, an empty trolley is a victory! Sun’s out too… 😉🤣👍🏻
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We’ve faced some challenges in the NHS over recent months but nothing as tough as having Bank Holiday Friday off work and having to do fancy dress Joe Wicks with the kids! Yes, that is a fake smile. Are you sure you don’t need me in ED today?
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@RAF_Luton
@Twitter
Fortunately these RAF Luton Harriers can see the funny side. Dubbed the "the Laughing Jet" by it's crews these GR8 Harriers are currently deployed in the Strategic Airborne Tactical Interdiction, Reconnaissance and Electronic warfare role (SATIRE)...
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Further to that the messaging around covid & "living with it" & returning to normal activities has ignored the severe strictures still in place across the NHS & the care sector & the numbers of admissions & subsequent morbidity being created.
🧵 5/6
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9 days to go! Y’day I said if you sponsored me to play for
@tyhafan
kids’ hospice I’d wear my hockey kit to work.
You did; so I have 🤦♂️
Still need more sponsors if you can help
@tyhafanhockey
Click⬇️⬇️⬇️
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Thanks to
#14
,
#6
&
#23
for the chat, the fist bumps & the smiles. This stuff is huge when you’re a kid. I really appreciate you taking the time to do the good stuff. Great job!
📸
@hayleylouz
Dean Woolley
@patwatling
@kevintansey6
@sauce_2392
@SteDan_Official
@steelershockey
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September last year I started training for the London Marathon & on Sunday I did it. I wanted 4:55:00 but came in at 5:28:04 but I did it and I smashed through my £3k target for the
@TheBHF
which is awesome and wholly down to you good people on here. A massive thanks to you all!
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That's why it comes as a total surprise when staff on the frontline break the news that you may have to wait & no, your mum can't stay in for a couple more days. An abreaction from relatives/carers often follows.
🧵 2/6
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@SoVeryBritish
I sense we can all agree that whatever you say it MUST be validated by slapping the tops of your thighs with both hands before standing up....
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I absolutely recognise the compelling narrative of ED on its knees but if you’re really sick/injured don’t be put off coming in. ED doesn’t judge. It is busy & there’s a lot going on but come & see us if you need to. Too often those that need us most haven’t wanted to bother us.
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@Nullen80
@charlotte_bbc
"I was walking to the post office when I met a group of people talking about Europe. I was curious and joined the convesration. It was at that point that I accidentally put on a black uniform, did a funny walk and went to a rally bedecked with Nazi type regalia...."
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Today, as I grow ever more down with the kids, I will be nominating some of my favourite
@tommcrae
songs with just emojis:
1) 💇♀️
2) ✏️⬇️⭐️⭐️
3) 👻🦈
4)🦇💙
5)
6) 🦴💀
7) 🧜♀️🟦🔵
8) 🔤🌪️
9) 💪⚡️
10)🌍🔚📰🗞️
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Whilst it all sits in the “too difficult” pile I seriously doubt I can truly make ED work, which is a shame because I liked to believe I was quite good at it… 🤷♂️
Anyhoo… new day! Here we go…
🧵7/7
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@Aidan_Baron
After OPEL 4 we’d go to “Trappatonis”. This was the name of the Italian pizza/tea shop at the end of the long corridor outside ED. If the trolleys stretched all the way there, then when we asked “Are we at OPEL 4?” the reply was “No, we’re at Trappatonis”
*name changed
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Nice move & a great surprise from
@ChiefExecIOWNHS
for our ED crew last night. A tough week but every day ED shows up and gets the job done with skill, professionalism, compassion and humour. Pizza went pretty quick! Not sure about the fruit though! Haha...
#teamiow
#edcommunity
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Get's dropped; knuckles down; gets on with it; gets back in and gets Man of the Match in his first game back.
Spent loads of time chatting to the kids and doing "the stuff" post game. Great lad. Credit to the club.
Take a bow Ryley Towler 🛞🛞🚪🚪
@Pompey
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It was great to find the boss waiting for me at the hospital entrance when I started my new role today… 🐈⬛
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@SoVeryBritish
I can't stress enough the need to breathe out heavily with puffed cheeks and slap the tops of both thighs whilst making these utterances... 👍🏼
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@MattHancock
“Blamesplaining” - when a health minister tries to be helpful but actually just wants to point out that less people would die if we all just stopped coasting...
“Preventable”? Really? All of them? I guess we’re just not trying hard enough, eh?
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Always great to meet
@Bmilesy10
after the game. Did his job tonight and picked up a couple of zips for his troubles. Still had time for the boys though… class.
Thanks for a great night of hockey
@StreathamHockey
but I’m fine if occasionally you just want to do it the easy way!
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Massive thanks to former Redhawk
@Brandonmilesss
for signing Howie’s jerseys. A tough night on the ice but still a great guy off of it. Cheers buddy.
@InvictaDynamos
@StreathamHockey
2
3
36
Oh man... I just got all kitted out for my 🍊
@steelershockey
away weekend against the
@BelfastGiants
in Belfast and now because someone's got a latex allergy in the arena I've gotta change all my outfits... 🤦🏼♂️
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My good friend
@icehubbs
with
@dragonblinds
who have absolutely smashed it out of the park (or rink!) by donating a brand spanking new defib to
@ukfallstars
One more rink made safer through their generosity.👏🏼👏🏼
You know where to go for your next set of curtains/blinds 😉
1
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Thoughts tonight with Adam Johnson, Matt Petgrave and all of their family and friends after tonight’s freak accident. Thoughts too for the PHEM medics of all disciplines dealing with such a complex event in such a challenging environment. All we can do now is wait quietly.
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We’re raising awareness and raising money.
Every rink in the UK will have a public access defib by the time we’ve finished.
Play/watch hockey? Get a t-shirt; save a life 👍🏻
@ukfallstars
We are also very proud to release this new shirt 'LAST NIGHT AN ALLSTAR SAVED MY LIFE'
Priced at £10
£5 from each sold will go to raise money and awareness alongside
@ukfallstars
for life saving defibrillators in UK hockey rinks.
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4
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@DrRobgalloway
Rob’s order:
1) Plain Fried Amoxiclav
2) Sweet and Sour Fluclox
3) Teicoplanin Chow Mein
4) Side order of flushes
Now read that back to me?
0
1
36
@djnicholl
@SueMarsden6
@Beth_Tastic
@gmcuk
So if you're a paediatric cardiac surgeon you can do what you want? More toxic "God complex" nonsense from the "oh, but he's a good doctor" excuses playbook.
If children suffer because he broke the law maybe he should own that and stop breaking the law?
4
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@PeterSweden7
Dear Peter,
Welcome to the Baader-Meinhof phenomenon. Defibs have been everywhere for years. The more the better.
Do your research.
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...and then it’s done! It’s been an honour to work in my hometown hospital. We’ve done some good things with some great people; and thanks for the best (because it’s the worst) leaving present ever! We all need Pompey socks with our face on!
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When you’re 8 years old and you get to hold the League Champions Trophy…
@StreathamHockey
@Bmilesy10
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@RAF_Luton
Once again my praise and respect goes out to the Canberra pilots taking their aircraft this low to get such amazing shots. Well flown sirs/madams; well flown.
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@StaycMaria
100%. It's also important to just miss the train as the doors shut, throw your head back and do a funny little disappointed dance which includes at least one 360 degree turn so that everyone's clear that you've just missed it. 🤣
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Quite a disturbing and confusing sight in ED this morning. I mean, it does happen of course. I remember one day back in, oooh, 2009 I think it was…?
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‘Cause 25% of patients can leave but have nowhere to go.
- no TDS/QDS packages of care for weeks; no carers
- rehab/community beds full
- no spot purchase capacity
- no D2A capacity
- no intermediate care capacity
- no social workers in the hospital
I can’t fix that 🤷♂️
🧵 2/7
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