Alex Thompson

a man with a mustache is wearing a white shirt and a blue sweater . ALT: a man with a mustache is wearing a white shirt and a blue sweater .

Things you don’t want to hear during a Friday afternoon clinic:

“I’m a farmer, and the pain from this new hernia is so bad I had to leave lambing”

Surprised to learn from @lwestafer.bsky.social ‘s #FOAMed just how behind the US is on moving asthmatics to ICS/LABA maintenance as reliever therapy, and saddened to realise how much of that is likely driven by the economics rather than the science.

a man wearing a cape and suspenders has the word ugh written on his chest ALT: a man wearing a cape and suspenders has the word ugh written on his chest

There’s nothing worse than finding out the hard way that a care home has given out your personal contact information to every relative.

I might have to change my mobile number

Vaccines cause adults!

Including the easily overlooked fall from height!

YouTube video by Pinkbike Friday Fails #331

I would like to introduce you to the long running “Friday Fails” series featuring every form of trauma!

youtu.be/lKqUWK-jfPc?...

This is also the map of those who use imperial measurements in preference to metric

They say buying a house is one of the most stressful things you can do in life. I did not believe it.

I now do.

I cannot understand how in an age of email and electronic documents, it can take 6 months to get nowhere.

Fully deleted twitter finally. I don’t want to be on the Nazi app.

Is talking stuff down an ambulance trait?

I read a lot of 999 reports, including for patients I’ve assessed/admitted, and almost always it’s “well we didn’t find much wrong in that instant” with small regard for the history.

Risk of underplaying things at handover?

Right, better start the Christmas shopping.

a man in a trench coat and tie is standing in front of a window Alt: Columbo in a trench coat and tie is wondering if retirement can be soon

Me: Completes consultation within the alloted time.

Patient: “By the way, do you know why both my arms feel really heavy and sore every time I have to walk anywhere or go up stairs? They get better when I sit down”

Solve a domestic disagreement for me:

Best voice actor of all time:
Alan Tudyk
Mark Hamill
Nolan North

My wife thinks the man who squawks three times in Moana, but I can’t really agree.

Never thought I’d ever see anyone be “pro-polio”

America is a fucking weird place.

a man in a suit and tie is standing in the dark and asking is there anyone alive out there . ALT: a man in a suit and tie is standing in the dark and asking is there anyone alive out there .

When your old twitter groups haven’t reconvened on Bsky and you have to go onto the dark place

Also, your "agitated" patient.

Are they delirious due to infection, or are they in pain and unable to communicate it clearly?

Give simple analgesia if they haven't had any before running to sedatives.

Analgesia FIRST. Always.
#MedSky

Newcastle: Hexham House tower block demolished The button to destroy Hexham House in Newcastle is pressed by three children who won a competition.

Children destroy flats in controlled explosion www.bbc.com/news/article...

Pretty sure my 3YO could have achieved this without explosives, give her record with our living room.

Not done viral swabs yet, but history/presentation is VZV every time.
Unilateral vesicular rash, single dermatome, herpetic neuralgia.

a woman says it 's me hi while standing in front of a window ALT: a woman says it 's me hi while standing in front of a window

Looking for opinions from #medsky #IDsky. 38yom with recurrence of trigeminal shingles. The 5th occurrence on v3 since 2012. Also T1 and L4 occurrences during that time.
Hep/HIV screen NAD, no known immunocompromise.

Frequency of recurrences is concerning. Looking for opinions/options.
Disclosure:

I feel like I shouldn't have to keep saying this, but it astonishes me that it keeps happening:

If your patient has a very obvious, painful, traumatic injury, give them analgesia. Give them proper doses & give it early.

Yes, even if they aren't screaming.

Don't let people suffer quietly.

#MedSky

It’s 3yo’s favourite film, so we’re off to see 2 as her first cinema trip.

I have no idea how this is going to go!

Off to see Moana 2 this weekend?

two police officers are sitting at a table talking to each other and one of them is saying `` pain '' . ALT: two police officers are sitting at a table talking to each other and one of them is saying `` pain '' .

Actually quite impressed with my GP today, phoned at 4.30pm with barn door v3 trigeminal shingles, phoned back by the duty GP within an hour, and a prescription arranged.

Hopefully treatment started in time to prevent the more unpleasant symptoms.

Finally bit the bullet and got a decent 1440p 180hz screen. I should have done it years ago.

Poor little graphics card is taking a bit of a beasting though.

Bleeding risk using non-steroidal anti-inflammatory drugs with anticoagulants after venous thromboembolism: a nationwide Danish study AbstractBackground and Aims. The bleeding risk of using non-steroidal anti-inflammatory drugs (NSAIDs) in patients treated with oral anticoagulants for ven

'Patients treated with oral anticoagulants for venous thromboembolism had a more than two-fold increased bleeding rate when using non-steroidal anti-inflammatory drugs' #doac #doac's #NSAIDS #cardiosky
academic.oup.com/eurheartj/ad...

That added ICH risk is quite something!

The role of glucagon‐like peptide 1 (GLP‐1) in addictive disorders Drug, alcohol and tobacco use disorders are a global burden affecting millions of people. Despite decades of research, treatment options are sparse or missing, and relapse rates are high. Glucagon‐lik...

Don’t forget that they reduce recipients desire to drink, smoke, and gamble:

They can’t come off patent soon enough.

pmc.ncbi.nlm.nih.gov/articles/PMC...

a man in a suit and tie is sitting next to a woman with the words that 's just common sense netflix below him ALT: a man in a suit and tie is sitting next to a woman with the words that 's just common sense netflix below him

I wonder if the best thing primary care paramedics could do for our ambulance colleagues is invite them in to general practice for a week so they can get an idea of what we can and can’t do.

And maybe to refer to us rather than neb chesty patients, then non-convey with inevitable 999 re-contacts

Naked noodles lied. This isn’t the “ultimate”, it’s the worst. Absolutely foul. Should have bought a pot noodle.

I don’t disagree, ARRS is being misused to patch holes in a system that has had funding obliterated. But your characterisation of ARRS staff delivering poor value is unfair, they’re working hard in the same pit as you, trying to do the additional roles, whilst being asked to deliver core services.