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Andrew J

@em-dr-jacklin

Ex fluctibus tranquillitas. Emergency Medicine Consultant, Medical Examiner, Digital Lead. East Midlands. Trying to avoid drama, trying to generate some worthwhile discussions. May fail.

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21.08.2024
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Latest posts by Andrew J @em-dr-jacklin

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Interesting how much trouble a little box with text can cause.

In the new ALS tachycardia algorithm the VT/is it VT? box is confusing enough that it's already been amended into a version 2 but also asks for procainamide (no UK license so it's interesting to source!).

22.02.2026 10:00 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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Happy New Year and a Prosperous Year of the Horse to everyone! Even to the wind that blew away the banners around my door.

16.02.2026 10:13 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
A Chinese New Year LEGO tree

A Chinese New Year LEGO tree

a sign hanging from a tree saying "thank you past me!"

a sign hanging from a tree saying "thank you past me!"

Wife brings this downstairs.
Me: "ooh, that's lovely, where did you get it?"
Wife: "you bought it last year cheap after last Chinese New Year."

15.02.2026 14:42 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

Half of the biathlon? Icy boxing?

14.02.2026 22:16 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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New Lilo & Stitch: defeats enemy by kinda winning a fight on a spaceship.

OG Lilo & Stitch: defeats enemy by stealing petrol tanker, driving it into a volcano, riding the explosion wave and beating up the alien guard whilst dropping wisecracks.

OG Stitch FTW every time.

10.02.2026 10:00 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

Drat, knew I'd been doing something wrong.

09.02.2026 22:54 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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www.england.nhs.uk/publication/...

Maybe it's just the way it's phrased but this just feels a bit like a lecture on the correct way to suck eggs is being delivered.

09.02.2026 21:46 ๐Ÿ‘ 4 ๐Ÿ” 0 ๐Ÿ’ฌ 3 ๐Ÿ“Œ 0

Also a non-breather mask sounds dangerous.

18.01.2026 17:35 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

Should there be a bit more history here?

18.01.2026 17:33 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

IKR.

05.01.2026 20:04 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

For a whole year now I've been responding to WhatsApp messages with themed emojis instead of just simple thumbs up/smiley faces and not one person has commented on it.

05.01.2026 18:57 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

Yes. Also, fun fact, in the original script it was spelt Inniego Man Toyer. But he still wanted you to prepare to die.

05.01.2026 18:01 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0
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@rowan.fyi @josswright.bsky.social

05.01.2026 15:18 ๐Ÿ‘ 3 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

Ok, but what are you going to draw on it?

25.12.2025 15:23 ๐Ÿ‘ 2 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0
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SO CLOSE

09.11.2025 23:04 ๐Ÿ‘ 2 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

Tired: two-factor authentication

Wired: n+1-factor authentication, where successfully authenticating on a new device just allows you to log in again, triggering another authentication request. Repeat ad infinitum

07.11.2025 19:45 ๐Ÿ‘ 870 ๐Ÿ” 83 ๐Ÿ’ฌ 50 ๐Ÿ“Œ 7
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Ok Gemini, that's pretty good.

IYKYK

07.11.2025 15:52 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

lowest acuity setting appropriate to them" and it almost feels like you could measure the success of a streaming initiative using it (apart from just measuring time to stream.)

06.11.2025 20:13 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

...then one of the goals of (safe) streaming of patients presenting to ED would be to produce a leftward shift.

I just really like it as a phrase but I'm not certain it actually speaks to anyone but it was a touch more exciting to me than the dry maxim "patients should be cared for in the

06.11.2025 20:13 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

@kurtstat.bsky.social has anyone ever used the phrase 'leftward shift of acuity in streaming' (and I'm slightly embarassed to be asking this.)

My thought: if you thought of acuity of setting on the x-axis with home at the left and ED resus on the right, and patient numbers on the y-axis...

06.11.2025 20:13 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

Also: today year's old when I found out Boba Fett was based on Clint Eastwood in Fistful of Dollars.

23.10.2025 10:03 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

The Mandolorian is quite good, isn't it?

23.10.2025 10:01 ๐Ÿ‘ 0 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0
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a cartoon character says witchcraft in front of a curtain ALT: a cartoon character says witchcraft in front of a curtain

People in the NHS when someone uses the BCC (blind carbon copy) function in e-mails.

20.10.2025 12:14 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

The most caustic effect of Brexit is the rise in the view that democracy is just about voting on things.

(Ideally it's a complex interlocking system that relies on the rules and interplay between Parliament, government, courts and the press to try and maximise freedom and quality of life for all.)

20.10.2025 12:10 ๐Ÿ‘ 2 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0

Or is that muddying the waters again and moving away from the idea of making this a metric of the 'middle period' of patient time.

20.10.2025 12:04 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

Indicators of patient flow dysfunction mainly focus on either the hospital front door (e.g. breaches of the four-hour target) or the hospital back door (e.g. delayed transfers of care). But patient flow dysfunction manifests itself *everywhere* in a general hospital.
1/6

16.10.2025 09:20 ๐Ÿ‘ 2 ๐Ÿ” 1 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

And thinking out loud - if it is WrongWardHours you could add in the length of time that the patient spends in ED waiting for bed, which are also wrong hours.

20.10.2025 12:01 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 2 ๐Ÿ“Œ 0

Is this a snapshot metric - e.g. this is the level of dysfunction in the hospital atm. or is it measured in something like WrongWardHours - e.g. how many hours each patient spends in the wrong place?

20.10.2025 12:01 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 2 ๐Ÿ“Œ 0

You're also missing out on the opportunity to create an Alan Partidge-esque moment where an adorable but annoying 7 year old struggles with the concept that she's two grades higher then you.

20.10.2025 06:50 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 1 ๐Ÿ“Œ 0

The important thing to understand about AI is that everything that everyone else creates using it is mindless slop that is heating up the planet but everything I create using it is like a cross between Oscar Wilde and Van Gogh and was 100% worth it.

20.10.2025 06:46 ๐Ÿ‘ 1 ๐Ÿ” 0 ๐Ÿ’ฌ 0 ๐Ÿ“Œ 0