Dr Mark listened carefully to my situation and was appreciative of the difficulties we were facing as a crew. He was keen to empower us as much as possible to deal with situation we found ourselves in and, therefore, gave us a large degree of latitude in which to manoeuvre in terms of additional doses of post ROSC midazolam.
I had contacted Julian reference a patient involved in an RTC who did not produce cortisol due to a disturbance in his HPA axis caused by the removal of his pituitary gland. The RTC was a stressful event and therefore a dose of Hydrocortisone IV would benefit him. I found Julian's advice extremely reassuring, caring, professional and informative giving me the confidence to treat this patient effectively and efficiently.
Dr Mark gave excellent advice over the phone, and helped towards making a successful diagnosis, as well as suggesting differing analgesia, which had a better outcome for the patient.
The situation involved emergency care in the pre-hospital environment. I had to give patient relevant information and describe a plan of action. I was listen to and then and given encouragement to go ahead with the plan, also advice was given in a constructive manner. I was also encouraged to seek further advice if needed and felt supported throughout.
I am a CS RAT paramedic, I phoned Julian, who was on call at 0330 to discuss patient who was agitated post ROSC with a view to giving him midazolam which is not included in our PGDs. Julian gave advise re initial dose and any subsequent doses. Very pleasant manner despite the unsocial time!
Short link to review Dr Julian Mark: http://iwgc.net/eer6m