Sorry for such a longwinded answer!!! It's just that I'm pleased you're looking at it because I'm really keen that we move away from these practices; needles hurt, and it's unnecessary to put in separate PRN lines and/or 2nd pumps for a 4th drug etc.

The other main change in the updated CSCI chapter was removal of the "don't mix more than 3 drugs" advice. It's completely baseless and there's now a wealth of 4, 5 and 6 drug compatibility data

Therfore, PCF chapter on CSCI updated it's advice last year to say "side ports can be used provided compatibility is considered" Just to add, I've routinely used side ports for years without problem: some patients find SC cannula placement painful and we have no reason to put in a separate PRN line

Reason it has so little impact is that the PRN effectively pushes a bolus of the CSCI admixture thru, which offsets the 30minute or so time that the infusion is effectively suspended (ie time taken for more admixture to make its way thru the deadspace)

Even midazolam (halflife can be as short as 1hr) would only drop to 95% of it's steady state level using a safeTintima (the deadspace affects the calculation)

Secondly, a concern that the PRN bolus interfered with the levels of the infused drug. If you email me, I can send you a spreadsheet that models this. But in short, we don't use anything with a short enough halflife to matter.

Firstly, compatibility Deciding whether the PRN can mix with the infusion is fairly straightforward both for specialists (who are used to doing it) and to generalists (providing their standard 4 JIC drugs don't include cyclizine - a good reason to avoid it, plus alternatives double up for agitation)

Traditionally, some steered clear of the side port due to 2 considerations (though unnecessarily, in my view).

@paulhoward.bsky.social Hi Paul. I'm trying to find the evidence or guidelines around use of the side port for prns when there is an existing syringe driver and drawing a blank. Do you have any ideas?

To mark the 1st day of my 4th year without Alice I have an announcement: I’ve joined up with a determined group of women working to change the narrative around trans people. Women standing in solidarity with our trans siblings. Our first step is to ask cis women to read and sign our open letter ⬇️

#EAPC2025 interested editorial for discussion...

"If we as individuals and players in health systems, lean into discomfort, & it IS uncomfortable, of being with people we find different to ourselves & put down the pressure to know everything about everyone, we might connect back to our professional & human curiosity?" 👏 @jedjerwood.bsky.social

first they came for the white South Africans, and I didn't speak out— because no one is coming for the white South Africans, you deranged paranoid lunatics. what the fuck is wrong with you

“Death is inevitable but pain and distress need not be." Yesterday, the Commission launched its report in Parliament. Sir Mike Richards, Chair of the Commission on Palliative and End-of-Life Care, emphasised how joined-up palliative care can profoundly benefit patients, the NHS, and acute hospitals.

A fabulous Friday! Thank you @drkathrynmannix.bsky.social for insightful, thoughtful & honest conversations, plus adding your wise words to our hospice wisdom tree 🌲 Also a big thank you to @jedjerwood.bsky.social & @sharonhudson.bsky.social #palliativecare #hospice #DyingMattersAwarenessWeek

My article for @uk.theconversation.com on plans to abolish NHS England. In summary: the policy centre does need rationalisation, but this sudden axing of NHSE together with halving staff in integrated care boards risks a distracting & protracted reorganisation. theconversation.com/abolishing-n...

Everything you need to know about the trans Supreme Court case: What it said, what it didn't, and what happens next iandunt.substack.com/p/everything...

The roots of racism, sexism, ableism&transphobia are the same You don’t have to look far to see this in play right now As a priority, I worry for trans women and men right now… and ultimately for all minorities, we know where this is heading Don’t be silent #supremecourt

Could you imagine if the head of the United States healthcare system didn’t believe that HIV caused AIDS? …And that instead they believed that AIDS is caused by recreational drugs (“poppers”) used by gay people? Oh wait…🥴

www.bmj.com/content/389/... Oh dear me What @mgtmccartney.bsky.social said, basically.......

A joyful day delivering education with the amazing @sharonhudson.bsky.social 🤩

UK clinicians - do you support unpaid/family carers of patients with breathlessness in advanced disease? This resource could help: supporting-breathlessness.org.uk. Plus we have a new batch of "mock prescription pads" in to help you signpost carers to it - just message me with your postal address!

Copies of ‘Words to Live and Die By’ available today in Belfast for #pcc2025 An anthology of Haiku poems about death, dying & grief. A guide for navigating the human experience through the language of others, specifically in times of loss Save yourself some p&p & us from a bulk of books on a plane!

Dr Gurpreet Gupta offers advice on working towards structural change Whatever we do individually is for the purpose of structural change. Self identify and stand up to do the work Lean into the tension Ensure psychological safety Do the small bits for marginal gains #PCC2025

"Words like racism don't go well in our fundraising departments" Dr Gurpreet Gupta & Professor Max Watson hold space to explore anti-racism & allyship in PEOLC #PCC2025 This editorial is more important than ever. Please read it and consider your response journals.sagepub.com/doi/full/10....

Dr. Harlem Johal at #pcc2025 on communication & conflict in critical care

Astonishing numbers of participants to CHELSEA 2. It IS possible to do research in Palliative Care #PCC2025

I have arrived at #PCC2025 Excited to see @clarefuller.bsky.social who kindly introduced the Chapter ‘ What Matters to Me’ in Words to Live and Die By - a book of poetry about death and dying, showcased in this poster! #wordstoliveanddieby #AdvanceCarePlanning #PEoLC

Professor Andrew Davies urges us to 'Just Do Research' in Palliative Care and the barriers to this #PCC2025

Key actions for public partnership ❤️Step back from the hamster wheel, connect and see hope ❤️Don't forget you a part of your own community- share your gifts ❤️Put a pin in the map for your service and search your community around them- engage, hear get involved ❤️Be PROUDLY PALLIATIVE #PCC2025

‘A form doesn’t help you think’ @tuffrey-wijne.com & Amanda #pcc2025 Let’s talk about funerals www.victoriaandstuart.com @roisincomms.bsky.social

Dr Rubenstein @drjrubenstein.bsky.social looks to a hopeful future and organisations like endwellproject.org Bringing real death and dying into the place the public really see it- in media, TV and films #PCC2025

Dr Kerrie Noonan @keznoo.bsky.social Urges us not to event plan and invite people in but instead actively show up within existing community, see and value the strengths, be curious and I would add be humble #PCC2025 #DeathLiteracy

The awesome @drjrubenstein.bsky.social discusses the need to improve health care workers understanding of Palliative Care - without that public involvement hits a dead end His animations give voice to the behaviours and fear and around Palliative Care #PCC2025 youtu.be/BbNi_-wYXJE?...

Next Up at #PCC2025 Responding to Public Curiosty and Fear about Dying

Dr Kirsty Boyd challenges us in the assumption that care at home is preferred or right and we should look at the reality of this in our planning and decision making #PCC2025

Dr Kirsty Boyd talks to us about 'Care for People who are Dying' instead of End of Life Care for people with multiple needs. Noting the increase in cause of death not just in dementia but renal and heart disease #PCC2025

Delighted and inspired that we are being challenged to stop patting each other on the back, recognise the real pressures in tbe system and be ACTIVE in changing our approach @idrisbaker.bsky.social & Dr Feargal Twomey #PCC2025

Here we go... Looking back and moving forwards #PCC2025

Any #PalliativeCare folk heading to @pccongress.bsky.social this year?

Here's me talking about our recent paper "Components of home-based palliative and supportive care for adults with heart failure: A scoping review", in @palliativemedj.bsky.social #podcast Would love to hear your thoughts! 🫀🏠 #homebased #supportivecare #pallativecare #heartfailure

New research from the Nuffield Trust and The Health Economics Unit, finds that 81% of total end-of-life healthcare spend goes on hospital care with only 15% spent on community and hospice care. healthcaretoday.com/article/end-... #publichealth #hospice #endoflifecare #hospital #communitycare

There’s not long left to book your place at #PCC2025 Don't miss out. Get your tickets TODAY! 🎟️https://pccongress.org.uk/registration/ Full Programme available via the website Day 1 - pccongress.org.uk/day-1-progra... Day 2 - pccongress.org.uk/day-2-progra... Registration open until 5 March

Any #PalliativeCare folk heading to @pccongress.bsky.social this year?

➡️Want to avoid being in hospital? ➡️What to live well with multiple long term conditions? ➡️Want to recover from being acutely ill in hospital in your own home? ➡️Want to have good end of life care at home? ✅️Invest in District Nursing.

And not just ED, wards have 4 additional beds squeezed into gaps too

"Choice can only be exercised when options exist that enable equitable access to comprehensive care." On the cover, a Comment explores assisted dying, complex systems, and global equity in palliative care. Read this & more ➡️ tinyurl.com/42n97mp4

I welcome the Palliative Care Commission, with some fabulous commissioners. But where is the nursing voice? Of 21 commissioners why 10 medical doctors and only 1 person with a nursing background? #hpm #hapc #nursing @alisonleary1.bsky.social palliativecarecommission.uk/commissioners