URN staff. Referenced from EMAS Annual Plan 2016/2017

URN F/507/4098 LO 1 Understanding what is required for competence in own work role. Describe the duties and responsibilities of own work role in line with own organisational Vision statement Values Behaviors Vision statement East Midlands Ambulance Service provides emergency 999 care and telephone clinical assessment services for a population of 4.8 million people. On average we receive a new 999 call every 34 seconds around 2,500 a day. Our vision is to deliver outstanding sustainable emergency and urgent care services across the communities of the East Midlands. To play a bigger part in the community through enhanced emergency and urgent care services delivered by proud, respected, highly skilled and compassionate staff. Referenced from EMAS Annual Plan 2016/2017 Section 2.1 Referenced from EMAS INSITE Homepage Having worked in workplace environments within the Royal Air Force and the Police Authorities of Cambridge and Lincolnshire, which are very disciplined and have strict protocols on work ethics and the strive for excellence.

I have found that my own personal vision for the service I am employed by is that I have received quality and intensive training to perform our role, not only in medical patient care and treatment, but been given an insight to our ever changing community service users. Our users are not all the same, they have different needs and capabilities and understanding of our service. Therefore, I pride myself in having the ability to deliver our service to my best potential. Sometimes it is not about treatment and medical issues.

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I have found over my career that there is a percentage of our role that deals with social issues and other factors that we need to be aware of and deal with accordingly, to each individual patient. For example, we should make a judgement if a patient is of a certain ethnic group or beliefs in a different religion. As far as I a concerned I am treating and looking after a person who needs our medical attention.

Reflective Practice I recall one particular individual, who was a 28 year old male, who had self-harmed by scratching his face. The injuries were superficial, but still needed transporting to an Urgent Care Centre for treatment, to prevent infection. The police were in attendance as the male appeared to be intoxicated. The male was assisted onto the ambulance vehicle, and whilst talking to him, taking past medical history, that lead up to the events that night, if became evident that this male was extreme right wing and supported Nazism. He explained that he had been in the Army and had served in Afghanistan. He had very outspoken views on ethic groups now living in the United Kingdom. I did not agree with his views at all, and felt that it would not be appropriate for me to express my opinion at the time, bearing in mind he appeared to be volatile.

If this patient had been in a position to negotiate, I might have engaged in conversation with him to determine why he felt this way, and maybe give him a little understanding why ethnics groups find themselves living in other countries because it has become untenable to live in their country of birth. Because of our continuing demand for our services, I have had conversations with patients and especially family members who are very upset about waiting so long for the ambulance to arrive. I have had critism about turning up at 4 oclock in the morning, in the middle of winter with horrendous working weather conditions.

I have explained to the families that although they are inside a warm house, the weather conditions outside do not allow us to proceed to a scene or premises at speed. Unfortunately, we are an emergency service but cannot meet our 8 minute response due to conditions that are out of our control. Most people have never considered these elements, but on explaining they now have an understanding of our demanding role. Reflective Practice Attending a 78 year old male with chief complaint of chest infection. On arrival his wife, who was a very little lady and clearly distressed.

My colleague attended the patient whilst I spoke with the wife in an attempt to calm her down. She explained to me that they had been together for 60 and she could not face losing him now. I explained to her that what Id seen of his condition and symptoms said to her that I thought he had a chest infection. Because this lady was distracted, she was busy sorting his overnight bag out, still in tears and distressed. When my colleague had assessed the elderly male, we decided to contact the GP for an appointment with a view for antibiotics. When the wife realised that this was not life threatening, she started laughing and disclosed to me that she had already sorted out her little black number to wear at his funeral.

Whilst chatting away with her she said that they did not have children and preferred just spending their money. She explained to me that her husband was very fruggle with his money, and all she wanted was a window cleaner, because she was too short to get to the top of the windows. I jokingly suggested that if she put the kettle on and made us a cup of tea, I would clean the top halves of her windows. After cleaning her kitchen, patio and conversatory windows, we were about to leave the premises. She could not have been happier, she was full of gratutute to both of us, and could not understand why the emergency ambulance staff would clean her windows. A few weeks later, my colleague and myself received a thank you letter from her, which was humbling to receive. Her parting comments to the CEO was that we should be given a pay rise.

On reflection to this detail, the patient was treated and given an alternative pathway for his treatment, the wife was delighted with having her windows cleaned. Values There are many qualities you will need to make a success of being a member of the EMAS team. Some you will learn as your career develops, others are personal skills A willingness to work as a member of a team Good communications skills Good levels of fitness and manual-handling skills (for some roles) Excellent driving skills (for some roles) Initiative Decision-making A calm manner even in the most challenging situations A willingness to learn and further develop your skills EMAS has 5 values which underpin everything we do how we deliver our services and how we work with each other. Think about how you can demonstrate the below values if applying for a role with EMAS. Respect Respect for our patients and each other Integrity Acting with integrity by doing the right thing for the right reasons Contribution Respecting and valuing the contribution on every member of staff Teamwork Working together and supporting each other Competency Continually developing and improving our individual competence Referenced from EMAS Homepage GIVE EXAMPLES FOR VALUES AND BEHAVIOURS IN YOUR OWN ROLE AS TECH Behaviours It is important to ensure that our attitude to patients and anybody we come face to face with, whether they be a patient, family members, staff, or other agencies. That we present ourselves in a professional manner.

We should not express our personal opinions, in order not to upset or distress our patients and families of their beliefs. We should ensure that we stick to our uniform regulations and present ourselves as a competent work force. EMAS values are Respect, Integrity, Contribution, Teamwork, and Competence.

Which I believe that all patients and family members and staff should all be treated equally regardless of their age, gender, race, religion, sexual orientation. This also extends to patients, family members and any other agencies that may be involved with patient care integrity and empathy. My understanding of the above extracts from the EMAS website is to be able to complete the initial training as an Ambulance Technician. To understand our responsibilities that is mandatory for the role.

To ensure the vehicle is fit for duty. To be able to work in a professional manner with many other members of staff, other agencies and importantly patients. To understand that our priority is to provide excellent patient care and we should deliver an outstanding service to our users of the emergency service. Reflective Practice On attending patient with a chief complaint of vomiting for 4 days. On arrival this 22 year old male lived in a high rise flat, which would make movement of the patient difficult if her was unable to walk unassisted. On entering the flat, is was clear that this family were living in poverty. There was evidence of drug and alcohol misuse in the front room. The paramedic first on scene, gave a brief handover and suggested transport to definitive care.

This young lad looked at me as if he had the impression I was judgeing him, he was in tears and clearly very unwell. I knelt down beside him and took him hand and asked him if there was anything I could get for him for the journey to hospital, he just wanted his coat. I collected his coat and put it around his shoulders, then took his hand in mind, put my other arm around his waist to steady him. He looked at me with a confused facial expression. I held his hand all the say down stair, giving him reassurance and comforting words. The impression I got from his body language was that, he had identified me as not judgeing him but to care for him the best I could. On handover, I said my goodbye and wishes him all the best with his recovery, he took my hand, (still in tears) and said he was thankful for my care.

Reflective impressions to me was that, I was there in a professional manner to treat his medical needs not the way he lived. Explain expectations about own work role as expressed in relevant standards. USE EXAMPLES SUCH AS CENTRAL GOVERNMENT LEGISLATION SUCH AS THE DATA PROTECTIONO ACT AND LOLAR REGULATIONS OR LOCAL POLICY DOCUMENTS SUCH AS DIGNITY AND RESPECT AT WORK POLICIES CONFIDENTIALITY CODE OF CONDUCT ALSO INCLUDES JRCALS GUIDELINES UK REGUS GUIDELINES Emergency Care Assistant As an emergency care assistant, you are a member of the emergency ambulance crew, answering 999 calls.

You will work alongside a more qualified member of the ambulance team, giving support and help to enable them to provide patients with potentially lifesaving care at the scene and getting patients to hospital as fast as possible. Working shifts and in all weathers you will deal with a range of different people and situations. EMAS Insite Role Description My expectations of my own role, is that I am obligated to work in accordance with EMAS policies and procedures.

Keeping up to date with medical bulletins and learning opportunities. Abide by my scope of practice in order to keep my work ethic within these realms. I have always prided myself in working to the best of my capabilities and knowledge and welcome constructive comments that will improve my work practice. I am also expected to be aware of the protocols of other agency legislation.

These include Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). These regulations place certain criteria on companies, care staff who use lifting equipment involved with patient care. LOLER states that all personal using any lifting equipment should only use it for the purpose it is designed for and appropriate for the task in hand. It outlines that before use there should be a plan in place before the move is commenced. Sufficiently staff should be using or assist,, they must have had the full training on the picece of equipment and be competent in its use. LO2 Be able to reflect on own practice. I am able to reflect on my own practice.

I usually keep a diary of events and incidents in order that I can read them back at a later date and reassess my thought process and identify if there was anything I could have done better and more importantly identify things that I might have got wrong. Through experience, I have re-visited the same scenarios and have learnt to deal with them differently and more efficiently and aim for a better outcome for the patient. I have on occasion discussed my actions with peers and colleagues, in order to ascertain what their approach would be and if I should adapt the same approach which will benefit the patient.

I am mindful not to disclose any patient details or any information that could identify the location of the incident. 2.1 Explain the importance of reflective practice in continuously improving the quality of service provided.

It is essential that we all are aware that reflective practise is important. This enables us to constantly reassess our attitude and approach to our patient care. Although we have initial training in our job roles, we still need to develop our skills in the community. With more exposure to life and death situations, we gain a vast amount of knowledge as time goes on.

We need to be able to look back on situations where we should or could have done things differently, and would these changes benefit the patient. Initially, starting as an Emergency Care Assistant (ECA) for EMAS, obviously were given the training and fully understood our role and scope of practice. On arriving on station for my first day I was crewed up with a paramedic with a vast amount of experience. Luckily, my training stood me in good stead. I was able to perform baseline observations and was able to provide my crew mate with the necessary equipment, albeit I had to be prompted at times. Sometimes I was not fully aware of where all the equipment was and what equipment would be used for certain incidents. In time, I became more aware with what my paramedic needed and at what time.

For instance, if we attended a diabetic patient with complications, I understood that the temperature was not the first observation we took, but it was the blood sugar in order to establish if they had a high or low blood sugar level. For me this was a learning development skill which I still use to date. In training we are always taught to look at the patient for an initial impression and to follow the ABC protocols. I have learned through working with experienced clinicians that this is still the case, but have also gained knowledge of when to up the game when necessary.


YOU MIGHT HAVE HAD TO ACCOMMODAT A RELIGIOUS BELIEF, WHICH MAY BE DIFFERENT TO YOUR OWN. YOU MIGHT HAVE HAD DEALINGS WITH THE AMBU SEERICE OR NHS WHICH MAY HAVE BEEN A POSITIVE OR NEGATIVE EXPERIENCE HAS THAT INFLUENCED YOUR WORKING PRACTICE My own personal values and beliefs may be affected by other peoples opinions, although we all have the right to formulate our own decisions, it is not appropriate to express those opinions to influence others. I have been in situations whereby, I have not been comfortable with a patients or work colleagues attitude to my beliefs, or beliefs of others.

For example, treating a patient who is racist and was verbally abusive. On this occasion I did not express my views, and treated his medical needs and performed my role professionally and tried not to engage myself into his conversation about his beliefs. LO3 Be able to evaluate own performance.

I am proud to work for the Ambulance Service and thoroughly enjoy patient contact. I have learned through working with experienced clinicians, that we are always adjusting our performance and approach to certain groups of patients. I feel that I can establish a good rapport with patients and other members of staff. Making sure that on time critical details, that I do show my concerns in a manner that will be evident to the patient or family members. 3.1 Evaluate own knowledge, performance and understanding against relevant standards. USE EXAMPLES OFMANUAL HANDLING CC 2 P14 BUT SIMPLY INCLUDE A REFERENCE I constantly evaluate my knowledge and performance whilst on duty and attending incidents.

I value the experience and professionalism of my crew mate, that being a technician or paramedic and welcome any constructive criticism they may have with my performance. I am also aware of my changing attitude and opinions to patients. I believe that the more exposure I have to different kinds of complaints, I understand more about the illness and their conditions, but more so the patients with regards to their individual needs. If I have attended a particular complaint or illness that I am now either aware of or have knowledge about. I will research the complaint to gain more knowledge and understanding of the complaint. As regards to our regular service users, on arrival I initially establish the nature of the call.

On most occasions we find it is not an emergency but an ongoing issue. I do understand the frustration some patients feel, with not being able to get a doctors appointment and have no other means to address their complaint. However, we do have to try and educate our service users as to the best course of action plan for them. This has to be address in a delicate manner, not to offend them, but try to explain that there might be other pathways we can instigate care for them. LO 4 Be able to achieve personal development plan. IDENTIFY SOURCES OF SUPPORT Firstly, identify your learning needs, and they develop a timescale to achieve your goals.

Seek help from peers and Clinical Team Mentors (CTM), to see if my learning needs and development can be assisted by either them or other tools available to the service. There are occasional workshops in a particular skill, whereby we can attend station and participate in scenarios, and use the equipment to gain more practice. The following items can be found on EMAS Insite Homepage. These are learning modules in various categories. Some require you to register to access the site, some are played videos for which you can receive a certificate for your portfolio. e-Learning Duty of Candour Jesip Health and Hate Crime E-Learning for Paramedics Tackling Inequalities Through Health and Social Care Design Display Screen Equipment (DSE) Seen and Heard HYPERLINK http//www.emas.nhs.

uk/insite/learning-and-development/access-to-learning/academy-10/ Academ0 Academy 10 Academy 10 provides free e-learning tutorials in a range of subjects from appraisal techniques to improving teamwork. These are 40 modules on this site, but it can only be accessed by registering. A certificate can be gained when completing the course. Wider workforce Functional skills courses including numeracy, literacy and IT Funding for individual training needs Qualification and credit framework Apprenticeships including Clinical Healthcare, Business Admin, Team Leading, Customer Service, Contact Operation Centre and IT. Learning Beyond Registration Learning Beyond Registration (LBR) provides the opportunity for post registration healthcare professionals (excluding doctors and dentists) to access a wide range of educational activity to develop competent, capable practitioners appropriately prepared to deliver a dynamic, flexible, quality, client focused service HYPERLINK http//lbr.eastmidlands.nhs.uk/ o Health Education East Midlands website t _blank Health Education – East Midlands, 2017 4.

1 Identify sources of support for planning and reviewing own development. See above learning tools from EMAS Insite I constantly seek the support from my crew mates and other members of staff on station. Additionally, I have spoken with our CTM in order to keep updated with new procedures and bulletins. Also, if I have attended a difficult detail or a complaint or illness I have not seen before, I will search the internet for sources of information to try and understand more clearly. As previously stated, we can use the EMAS Insite website for other learning tools. I am not an academic learner, but find it easier to learn visually and practically. I do search You Tube on a regular basis for documentary or medical videos.

4.2 Assess own personal development needs. At the beginning of my career in 2012, I primarily worked with a paramedic with 30 years of experience. Since moving to Louth Ambulance Station, I have found myself working with external technicians. As the parameters have changed, I no longer, as an ECA are permitted to attend the patients. I have found this very frustrating, but still try and keep as involved as possible in their treatment. I feel over the last 2 years I have had skill fade. I believe that too much knowledge can be dangerous therefore, I believe that this new Ambulance Care Practice (ACP) course will be a completely new start for me and am looking forward to learning the most up to date protocols in the ambulance service.

As a technician I will be able to contribute more to patient care. Having the ability to access the EMAS Insite website from home, enables me to keep up with our ever-changing work role. 4.3 Identify existing development activities that are appropriate with identifying development needs. Within my role as ECA, I have identified that in order to develop my skills to a better quality, I need to listen to other members of staff and clinicians in order to gain knowledge, and this could be a simple task, such as moving and handling or having a set approach to situations. For example, when attending a Road Traffic Collision (RTC), in the past I would attend the patient (on scene) with the clinician, I have developed my approach by making sure I stick to my role, which on this occasion would be to prepare the equipment required by the clinician. Making sure our exit or extrication route is clear, to not waste precious time in life threatening situations. In my role as Technician, I am aware that I may be the senior clinician on scene and need to develop a good working relationship with my crew member.

This will be done with good, clear communications skills, so that we are both aware of each others expectations, strengths and weaknesses. 4.4 Identify options that would meet the needs of the development plan. A personal development plan (PDP) is an action plan that helps you get organised, identifies learning and development needs to help you do your job better or help in your career, and then track progress To identify What do I want to achieve What are the standards, skills and knowledge required By my current role and do I have any gaps What are the learning and development opportunities in my current What are my ambitions and goals Am I making the right choices to get me there Referenced from Care Certificate Standard 2 Your personal development. My aim within the health care profession is, ultimately become a paramedic. At the moment its my belief that I need to gain far more experience in the working environment and to develop my skills as a Technician first.

I am aware of the standards required and also accept that my knowledge needs to be better for career progression. There are learning opportunities in my role. These can be accessed by online studies and research, contacting CTMs for advice for which training needs can be identified. 4.5 Translate skill and competence needs into realistic development plans Smart. INCLUDE A REAL DEVELOPMENT PLAN TO SATISFY YOUR IDENTIFIED LEARNING NEEDS. THIS HAS THE COMPONENTS FROM LO4.2-4.

4 To identify What do I want to achieve What are the standards, skills and knowledge required By my current role and do I have any gaps What are the learning and development opportunities in my current What are my ambitions and goals Am I making the right choices to get me there Referenced from Care Certificate Standard 2 Your personal development. 4.7 Review progress and use feedback to continue personal and professional development needs. As previously stated, I do keep a reflective diary on certain situations that I have attended. This is to be able to reflect back and consider if I made the right choices at the time and did the patient benefit or not. Sometimes there is a need to have a de-brief, especially at difficult details, normally when several agencies have been involved. I feel that these de-briefs are vital for us to understand each others roles and responsibilities. Constrictive analysis of all our roles can only benefit us to improve and fine tune our emergency service approach.

LO 5 Be able to use learning opportunities and reflective practice to contribute to personal development. We have the opportunity to learn and develop our skills by seeking advice from our peers CTMs and have access to online learning tools. EMAS also have learning programs with insite. There are also several sites online in which we can complete and gain a certificate. This is ideal for researching a specific learning need. 5.

1 Evaluate how learning activities have affected practice. Whilst working with EMAS for the past 5 years, I had the opportunity about 3 years ago to work in the Accident Emergency at Pilgrim Hospital for an observation night. Although, we take our patients in them under varying conditions, I personally did not know at the time what happened to them after we handed over.

For instance, why do they do blood tests routinely, CT scans and certain treatments we do not do. After my very long night shift, I had more understanding of the post hospital care that is provided by the NHS. This experience highlighted to me that the more knowledge we have about our initial care and then further care, enables us to make even better choices for the patient on first contact. LO 7 Understand the need for continuing personal and professional development. It is essential that all staff, in any organisation should keep up to date with changes in policies and procedures. This will enable all professions to give the best quality of service for our patients. For us as an Emergency Service, this is more so important.

As clinicians (with a registration or not) we have a responsibility to give the best care we can, through gaining knowledge and experience. We should be mindful that we have a duty of care. Also, bearing in mind that our practice will or might have a detrimental outcome for the patient, this could be life threatening or life changing and we are all accountable for our actions. 7.1 Explain the requirements for continuing personal and professional development. We are required under our terms of reference to be aware of any changes to patient care.

We work in an environment which changes constantly. New research is always ongoing and although we may have performed a procedure for many years, those procedures to change and we all responsible for out continuing person and professional development, in order to keep up our reputation as a service and continue giving the utmost care to our service users. 7.

2 Identify the personal and professional development needs to match the present and future role requirements. THIS REFERS TO WHAT YOU HAVE TO DO NOW TO COMPLETE THE AAP COURSE. THINK ABOUT THE COMPONETS OF THE COURSE IE COMPLET THE THEORY PORTFOLIO, THE PRACTICE PORTFOLIO FURTHERMORE YOU WILL NEED TO COMPLETE THE ANNUAL STAT AND MAND AND PDR AS PART OF YOUR PRESENT ROLE YOU MIGHT HAVE ASPIRATIONS TO BECOME A PARAMEDIC. IF SO THINK ABOUT WHAT CPD ADDITIONAL TRAINING YOU WOULD UNDERTAKE TO MEET THIS ROLE It is essential that we all take responsibility for our own learning needs. We are responsible for our own professional development. We need to have the ability and opportunity to progress in our career. Personally, for me, I would be seeking assistance from my CTMs in order to address my strengths and weaknesses. LO 8 Be able to maintain professional competence through the use of a continual personal and professional development portfolio.

By keeping a reflective diary of events or specific incidents I have attended, I am able to again reflect on my attitude and approach to the job. I feel we should always be aware of our professional commitment and ensure that in our development portfolio this should be highlights, so that we can see a progression in personal and professional development. 8.1 Identify different types of information that can be included in a portfolio. There are several ways of completing our portfolios through providing evidence of events and training. These are as follows DO Direct Observation This is where the assessor observes the learning working in the learners workplace and records their findings. These can be used as competence and knowledge evidence. WE Witness Evidence Expert witness evidence.

This is where an expert witness, such as a qualified professional. Observes the learning working in their workplace and records their findings when it would not be possible for an assessor to observe the learners practice. Qualified staff can be expert witnesses, they sometimes see things that can be used as evidence that assessors cant. The centre will have approved the expert witness but the evidence provided by the expert witness will be judged against the assessment criteria by a centre assessor, this can be used as competence and knowledge evidence. PO Peer observations Peer observations reports (Lifelong Learning Qualifications only). This is where the learners peers observe the learner carrying out micro teaching and record their observations. WT Witness Testimony Witness testimony, this is where an individual such as a service user or a co-worker can write a statement about the activity that the learner has carried out in the work setting and which has not been observed by the assessor this can be used as competence and knowledge evidence.

WP Work Product Work products. These are products activity plans, individual learning plans, care plans etc. that the learner has produced or been involved in producing and used in the work place.

These can be used as competence and knowledge evidence. LR Learner Reflective Accounts. Leaner Reflective account.

The learner writes these and will use them to cover situations that the assessor had not seen and where learners have though about their actions, experiences or learning and the implications of these so that they can celebrate good practice and/or suggest changes for future action, learning or practice. These can be used as competence and knowledge evidence. LD/LS Learners Diaries/Learners Statement This is a record of activities carried out by the learner, with evaluation and/or reflection of those activities. A learner should consider their actions, experiences or learning so that they can develop their practice these can be used as competence and knowledge evidence. PD Professional Discussions These are pre-planned discussions between the learner and their assessor and can be used to fill gaps in evidence and/or demonstrate depth and breadth of knowledge and/or competence. These can be used as competence and knowledge evidence.

Obs Observations These are carried out by the learner where they record information about children, young people or adults in a variety of situations or activities. (Observations may be used in court, as part of an official report). Child observations will be used as part of the childs learning journey record. They will be used to help decide what individual needs are and how they can be met.

These can be used as competence and knowledge evidence. CO Clinical Observations. These are observations that the learner may carry out in their health care role and will record their findings according to agreed work place practice. These can be used as competence and knowledge evidence. RPL Recognition of Prior Learning. The assessor will consider whether the learner can show that they can meet the assessment criteria for a unit or part of a unit through knowledge, understanding or skills they already possess.

This can be used as competence and knowledge evidence. QA/WQ Questions and Answers/Written Questions Questions can be written or oral. Questions will be asked by the assessor to enable the learner to demonstrate knowledge and understanding. Questions and answers must be recorded by the assessor. Questions may or may not be pre-planned.

It is often useful to ask questions at the end of a direct observations to clarify points or to add a depth of knowledge to the observation. These questions would not be pre-planned. These can be used as competence and knowledge evidence. MCQ Multiple Choice Questions (Cannot be used in Childrens and Young Peoples Workforce or Health and Social Care qualifications). Multiple choice is a form of assessment in which respondents are asked to select the best possible answer (or answers) out of the choices from a list. These can be used for knowledge evidence.

DA Direct Assessment OSCE Observed Structured Clinical Examination Referenced from Level 4 Diploma for Associate Care Practitioners (L4 DAAP) 8.3 Review own portfolio in the light of constructive feedback. Please see evidence A titled Principles of Feedback attached to this Unit. I have read through this piece of evidence, which was referenced from Nottingham University. I have highlighted specific items and comments which I can directly identify with myself. This piece of work has enabled me to receive and deliver constructive feedback in a disciplined manner.

I have now a better understanding of what feedback means, it is not necessarily destructive feedback, but is a learning tool used by peers and managers to enable members of staff to gain experience, sometimes through error. Y, B8L 1(IzZYrH9pd4n(KgVB,lDAeX)Ly5otebW3gpj/gQjZTae9i5j5fE514g7vnO( ,[email protected] /[email protected] 6Q