The Surge: Surgery. Trauma. Critical Care

Given the situation in Ukraine and the fact that many people are volunteering. I am postponing my original plans for an MMA/ Combat sports medicine talk and switching it up to a series for beginners on topics I think may be useful. This episode is about preparing for humanitarian work and deployment.   PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327 direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA Spotify: https://open.spotify.com/show/0fV5RTUrwqUT3FdMs6ygnB Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy83NWQ4ZmQ1NC9wb2RjYXN0L3Jzcw Amazon Music /Audible: https://music.amazon.com/podcasts/6d5234b5-58d9-48fd-a7c0-e32be1849deb They are free and although the quality is still sketch, I'm hoping to imporve with your input. Fell free to suggest other topics.

Just some random thoughts on when and where we can skip the ER. Thankyou all for all the kind feedback. For the record .... this isn't my best work ..... I know LOL .....   PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327 direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA Spotify: https://open.spotify.com/show/0fV5RTUrwqUT3FdMs6ygnB Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy83NWQ4ZmQ1NC9wb2RjYXN0L3Jzcw Amazon Music /Audible: https://music.amazon.com/podcasts/6d5234b5-58d9-48fd-a7c0-e32be1849deb   They are free and although the quality is still sketch, I'm hoping to imporve with your input. Fell free to suggest other topics.

You can have all the surgical training in the world but if you don't have confidence it counts for shit. It's kind of like having a wallet with a billion in bitcoin but not way of accessing it ....... And the literature proves it..... As always please like comment and subscribe ! PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327 direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA Spotify: https://open.spotify.com/show/0fV5RTUrwqUT3FdMs6ygnB Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy83NWQ4ZmQ1NC9wb2RjYXN0L3Jzcw Amazon Music /Audible: https://music.amazon.com/podcasts/6d5234b5-58d9-48fd-a7c0-e32be1849deb They are free and although the quality is still sketch, I'm hoping to imporve with your input. Fell free to suggest other topics.

I know it's been a while. I've been working on alot of things here and there. Stay tuned for the first episode of the new season this morning.     PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media       Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327 direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA Spotify: https://open.spotify.com/show/0fV5RTUrwqUT3FdMs6ygnB Google Podcasts: https://podcasts.google.com/feed/aHR0cHM6Ly9hbmNob3IuZm0vcy83NWQ4ZmQ1NC9wb2RjYXN0L3Jzcw Amazon Music /Audible: https://music.amazon.com/podcasts/6d5234b5-58d9-48fd-a7c0-e32be1849deb   They are free and although the quality is still sketch, I'm hoping to improve with your input. Feel free to suggest other topics.  

Overview of the actual evidence for AMA discharges. How to do it? Is it legally protective? Is it ok for patients to do it? Sources https://www.jem-journal.com/article/S0736-4679(11)00540-3/abstract https://pubmed.ncbi.nlm.nih.gov/27623726/ https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.51.7.899   PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327 direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ instagram TV https://www.instagram.com/saudn/channel/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA and soon google play as well. They are free and although the quality is still sketch, I'm hoping to imporve with your input. Fell free to suggest other topics.

This episode is a quick rundown of some pitfalls and some tips on how to deal with an extremely challenging aspect of trauma/obstetric/ED and Critical care without hitting that panic button. 

I was genuinely disturbed and intrigued by the Vastaamo breach where a hacker managed to obtain 40000 patient records, send out emails threatening to release their data. Imagine if your most intimate thoughts and fears where out there. Full transcripts from the computer system of a mental health facility.  How do you prevent something like this? We owe it to our patients to be better at cyber security Medsec/ Healthcare Sec.  Useful links: https://haveibeenpwned.com/ https://darknetdiaries.com/ https://www.youtube.com/watch?v=bsZq-BiKqfY   sources: https://twitter.com/mikko/status/1320061214647439360?lang=en https://therecord.media/hacker-directly-targets-patients-following-a-data-breach-at-a-finnish-mental-health-provider/ 2/4  https://www.politico.eu/article/cybercriminal-extorts-finnish-therapy-patients-in-shocking-attack-ransomware-blackmail-vastaamo/ https://hotforsecurity.bitdefender.com/blog/vastamo-hacker-says-he-doesnt-care-if-therapy-leaks-drive-patients-to-suicide-24408.html  https://www.avesnetsec.com/psychotherapy-ransom https://twitter.com/nulllzero?lang=en  

After a little Hiatus we are back!    Just a recap on central line complications when it comes to guidewire mishaps and cannulation issues.    Stay tuned for better content soon!    #trauma #centrallines #angio #criticalcare #icu #foamed #cath #angio   Please rate comment and subscribe!    Saud

How to optimise your CPR for the best outcomes possible with minimal stress.     

In this episode I wanted to talk about skill decay. The notion that taking a research year off, medical leave or something of that nature makes you worse at your job, and whether there is any evidence for it in the medical field. 

Just some thoughts on the article published in Journal of Vascular Surgery   https://www.jvascsurg.org/article/S0741-5214(19)32587-X/fulltext   and what it means to be a professional really.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769526/ https://pubmed.ncbi.nlm.nih.gov/31255853/ https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-017-0997-x   Redaction Below   https://twitter.com/JVascSurg/status/1286831352520888320    

I'll still use them but sometimes you get to wondering. 

How often do take the time to try and speak to families?    How much of an impact does it have?    Why aren't we good at it?    What are the best strategies for a family meeting?    Why is it important?

THIS IS NOT A PHARMACOLOGICAL DISCUSSION, THIS IS A STRATEGIC ONE.  Some thoughts on how , when and why we use them.   Please Like, Comment and Subscribe!  #vasopressors # ionotropes #icu #criticalcare # shocks 

Doctors and Oaths aren't new in medicine. But what does it really mean? What does it mean to you? Comment below   PLEASE LIKE COMMENT AND SUBSCRIBE !!!!

Second part of a live stream session for surgq8 an initiative of the American College of Surgeons Kuwait Chapter in Association with the Kuwait Association of Surgeons   PLEASE LIKE COMMENT AND SUBSCRIBE

First part of a live stream session for surgq8 an initiative of the American College of Surgeons Kuwait Chapter in Association with the Kuwait Association of Surgeons   PLEASE LIKE COMMENT AND SUBSCRIBE !!!!

A review of low velocity penetrating hand injuries. Mostly for fun. Summary: Short course of antibiotics. Tetanus yes. Rabies Rx very rarely Be aware of Killer Avocados.   PLEASE LIKE COMMENT AND SUBSCRIBE !!!! 

Its been a while and I promised I was gonna limit my covid 19 posts but I'm seeing alot of dangerous comments on social media lately.... so just my 2 cents. Let me know your thoughts.    PLEASE LIKE COMMENT AND SUBSCRIBE !!!! on the following media   Apple itunes store https://podcasts.apple.com/us/podcast/the-surge-surgery-trauma-critical-care/id1211210327   direct podcast link https://thesurge.podbean.com/feed.xml temporary website https://thesurge.podbean.com/ i nstagram TV https://www.instagram.com/saudn/channel/ Youtube https://www.youtube.com/channel/UCfAzB7NsOFtoBibYKDIcdWA and soon google play as well. They are free and although the quality is still sketch, I'm hoping to improve with your input. Fell free to suggest other topics.

  Fahad Al Saleh who is our chief resident in our local program and  Hind Al Otaibi who is one of our ENT residents who spends way too many nights covering call with us in the trauma program !  Real Life Neck Injury Case GUEST HOSTS @steato and @haifaalotb #trauma #criticalcare #icu #airway #neck #intubation #emergency #resusciation #foamed #meded  

My argument against neck zones in 2020 . Are they still relevant?  Also a review of some operative maneuvers and techniques for tracheal, laryngeal and vascular injuries from cases studies.         

It's rarely talked about and unfortunately the complications are devastating and the incidence is higher than you think .   #BCVI #TRAUMA #VASCULAR #ER

Part of a series of talks coortdinated for @surgq8.  A review for how to intubate in cases where the Trauma Component leads to challenging anatomy.  Als controversies in surgical airways in the ER    #foamed #meded #trauma #icu #surgery

I was just hoping to introduce some of the concepts that can help you predict which will declare themselves as stable and which will declare themselves unstable when it comes to partial responders. 

As requested by Squashboi89 on Reddit, here is an epsidoe with some clinical pearls, some not so clinical pearls and some do and don'ts.    Bottom line is that its a 5 year investment in a 25 year career.    #education #residency #internship #burnout

I received a request on itunes reviews for an episode on REBOA so here it goes!    How to use it, when to use and what the data is like.    #reboa #endovascular #trauma #criticalcare #resuscitation

So this is just a cap stone, run through of everything we talked about for the past couple of episodes.    If you have any other topic suggestions please do not hesitate thesurgepodcast(at)gmail.com

Again, I've been getting emails asking me about my thoughts on the subject.  I actually asked some of my colleagues about it as well and realised that theres some food for thought here and is extremely challenging.    ALSO AN APOLOGY, IN THE PREVIOUS EPISODE I SHOULD HAVE MADE IT MORE CLEAR THAT MENTAL HEALTH REQUIRES A MULTIDISCIPLINARY SUPPORT TEAM AND IS NOT MY PRIMARY SPECIALTY.  Also if you have any suggestions for other topics please reach out thesurgepodcast(at)gmail.com  

So social isolation, the stress of being in a hospital and the things that patietns see as a result of overcrowding are all part and parcel of the journey we are all going through world wide.    Just a short talk with some thoughts on how to start to help your patients stay happy and healthy mentally. 

I've received an email about how people can help without being frontliners or if they cant be.    One of the key things you can do to support front liners is not material; it's to be part of their mental support system. 

So with all of the issues with offsite ventilation of COVID-19 patients around the world, I've had requests from my surgical colleagues to do a trouble shooting talk on ventilators.    So here it goes....... 

So this WILL NOT BE a be and end all.  It's about the basics of what modes are, what to do where and what works where.  For now I'm recommending ARDSNET protocol if in doubt but it will or may change as our reality is we've never done this before so. 

Not a be all , end all summary, more so a run through of relevant parts for a non-gas jockey (I am one so it's okay) to be comfortable.    It literally starts with a drawing of an alveolus and gets to nitrogen content in 40 minutes.    #covid-19 #resuscitation #ventilator #ICU #criticalcare

Just a quick review of how to prepare legally and logistically for the realities of a pandemic. How do you safely comeback to work and volunteer? How do you coordinate your team to set up and write a legally binding document that makes sure that you can provide care with limited liability   #Corona #Covid-19 #ICU #Criticalcare #admin #administration #foamed #MEDED #emergencymedicine 

Completely (almost) non clinical episode, I feel kind of like we need a COVID-19 break and I received an email asking me why I kept referring to belt rankings.    In my mind there is a growing body of literature that myelin leads to speed of action and speed of thought. Also to Mylenate your brain you need to do drills, develop passion and practice. As a guy who has done a little judo and a little brazilian juijitsu I can tell you it's the same there.  The key difference is that although people identify belt ranks with a hierarchy they are actual more about masteryand so it's pretty similar to acute care.   

Just some thoughts and a summary on the ICU and critical care guidelines outthere.    #foamed #icu #criticalcare #resuscitation #covid19

Basics of  Hemodynamics Shock  Sepsis Why Swans can be a problem.  Vasopressor review.   #FOAMED #MEDED #COVID-19 #Hemodynamics #ICU #criticalcare #ER #resuscitation

So this is just a quick look at indications, strategies and considerations when needing to intubate.  This isn't how to manage oxygenation or ventilation. Just the basics of intubating for a white belt to become a blue belt.    #COVID-19 #FOAMED #MEDED #ICU #AIRWAY #ER #EMERGENCYMEDICINE #INTUBATION #RESUSCITATION

With everything going on in the world we will be handling patients on the ward that COVID-19 positive.    How do we do it?  How do we set up "safe" strategies to prevent cross infection and healthcare worker infection?  #FOAMED #COVID-19 #pandemic

So as of today there is as of yet no consensus guideline for handling operating rooms with COVID patients.  What follows is a smorgasbord of review articles, letters to the editor and practical points, to help prepare for that first COVID-19 case.    #FOAMED #COVID #TRAUMA #CRITICALCARE #ICU #EM #ER #COVID-19 #SURGERY #surgeon

So is there any evidence for doing journal clubs or m and ms?  Do you feel stressed out by them?  Stay tuned for this episode on how to set your self up to win and learn.    #foamed #grandrounds #communication

How to wear it?  When to Wear it?  What to Wear?  How to make people DO IT!!!!!!   (Requested on Reddit) #COVID-19 #Corona #ICU #PPE #FOAMED #MedED

Chest tube in the lung?  Chest tube in the liver?  I though it was a pneumothorax but now its draining blood!  How to deal with a diagnose misplaced chesttubes   #thoracics #trauma #chesttubes #emergencymedicine #surgery #anesthesia #thoracics #criticalcare #pneumothorax #hemothorax 

Or Child Abuse and Neglect.  How to spot it ? What causes it?  What you can do the ER?  What's next?  #pediatrics #trauma #pediatricsurgery #ICU #criticalcare #Scan #childabuse #childprotection  #emergencymedicine

When to do a CT brain?  Screening for Drowning and when they can be cleared for discharge?  Antibiotics?  #drowning #neardrowning #TBI #concussion #pediatrics #pediatricsurgery #ER #trauma #surgery #pedsemerg #emergencymedicine #criticalcare #concussion

So this was inspired by a tough day at work where a resident just genuinely didn't feel the need for documentation.  Short Journey from Hippocrates (who probably didn't write that oath) to modern drivers of documentation and AI.  You can blame him if it's too boring.  #Medicalhistory #history #documentation #hippocrates #foamed #meded

What is the most common missed injury?  Whats the most common cause of mortality?  Why are they so hard to intubate?    All of these questions and more. #trauma #ICU #SURGERY #ER #Resuscitation #PALS #injury #criticalcare #foamed #meded #pediatrics #pediatricsurgery

Continuing on the theme from the last two episodes we're looking at how ECLS can apply in pregnant patients.     

Ever wondered what to do with a pregnant GSW? Burn? MVC?  Risks?  Fetal Monitoring?    If it sounds overwhelming well tune in  #foamed #obstetrics #trauma #icu #surgery #orthopedics #ER #emergencymedicine #pregnancy #neontology

How to train people?  Should split the patient among attendings?  How make a temporary negative pressure isolation room and ward.  How to deal with the stress involved?  Preplanning.  Also don't forget to check out the emcrit podcast dedicated to covid19 airways  #cov-19 #COVID19 #corona #isolationrooms #infectioncontrol #FOAMED #MEDED #ICU #criticalcare

Just a brief review of the literature.  Key Questions.  What populations? What are the risks? Heparin ?  #trauma #ECMO #surgery #CRITICALcare #ICU #MEDED #FOAMED #Emergencymedicine #ECLS