Podcast appearances and mentions of andrew petrosoniak

Ever wondered if we should have tested the new hospital space before moving in? Thinking that new piece of equipment won't work for your current workflow? Want to implement a new checklist but not sure if it will work?    In this episode Vic and Ben speak with Andrew Petrosoniak and Christopher Hicks from Advanced Performance. Chris and Petro are both emergency physicians who have built an impressive repertoire of using simulation to explore and improve performance of team, systems and spaces in healthcare.    Our conversation is wide ranging, offering perspectives on why this use of simulation is still relatively limited, as well as how the processes for this technique are evolving.  We talked about design thinking and simulation, the use of framework analysis, the Macleamy curve, and the concepts of ROI for this work.    Ben shared his favourite book on design principles. We referred to some other excellent podcasts including Paul Phrampus talking about connecting with hospital executives on One Million Lives, and our own episode of Simulcast discussing Nora Colman's paper saving $90 million testing a hospital before it was built.    Lots more on the Advanced Performance website.    Happy listening    

In this month's EM Quick Hits podcast: Zafar Qasim & Andrew Petrosoniak on whole blood transfusion in trauma, Justin Morgenstern on calcium pre-treatment to prevent diltiazem-induced hypotension, Kiran Rikhraj on dynamic LV outflow tract obstruction, Anand Swaminathan on resuscitative thoracotomy, Andrew Tagg on uterine casts, and Jesse McLaren on scale & proportionality in occlusion MI ECG interpretation. **Please support EM Cases to continue to be free open access by making a donation: https://emergencymedicinecases.com/donation/

In today's episode of Ditch the Lab Coat, we dive into the raw, real-world chaos of trauma that unfolds beyond the controlled environment of a hospital. Dr. Mark Bonta is joined by Dr. Andrew Petrosoniak, a trauma director and emergency medicine expert who specializes in designing effective healthcare systems, to explore the unpredictable nature of street-level emergencies.Throughout the episode, the duo unpacks the reality of responding to accidents in real-world settings, where medical tools are limited and the stakes are high. From discussing the importance of overcoming the bystander effect to the critical role of tourniquets in stopping a traumatic bleed, Dr. Petrosoniak shares actionable insights that go beyond traditional medical scenarios.Dr. Petrosoniak reflects on his experience with high-stress situations, emphasizing the power of a calm presence and strategic communication to provide reassurance until professional help arrives. The conversation highlights how anyone, not just medical professionals, can make a significant difference during emergencies through basic actions like calling for help and offering reassurance.Listeners are encouraged to rethink what being prepared means, urging them to consider keeping essential items like a tourniquet, defibrillator, and first aid kit nearby. This episode serves as a poignant reminder that life-saving efforts often start not in the ER but at the scene of an accident, where immediacy, intuition, and courage can have the most profound impact.Join Dr. Bonta and Dr. Petrosoniak as they explore the instinctual side of emergency response, sharing both practical advice and engaging anecdotes from the frontline of trauma care.Episode HighlightsApplying Tourniquets Properly Apply a tourniquet tightly enough to stop bleeding below the site. This is crucial in emergencies to prevent excessive blood loss.Understanding Trauma's Reality Trauma doesn't happen in a controlled environment. Real-life situations require quick thinking and improvisation with limited resources.Importance of the Bystander Effect Overcome the bystander effect by taking charge in emergency situations. Your presence and action can make a significant difference.Street-Level Medical Preparedness Real-life medical emergencies demand an understanding of how to act without hospital tools – a phone call and support can be vital.Interpreting Blood Loss Know signs of severe blood loss—confusion and cold extremities—rather than estimating based on visible blood alone.Role of First Responders Sometimes non-medical professionals, like St. John Ambulance volunteers, are better prepared for emergencies due to their specific training.Communication in Crisis In emergencies, communicate clearly, outlining the plan to provide comfort, rather than giving false assurances of safety.Understanding Electrical Injuries High-voltage injuries are extremely dangerous. Never approach if there's a risk of being electrocuted. Safety should be our top priority.Value of Proper Equipment Keeping simple equipment like a tourniquet and blanket in your car can be life-saving during an unforeseen emergency.Preparedness Beyond Hospitals Being prepared for emergencies means more than medical skills. It's about readiness to act and show compassion, no matter where you are.Episode Timestamps04:44 — Thrill-seeking risks and physiological reactions08:12 — Managing stress and preparedness in emergencies11:54 — Immobilization advice after falls15:55 — Survival odds after high falls18:20 — Crisis communication in prehospital care22:35 — Ski injury first-aid and bystander concerns26:09 — Tourniquet use: prioritize stopping bleeding27:01 — Emergency situational awareness tips31:29 — Assessing blood loss in hospital settings33:31 — Understanding the impact of blood loss36:38 — Electrocution safety and response challenges39:56 — “Mark's Power Room Dilemma”43:58 — Simplifying trauma response protocols45:48 — Compassion in crisis: the human side of trauma careDISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization a

On this month's EM Quick Hits podcast: Stephen Freedman on pediatric bloody diarrhea, S-TEC and hemolytic uremic syndrome, Justin Morgenstern on the evidence for IM epinephrine in out of hospital cardiac arrest, Matthew McArther on recognition and ED management of dengue fever, Andrew Petrosoniak on imaging decision making in trauma in older patients, Brit Long & Michael Gotlieb on recognition and management of TTP...Please consider a donation to EM Cases to help ensure continued Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

In this episode, recorded at Tactical Trauma 2024, Andrew Petrosoniak discusses real-world experiences in trauma care, and the innovative use of simulation to resolve systematic issues in blood delivery and overall trauma resuscitation protocols. Key takeaways include the concept of intelligent failure, reducing cognitive overload for medical staff, and the creation of efficient medical environments. Moreover, the episode delves into the significant improvements achieved through simulation, such as a 50% reduction in blood delivery times, and the integration of performance data to enhance CPR and clinical space design. Emphasizing the importance of using data to drive improvements, the conversation explores the implementation of roles like a CPR coach and the scalable application of these practices across individual, team, and systemic levels. Listeners are encouraged to view failures constructively and leverage simulations and data for better patient outcomes and team performance. 00:00 Introduction to Simulation in Emergency Medicine 01:05 A Real-Life Trauma Case 02:18 Identifying Systemic Issues 02:46 Implementing and Testing Solutions 05:45 The Concept of Intelligent Failure 09:41 Scaling and Impact of Simulation 10:22 The Power of Simulation in Experimentation 10:56 Data Integration in Healthcare and Sports 11:29 Evaluating CPR Quality Through Simulation 12:14 Using Data to Improve Clinical Performance 13:47 Designing Clinical Spaces with Simulation Data 15:28 Scaling Impact with Simulation 18:02 Efficient Team Communication in Trauma Bays 19:04 Broadcasting and Recording Simulations for Education 19:39 Conclusion and Future Directions The Speaker Dr. Andrew Petrosoniak is an emergency physician and trauma team leader at St. Michael's Hospital and an Assistant Professor in the Department of Medicine at the University of Toronto. He has completed a Master of Science in medical education where he focused on the use of in situ simulation (practice in the actual workplace) in procedural skill acquisition. Andrew's field of research includes in situ simulation and simulation-based technical skill acquisition. His work focuses on usability testing and the identification of personnel- and systems-based safety threats within acute care medicine. He is the principal investigator of the TRUST study (Trauma Resuscitation Using in Situ simulation for Team Training) that includes a partnership with human factors experts to evaluate systems and processes during high-stakes trauma simulations.

On this month's EM Quick Hits podcast: Kevin Wasko on post-tonsillectomy hemorrhage management, Brit Long on assessment and management of post-CABG surgical incision infections, Anand Swaminathan on evidence, pitfalls and tips on using Bougies, Leah Flannigan on when to suspect vascular injury in patients with low energy mechanism pelvic fractures, Andrew Petrosoniak on debriefing after cases: why, when and how... Do you learn a lot from EM Cases? Please consider a donation to ensure EM Cases continues to provide you high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

In this month's EM Quick Hits podcast: Andrew Petrosoniak on the role of vasopressors in the hemorrhaging trauma patient, Megan Landes on providing HIV PEP and PrEP in the ED, Justin Morgenstern & George Kovacs on the PREOXI trial and evidence for pre-oxygenation with NIPPV before intubation in RSI, Brit Long on recognition and management of blast crisis in the ED, and Leah Flanagan & Liam Loughrey on the rise of nitrous oxide toxicity...

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.   >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.       Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome to *Ditch the Lab Coat*, the podcast where we dive deep into the intricacies of healthcare design and innovation. I'm your host, Dr. Mark Bonta, and in today's episode, we're joined by two remarkable guests, Dr. Chris Hicks and Dr. Andrew Petrosoniak, esteemed emergency physicians and trauma team leaders who are reshaping the landscape of trauma care. Our conversation revolves around the critical lack of user-focused design in healthcare environments and the innovative steps Chris and Andrew have taken to address this issue, particularly in building an optimized trauma bay. We'll uncover how thoughtful design, focusing on human factors and ergonomics, can dramatically improve efficiency and patient outcomes. Listen in as we delve into the use of simulation to understand and enhance current medical practices, the complexities of team dynamics, and the invaluable lessons learned from other high-stakes industries like Formula One racing.This episode is packed with insights on leadership, communication, and the importance of feedback in medical training. Dr. Hicks and Dr. Petrosoniak will share their experiences and discuss the life-saving impact of a well-coordinated trauma team. Whether you're a healthcare professional, a design enthusiast, or simply curious about the behind-the-scenes action in emergency medicine, you won't want to miss this enlightening discussion.Stay tuned as we explore the fascinating interplay between space design, teamwork, and trauma care, and be inspired to rethink how we can improve both our work and personal environments through better design.TIMESTAMPS : 00:00 Doctor Petroniak integrates user-focused design, clinical expertise.05:21 Two emergency physicians explain their overlapping roles.08:34 Passion for trauma care drives my career.11:11 Bad mechanism can result in major injuries.13:53 Medical professionals use stickers for role identification.17:22 Technicians provide hands-on expertise, create shared mental models.22:56 Challenges of trauma resuscitation and team dynamics.24:36 Maintaining situational awareness crucial in medical settings.27:00 Continuous improvement through feedback and reflection is key.30:21 Healthcare industry lacks awareness of human factors.35:34 Medical education teaches problem-solving for known issues.39:50 Believe in the process and accept outcomes.42:16 Training and environment impact performance of teams.44:49 Addressing lack of user-focused clinical design.47:24 Stressful situations caused by lack of equipment.52:54 Importance of trauma response in healthcare emphasized.54:10 Improving access to fruits and vegetables, inspiring.

Olivia Ostrow on the management of button battery ingestions, Brit Long on C difficile infection, Jesse McLaren on an approach to ECG's in the tox patient, Joe Mullally on the identification and treatment of bed bug bites, Andrew Petrosoniak on fibrinogen replacement in bleeding trauma patients, Justin Morganstern on Cold Air for Croup... The post EM Quick Hits 54 Button Battery Ingestion, C. difficile, ECG in Tox, Bed Bugs, Fibrinogen in Trauma, Cold Air for Croup appeared first on Emergency Medicine Cases.

On this month's EM Quick Hits podcast: Anand Swaminathan on the role of methylene blue in septic shock, Nour Khatib on jaw dislocation reduction techniques, Hans Rosenberg on a phenotypic approach to Crohn's disease emergencies, Gil Yehudaiff on evidence based analgesics in renal colic, Brit Long on the importance of inhaled steroids for asthma, and Andrew Petrosoniak on the "lethal diamond" in polytrauma patients and the current state of hypocalcemia in bleeding trauma patients... The post EM Quick Hits 51 – Methylene Blue in Septic Shock, TMJ Dislocation, Crohn's Disease, Analgesia for Renal Colic, Inhaled Steroids for Asthma, Hypocalcemia in Bleeding Trauma Patients appeared first on Emergency Medicine Cases.

On this month's EM Quick HIts podcast: Anand Swaminathan on EVT for large vessel occlusion strokes, Sarah Reid on picking up intussusception, Andrew Petrosoniak on 5 Penetrating Trauma Tips, Peter Toth on using a slit lamp to manage skin foreign body hack, Nour Khatib and Jonathan Wallace on CT Radiation Risk and Matt Poyner on setting up an emergency fund... The post EM Quick Hits 49 Stroke Management Update, Intussusception, 5 Penetrating Trauma Tips, Skin Foreign Body Hack, CT Radiation Risk, Emergency Fund appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast: Justin Hensley and Aaron Billin on Wilderness Medicine, Elisha Targonsky on Bowel Prep Hyponatremia, Brit Long on Non-Convulsive Status Epilepticus, Andrew Petrosoniak on Morel Lavallee Lesions, Jesse McLaren on Pacemaker ECGs and Matt Poyner on paying off loans vs investing... The post EM Quick Hits 46 – Wilderness Medicine, Bowel Prep Hyponatremia, Non-Convulsive Status Epilepticus, Morel Lavallee Lesions, Pacemaker ECGs, Loans vs Investing appeared first on Emergency Medicine Cases.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast, Brit Long, MD (@long_brit) interviews Andrew Petrosoniak, MD, MSc, FRCPCP @petrosoniak) on decision making in emergency medicine.Andrew is a world-renowned leader in decision making and trauma. He is currently an EM attending physician, assistant professor at St. Michael's Hospital, University of Toronto.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

Dr. Andrew Petrosoniak on design thinking in emergency medicine, the power of systems in uncertainty, the value of holding the problem space and much more.

Dr. Petrosoniak is an emergency physician and trauma team leader at St. Michael's Hospital. He's the inaugural lead for translational simulation at Unity Health Toronto. He's an assistant professor at the University of Toronto where his research work focuses on 1) using in situ simulation to improve systems and design and 2) optimizing the care of bleeding patients. He's also co-principal of Advanced Performance Healthcare Design, a design and consulting firm that uses simulation to inform enhance high stakes decision making.

In this EM Quick Hits podcast: Salim Rezaie on venous thromboembolism recurrence in subsegmental pulmonary embolism, Andrew Petrosoniak on pain management in the polytrauma, Nour Khatib on a rural EM case on management of near-drowning patient, Sara Reid delivers a polio primer, Anand Swaminathan on head-up CPR... The post EM Quick Hits 42 – Subsegmental PE, Trauma Analgesia, Near-Drowning, Polio, Head-up CPR appeared first on Emergency Medicine Cases.

Al'ai Alvarez, MD aka LA is a national leader and educator on Wellness and Diversity, Equity, and Inclusion. He is a clinical assistant professor of Emergency Medicine and the Director of Well-Being at Stanford Emergency Medicine. He co-leads the Human Potential Team and serves as the Fellowship Director of the Stanford EM Physician Wellness, and Co-Chair of the Stanford WellMD's Physician Wellness Forum. His work focuses on humanizing physician roles as individuals and teams through the harnessing of our individual human potential in the context of high-performance teams. This includes optimizing the interdependence between Process Improvement (Quality and Clinical Operations), Recruitment (Diversity), and Well-being (Inclusion). Currently, he is one of the 2021-2022 Faculty Fellows at the Stanford Byers Center for Biodesign.  Andrew Petrosoniak MD is a trauma team leader and emergency physician at St. Michael's Hospital in Toronto, Canada. He's an assistant professor at the University of Toronto and he leads the translational simulation program at St. Michael's Hospital. His research focuses on the use of in situ simulation and design thinking to support human-centered care. He's also co-principal at Advanced Performance Healthcare Design, a firm that consults with hospitals, start ups and high stake industries using simulation to improve decision making and inform the design of systems, spaces and teams. White paper on simulation informed design. In 2004, Patrick MacLeamy drew a set of curves based on a pretty self-evident observation: an architectural project becomes more difficult to change the more developed it becomes. For this earth-shattering revelation MacLeamy named the curve after himself (although the title should probably go to Boyd Paulson who drew the curve much earlier [see Noel's comment to this post]). You have probably seen the graph before. It gets trotted out in every slide deck promoting BIM / IPD / or early-stage environmental analysis.  The key point is that architects expel their effort at a time when design changes are relatively costly. MacLeamy and his disciples advocate shifting design effort forward in the project, front loading it, in order to reduce the cost of design changes.

In this month's EM Quick Hits podcast: Brit Long on Surving Sepsis Campaign -2021 Updates, Nour Khatib on rural medicine case - angle closure glaucoma, Reuben Strayer on bougie vs endotracheal tube and stylet on first-attempt intubation, Justin Hensley on management of frostbite, Sarah Foohey on the hot and altered patient, and Andrew Petrosoniak on central cord syndrome... The post EM Quick Hits 36 – Surviving Sepsis, Angle Closure Glaucoma, Bougies, Frostbite, Hot/Altered Patient, Central Cord Syndrome appeared first on Emergency Medicine Cases.

We've all experienced the frustration of working in clinical environments that just don't seem to be set up intuitively. But what if there were ways to improve the design of the places and processes where clinicians practice? In this episode, we spoke with Dr. Andrew Petrosoniak and Dr. Chris Hicks, both ER docs at St. Mike's Hospital in downtown Toronto. They have done extensive work on human-centred design, particularly in the emergency department, and have done amazing work redesigning the St. Mike's trauma bay and many other areas in the ED. Check out links in the shownotes to see pictures of their newly redesigned trauma bay, and also check out their website advancedperformance.ca. Links: 1. Breaking the Shackles of Poor Design: https://emcrit.org/emcrit/breaking-the-shackles-of-bad-clinical-design/ 2. Trauma Resuscitation Using in situ Simulation Team Training (TRUST) study: latent safety threat evaluation using framework analysis and video review. https://pubmed.ncbi.nlm.nih.gov/33097610/ 3. Design Thinking-Informed Simulation: An Innovative Framework to Test, Evaluate, and Modify New Clinical Infrastructure. https://pubmed.ncbi.nlm.nih.gov/32039946/ 4. The Human Factor: Optimizing Trauma Team Performance in Dynamic Clinical Environments. https://pubmed.ncbi.nlm.nih.gov/29132571/

In this month's EM Quick Hits podcast: Arun Sayal on the nuances of assessment for scaphoid fractures, Justin Morgenstern on the evidence for therapeutic hypothermia post-arrest and the TTM2 trial, Sarah Reid on HEADS-ED mental health screening tool for children, youth and young adults, Andrew Petrosoniak on pelvic trauma and pelvic binder tips and pitfalls, Michelle Klaiman on what we need to know about Kratom and Anand Swaminathan on why femoral lines are often a great central line choice... The post EM Quick Hits 30 Scaphoid Fracture, Therapeutic Hypothermia, HEADS-ED, Pelvic Trauma, Kratom, Femoral Lines appeared first on Emergency Medicine Cases.

Effective resuscitation begins BEFORE the primary survey, with a deliberate appraisal of self, team and environmental resources and limitations.  The Zero Point Survey describes an organized approach to setting the stage, even in the most complex clinical situations.  Hicks and Petro help you set up for success.

Dr. Jeannie Callum, Dr. Andrew Petrosoniak and Dr. Barbara Haas join Anton in answering the questions: How do you decide when to activate the MHP? How do you know when it is safe to terminate the MHP? What lab tests need to be done, how often, and how should the results be shared with the clinical team? Once the dust settles, what do we need to tell the patient and/or their family about the consequences of being massively transfused? What should be the lab resuscitation targets? Why is serum calcium important to draw in the ED for the patient who is exsanguinating? How do we mitigate the risk of hypothermia? What can hospitals do to mitigate blood wastage? If someone is on anti-platelets or anticoagulants what is the best strategy to ensure the docs in the ED know what to give and how much? Until the results of lab testing come back and hemorrhage pace is slowed, what ratio of plasma to RBCs should we target? What's better, 1:1:1 or 2:1:1? Should we ever consider using Recombinant Factor 7a? If the fibrinogen is low, what is the optimal product and threshold for replacement? When and how much TXA? Anyone you wouldn’t give it to? and many more... The post Ep 152 The 7 Ts of Massive Hemorrhage Protocols appeared first on Emergency Medicine Cases.

Design thinking, a human-centered design method, represents a potent framework to support the planning, testing, and evaluation of new processes or programs in healthcare. As opposed to traditional education needs assessment, design thinking takes the next step (beyond the impact on learning) to explore, diagnose, and test how new interventions will impact actual patient care and workflow. Andrew Petrosoniak, Chris Hicks, and Kari White from St. Michael's Hospital in Toronto will discuss how their team used design thinking to open a new emergency department. They employed end-user engagement and feedback to brainstorm and implement effective solutions to problems encountered before opening. The iterative steps and targeted use of simulation resulted in better designed departmental processes and actual clinical space while mitigating safety threats and departmental deficiencies. Design thinking, coupled with simulation, can be applied to current healthcare system challenges such as COVID-19. This session builds on this team's recent publication in Simulation in Healthcare to achieve the following objectives: Contrast traditional educational needs assessment with design thinking “customer empathy” Apply the steps of design thinking to create simulation interventions that best meet “end-user” needs Describe “use cases” of high impact design thinking-informed simulation education and quality and safety interventions

In this month's EM Quick Hits podcast, Anand Swaminathan on postpartum hemorrhage, Justin Morgenstern on phenobarbital in pediatric status epilepticus, Michelle Klaiman on managed alcohol programs, Andrew Petrosoniak on traumatic cardiac arrest, Brit Long on cholangitis pearls and pitfalls and Bourke Tillman on ED approach to ARDS... The post EM Quick Hits 22 Postpartum Hemorrhage, Phenobarbital in Status Epilepticus, Managed Alcohol Programs, Traumatic Cardiac Arrest, Cholangitis, ED Approach to ARDS appeared first on Emergency Medicine Cases.

Anand Swaminathan on oxygenation strategies for COVID-19 learned from the New York experience, Andrew Petrosoniak on trauma care modifications in the COVID-19 era, Michelle Klaiman on addiction medicine considerations, Brit Long & Michael Gottlieb on cardiac complications of COVID-19 and Leeor Sommer on physician compassion and preserving patients' humanity... The post EM Quick Hits 16 COVID-19 Oxygenation Strategies, Trauma Care, Addictions Considerations, Cardiovascular Complications and Compassionate Care appeared first on Emergency Medicine Cases.

In this EM Quick Hits podcast we have Emily Austin on physostigmine for anticholinergic toxidrome, Walter Himmel on understanding nystagmus to differentiate central vs peripheral causes of vertigo, Rob Devins on the role of transesophageal echocardiogram in cardiac arrest, Jesse MacLaren on nuances in inferior MI ECG changes and aVL, Andrew Petrosoniak on a practical approach to blunt cerebrovascular injury and Reuben Strayer on choicebo... The post EM Quick Hits 11 Blunt Cerebrovascular Injury, Physostigmine, TEE in Cardiac Arrest, Understanding Nystagmus, Subtle Inferior MI, Choicebo appeared first on Emergency Medicine Cases.

Justin Morgenstern on the lack of evidence for burn debridement, Jesse MacLaren on ECG Cases - missed ischemia and pitfalls of "normal" computer ECG interpretations, Arun Sayal on clinical diagnosis pitfalls of compartment syndrome, Sarah Reid on pediatric asthma pitfalls and myths, Andrew Petrosoniak on T-spine and L-spine fracture work-up, Michelle Klaiman & Taryn Lloyd on motivational interviewing part 2... The post EM Quick Hits 9 Burn Blister Debridement, ECG Cases, Compartment Syndrome, Pediatric Asthma, Spinal Trauma, Motivational Interviewing P2 appeared first on Emergency Medicine Cases.

“Re-sequence your approach based on physiologic priorities” -Petro“Customize, then optimize” -ChrisATLS provides a useful and structured approach to the patient with multiple injuries. However, strict adherence to the ABCDE script can cause harm in certain circumstances. In this talk, Chris and Petro discuss how to customize resuscitation based on physiologic priorities. (18:36)

In this EM Quick Hits episode: Andrew Petrosoniak on diagnosis and risk stratification of blunt cardiac trauma, Clare Atzema on latest guidelines for anticoagulation in atrial fibrillation, Maria Ivankovic on hydromorphone vs morphine for acute pain, Brit Long on clinical pearls in the diagnosis of myasthenia gravis, Anand Swaminathan on venous access tips and tricks, and bonus material from EM Cases Course June 2018 with Walter Himmel and Barbara Tatham on Physician Compassion and tools to prevent burnout... The post EM Quick Hits 6 Blunt Cardiac Trauma, Atrial Fibrillation Anticoagulation, Hydromorphone vs Morphine, Myasthenia Gravis, Venous Access appeared first on Emergency Medicine Cases.

Andrew Petrosoniak and Patricia Trbovich: Resuscitation Economics “We are predictably irrational” -Patricia Nudging behaviour. Friction. Opportunity cost. Resuscitation by definition requires making choices and working with finite resources. Petro teams up with human factors engineer Patricia Trbovich to describe how principles of behavioural economics can be used to improve patient safety and resuscitation efficiency. (20:40) More info on TRUST: https://bit.ly/2VJT0MP 

In this Quick Hits Podcast: David Juurlink on acetaminophen and warfarin drug interaction, Hans Rosenberg on management of dental infections, Emily Austin on dialysis in massive acetaminophen overdose, Andrew Petrosoniak on MTP decisions and the RABT score in trauma , Joel Yaphe on statins for STEMI from Whistler's Update in EM Conference, and George Kovacs on how to maximize success of a cricothyrotomy from EM Cases Course 2019... The post EM Quick Hits 4 Acetaminophen Overdose & Warfarin Interaction, Dental Infections, MTP RABT Score, Statins for STEMI, Cricothyrotomy Tips appeared first on Emergency Medicine Cases.

On this EM Quick Hits podcast we have Emily Austin on organophosphate poisoning, Arun Sayal on malrotation of metacarpal fractures, Andrew Petrosoniak on pitfalls in abdominal stab wound management, Anand Swaminathan on tranexamic acid for non-massive hemoptysis, and Natalie May on pediatric IV cannulation tips and tricks... The post EM Quick Hits 2 Organophosphate Poisoning, TXA for Hemoptysis, Metacarpal Fracture Rotation, Abdominal Stab Wounds, Pediatric IV Cannulation appeared first on Emergency Medicine Cases.

EM Quick Hits is a brand new EM Cases podcast that contains 5 minute segments chosen from 10 specific topics by 10 different experts and educators. These topics are ones that either are not taught very well in training and/or that physicians tend to be not completely comfortable with. They include toxicology, trauma, ophthalmology, orthopaedics, resuscitation, human factors, addiction and pediatric emergencies. The EM Quick Hits Team is: Emily Austin, Peter Brindley, Chris Hicks, Michelle Klaiman, Anna MacDonald, Natalie May, Justin Morgenstern, Andrew Petrosoniak, Hans Rosenberg, Arun Sayal and Anand Swaminathan... The post EM Quick Hits 1 Massive PE, Gabapentin for Alcohol Withdrawal, Dental Avulsions, Pediatric Eye Exam, Best Resuscitation Fluid appeared first on Emergency Medicine Cases.

In anticipation of EM Cases Episode 118 Trauma: The First and Last 15 minutes with Andrew Petrosoniak, Kylie Bosman and Chris Hicks we have Joe Nemeth, Trauma Fellowship Director at Montreal General and Associate Professor at both McGill University and University of Toronto discussing his Best Case Ever of a teenager who was "stabbed in the box". Rajiv and Joe discuss preparation for trauma, the role of POCUS in predicting survival in traumatic cardiac arrest, the HOTT mnemonic for reversible causes of trauma arrest and more... The post BCE 78 Traumatic Cardiac Arrest appeared first on Emergency Medicine Cases.

Today, your host Ellen Gardner, Communications and Marketing at HIROC, speaks with Dr. Andrew Petrosoniak, Emergency Physician and Trauma Team Leader at St. Michael’s Hospital. When people come into emergency it’s often the worst day of their lives. For emergency physician and trauma team leader Dr. Andrew Petrosoniak, that’s what makes trauma care interesting and rewarding. He energizes teams and has built an international reputation around the value of in situ simulation as a quality improvement tool. Watching how people perform their jobs in the real work space and getting feedback enables Petrosoniak and his team to identify the latent safety threats and make changes before the patient ever arrives.     Key Takeaways: [1:26] What drew Andrew to emergency medicine [4:00] The factors that go into high-level team performance [6:06] How working in New Zealand opened Andrew’s eyes to the value of simulation in improving systems and processes, beyond just being an educational tool [10:50] Coping with resistance to simulation [11:07] How to build support for simulation [13:01] Using simulation to tackle one of the big challenges in trauma care – the massive transfusion protocol [18:21] Why simulation is more effective than the classroom for teaching hands-on, technical skills [20:41] The financial benefits of simulation [23:08] How Andrew and the team are using the principles of design thinking to solicit feedback, understand what people need, build prototypes, and test new physical spaces at St. Mikes. [25:50] If you can make the healthcare space work better for you, that impacts how patient care is delivered. [27:20] Why Andrew is a big believer in including the perspectives of everyone who is part of the process.   Mentioned in this Episode: St. Michael’s Hospital Design Thinking PDSA Cycle   Listen to more interviews with Healthcare Leaders at HIROC.com Follow us on Twitter, and listen on iTunes and Google Play Music. Email us at Communications@HIROC.com.

This edition of the Emergency Medicine Clinics podcast features discussion on the February 2018 issue on Damage Control: Advances in Trauma Resuscitation. Guest editors, Drs. Christopher Hicks and Andrew Petrosoniak, dissect the articles and offer key points and issue highlights.

Chris Hicks is @HumanFact0rz He is into Human Factors. He is reading about Human Factors. He is writing about Human Factors. He is on stage, he is on EMCrit, he is on fire. But it’s a smouldering kind of fire, a nice fire, not a raging forest fire. A raging forest fire would be a better metaphor for what drove Chris into Human Factors; a bunch of over heated but talented egos coming together, with the all the poise of a conflagration, in a trauma bay. I met Chris first in Dublin, with a bunch of other erudite, humorous and well grounded Canadians. There does seem to be a rich vein of talent up there. What’s happening in Canada? Is it all as good as it looks from afar? Or does Justin Trudeau just look handsome and apologise a lot? Maybe its just the contrast to that orange person to the south that some people call Mr President? Either way I keep meeting charming gifted Canadians. So that bit is good. The orange guy is a worry. In an effort to improve those trauma bay infernos Chris and his chum Andrew Petrosoniak have recently edited/curated a special EMClinics of North America. It is a trauma special and being Chris, you know the Human Factors stuff will be good. That’s just the start of it too. He has people from all over the place in there. Amal Mattu, George Kovaks, Katrin Hruska, Brian Burns, Paul Engels, Karim Brohi and Captain America. That’s a lot of FOAMed types and a few superheroes too. Some of the EMClinics chapters will available for free until the end of December 2017. You can get free PDF’s from https://www.sciencedirect.com/science/journal/07338627 I reckon we should all download it. If the EMClinics of North America that was free for a while gets double or triple the downloads that it normally achieves then the publishers would surely sit up and take notice. That might cause a little disruption. Chris is good at that disruptive stuff. It is worth remembering that all this #FOAMed stuff is not necessarily safe from harm. If we lost a few major protagonists for whatever reason then how would FOAMed change? It is all happening because a relatively small number of people put a relatively huge amount of effort in. I don’t think we can get complacent. We certainly have not achieved universally free medical education have we? #FOAMed is great but conventional medical education is not getting any cheaper. Meanwhile if you’re reading this on Lifeinthefastlane, Intensive Care Network or TheTopEnd.org you’ll hopefully appreciate that you couldn’t possibly get any thing any cheaper. F is for Free. House keeping; the CVC Checklist guy I couldn’t remember was Peter Pronovost from John Hopkins. More housekeeping; the tunes are provided by Mood Ruff, a Hip Hop crew from Winnipeg. You can find them on iTunes but you won’t find that track, No Hooks. (12 inch vinyl from 1989.) You can get more Hicks at EMCrit.org and @HumanFact0rz on twitter. You can get more Jellybeans on iTunes and Stitcher Radio. (Links Below) You can find collections on www.lifeinthefastlane.com and www.IntensiveCareNetwork.com Special interest playlists (emergency, pre-hospital, intensive care etc) are put together on www.soundcloud.com/TheTopEnd and they all live happily together at www.TheTopEnd.org

Resuscitation of the critically ill trauma patient involves a myriad of high-stakes, time-sensitive management decisions. The landscape is shifting rapidly: new evidence on hemostatic resuscitation and component therapy in hemorrhagic shock, peri-arrest point-of-care ultrasound, novel approaches to resuscitative thoracotomy and trauma RSI have at once clarified and muddied the waters. In this rapid-fire, case-based session, Petro and Hicks will debate some of the recent and potentially practice changing literature to assist with key inflection points in the care of the sickest -- and sometimes deadest -- trauma patients, and engage in some trauma dogmalysis in the process.

Be open and honest with the team about the true objectives you are trying to achieve. When these are focused on doing better for the patient, people will join the ride. Case: You’ve been running fortnightly scenarios in the nearby simulation centre. These are part of the resident training program and from time to time may get a nurse or two along depending on how busy the department is. While well evaluated, you see the residents go back to the shop floor and struggle to apply any of the lessons that the group agreed had been take homes from the previous sim session. They can’t find equipment, struggle to coordinate the multidisciplinary team and seem much slower to achieve critical actions in the real resus. You approach the Department director and the nurse manager and suggest starting to conduct one of the sim sessions in the department in a real resus bay once a month. This is met with resistance, “we’re too busy theirs not enough staff or time”, “the staff have done mock codes before, they really disrupt things and they hated them”. You go back to your office and try to come up with how you will make this happen. Welcome to Episode 5 of Simulcast. In this episode we discussed how moving some simulation efforts out of the lab and into the workplace can yield big benefits and get some tips on how to drive change management and make a sustainable in situ simulation program. Our guest for episode 5 was Andrew Petrosoniak, an emergency physician and trauma team leader at St. Michael’s Hospital, and Assistant Professor in the Department of Medicine at the University of Toronto. Petro has a strong grounding in the sim lab, but is a vocal advocate for point of care or in-situ simulation. Petro is the taller, better looking, and all round more refined co-lead on TRUST, an in-situ simulation-based study examining design ergonomics, human factors and latent safety threats in trauma resuscitation. Petro and his colleagues have also recently published a great article on in situ sim in Emergency Medicine Australasia. Through this episode we give a brief overview of in situ simulation, what can you get out of it that isn’t possible in the lab and how would you assess the functional alignment of in situ versus sim lab. We also look at some functional domains that can help better understand objectives for in situ sim. We picked Petro’s brain about the TRUST study and try to answer the big question – how hard has the change management process been in bringing sim out of the lab and into the department? More resources: Spurr, Gatward, Joshi and Carley EMJ Article –Top 10 (+1) tips to get started with in situ simulation in emergency and critical care departments - http://emj.bmj.com/content/early/2016/03/11/emermed-2015-204845.full.pdf A process tracking video from TRUST simulation - https://www.youtube.com/watch?v=itLtqAAwe_w&feature=youtu.be