POPULARITY
SMACC Chicago Q & A session on Funky Physiology with Mybourgh, Saxona, Hensley and Perner.
Andy Naidech gives a fascinating and powerful short talk on controversies in management of aneurysmal subarachnoid haemorrhage, followed by discussion from the panel of experts and questions from the crowd. This was recorded at the neuro workshop for SMACC Chicago and was a very popular session.
Simon Carley has us asking ourselves some confronting questions about our abilities in his SMACC Chicago talk ‘Are You as Good as You Think?’. Carley has us delve into our confidence, competencies and whats makes for a good self learning environment. Initially Carley asks how good we think we are at driving? He then sites studies of Australian and European driver responses stating that 93% of Aussies and 69% europeans rate themselves as above average drivers. In using the example Carley suggests as individuals we are not particularly good at rating ourselves, while inexperienced people tend to rate themselves more highly then experienced people, calling this illusory superiority cognitive bias. Carley asked the question since you can’t have awesome without average, how do we measure ourselves?. He then talks us through the following tools and processes to establish better self learning and teaching processes; Reflection Diaries - revisit it (clinically and physically), follow up. Peer reviews: 1:1 feedback doesn’t work. It needs to planned with clear goals and objectives such as; Clarify expectations review logistics focus lens plan feedback observe event (i.e teaching) debrief and action Clinical Feedback Follow up - not just the exceptionally sick patients, but follow up with the routine ones. Build Peer Reviews into your practice. Carley finishes by asking us to choose on of the following items and commit to ourselves to making it happen within the month. I am going to … Organise Trainee Feedback Focused 360 Assessment Keep a Patient/Teaching Diary Be Peer Reviewed Reflect Develop Team Feedback Follow up with Patients Something Else Nothing I am already Awesome! What have you committed too?
Cliff Reid unites our passion of Critical Care in his SMACC Chicago talk Advice to Young Resuscitationist - It’s up to us to Save the World. Talking us through his advice to his former younger self, Reid sights mistakes, case examples, and essentially provides us with invaluable tips to nudge us along to Resus Mastery. Reid offers the following advice to his former, younger self; Your career and speciality is a journey and you chose your destination: Don’t be defied by the expectations of one chosen path. Have an appreciation of what other specialities can add and what you can learn from them. Leave your ego at the door. Have a balance of confidence and competence. When something goes wrong you have to change something: Be it either yourself, your colleagues or the system. Follow up on your hypothesis: You won’t know if you got it right or wrong and will not gain or learn from the experience. Preserve comfort and dignity for your patients: 'No one knows how much you know, until they know how much you care' - Greg Henrey. Protect yourselves: Think about the people around you and share your experience with them, chose your colleagues and where you work wisely. Increase team cohesion - it is protective against burnout and compassion fatigue. Be Aware: look after the tools of your trade, your body and mind. Try and maintain good physical health, and train your mind to be more effective under stress. Remember society puts their trust in you - you only fail them when you fail to learn in them. Every patient is a gift/lesson accept it with grace and gratitude. Behave in the way you want to be remembered. Keep perspective and enjoy the ride!
Imogen Mitchell’s SMACC Chicago talk 'Morphing the Recalcitrant Clinician’ talks us through the steps to engage the reluctant physician when implementing change. Imogen initally touches on the stages of physician engagement from aversion, to apathy, to engaged and then outlines the steps to morphing the reluctant physician. 1. Seek out a clinical champion 2. Establish a common purpose/vision 3. Standardise what is standardisable 4. Communication, communication, communication 5. Work out barriers and overcome them 6. Deal with the ‘Whats in it for me?’WIFM
Rick Body’s SMACC Chicago talk 'Is compassion a Patients Right?' takes us on a journey of emotions in critical care. Starting with his rendition of john Lennons ‘Love’. Body, explains the origin of the word compassion - a move to act based on someone else suffering, a sharing of suffering with. Body, initially focuses on a study conducted within his hospital of 125 patients, who were interviewed when admitted to their emergency department and when they where discharged. From the study it was depicted that, what patients truely wanted was simple human intervention; reassurance, friendliness, explanation, basic care. These responses were then coded into 5 different themes to depict how patients believe their suffering should be addressed; 1. Emotional distress 2. Physical symptoms - including pain (but not restricted to) 3. Information - Included reassurance and explanation 4. Care - Basic care 5. Closure - patients want to put this horrible episode behind them Body notes that patients are telling us that they want something positive from us. They don’t want us to focus on what we shouldn’t do. They want us to be thinking about what we can do to help… suggesting that if we follow the above ‘EPPIC' we could provide more compassionate care. The problem is this is not compassion as compassion is an emotion and needs to be felt. Body then explores whats stopping us (care providers) from showing compassion? Sighting the The Good Smaritian Study: that depicts the more in a rush one is the less likely they are to show compassion. The By Standers Affect: if a large crowd is doing nothing, you are more likely to do nothing. Unclear of Who is Responsible: less likely for anyone to respond and Personal Reasons: the responsibility for other peoples lives, fatigue, tough, resilient to showing emotion, emotion been seen as a weakness and a feeling as doctors we are not meant to show emotions. Body, then shows a picture of a doctor crouched slumped over and inconsolable, shortly after the image was taken the doctor loses a 19 year old patient he was treating and minutes later the he walks back into the emergency room and continues working. This picture went viral on social media and the doctor pictured was seen as admorable. Body sites this example to state that clearing having compassion and showing compassion is right, but is it a right?. And, asks the question 'Would you prefer the surgeon who shaking with emotion as you go into surgery or the surgeon who is composed, objective, calm, tough, resilient, unmovable and efficiently get on with the task in hand?'. Body believes that patients don’t have a right to compassion as it is an emotion and means to suffer with but asks for health providers to be emotionally intelligent. Explaining that emotional Intelligence recognises that there is a difference between traditional intelligence, IQ and our ability to form effective forms of interpersonal relationships. Siting the 5 domains of emotions intelligence as; 1. Know your emotions - know what we are feeling 2. Manage your emotions - cool rational and object in the rests room, show emotion with patients and family 3. Motivating ones self 4. Recognising emotions in others - empathy 5. Handling Relationships - interpersonal Skills - relate to other people Body suggest that these are skills that can be developed as ones life goes on and by building skills in emotional intelligence that maybe one can be both a compassionate and effective doctor. Body concludes by asking the question 'How are you going to care more for your patients?'
Andrew Healey takes us on an exploration of the early phases of donor management in ICU and Emergency Medicine in his heart felt SMACC Chicago talk Optimizing the Care of the Organ Donation Patient. Which focuses on the processes of managing donor patients and their families, while they ride their ICU/ ED journey through to organ donor. Healey summarises his talk into four main points: 1. Set families up to make the right decisions - be it with end of life care or organ donation. 2. Preserve the opportunity for donation - understand that this is often the last decisions a family will have to make about a loved one and they may need time. 3. Never Say No - never say no to an organ donation, ask the specialist. The only people who can decide if a person is not ideal for organ donation are those people who intimately know the recipient. Healey sights some interesting stats that are worth thinking about such as; 1 out of every 4 people who are on the heart transplant list in Canada die. While, the risk of contracting HIV or Hepatitis from a transplant heart is 1 in 4000 (HIV) and 1 in 245 (hepatitis). With these in mind the elevated risk donor can look less risky. 4. Remember Organ Donation is never merely a mention - It's up to physicians and critical care providers to guide families to make the right decisions.
Jeremy Cohen took us on an Adrenal Function journey at SMACC Chicago with his talk Raging Hormones in Critical Care. Cohen explores the natural roll of cortisol in the human body, various schools of thought and recent research in the areas of sepsis and cortisol resistance.
Jellybean Redux with Rob MacSweeney of www.CritCareReviews.com It's a very Irish Jellybean. Rob MacSweeney & Matt MacPartlin in Fairy-Land with one of the greatest punk bands of all time; The Undertones. (It makes sense when you listen to it.) Matt and Rob meet up in a simulated Fairy-Land in Illinois. When this was recorded Rob had just debated Paul Marik (Mr Fluid) at SMACC Chicago and lost despite being one of the best read people in medicine. Maybe the most conspicuous reader around at the moment given his work on www.criticalcarereviews.com Ok, lets do a Checklist; Read EVERYTHING. Check. Figure how to be a New Consultant in Belfast. Check. Organise SMACC Dublin. Check. And that wasn't enough to keep him occupied so he has set up a new breed of journal in the form of www.criticalcarehorizons.net This is something I had been waiting for a while. It's a fantastic concept and it's free. Actually it is free x free x free. Which means they are proposing to do it all for free. (That sounds like a lot of work.) The idea is fantastic but it requires buy in from all #FOAMed types. A lot of us are educators and a few of us are researchers. Rob and Andrew Ferguson are doing the heavy lifting but check out the team behind them. It is a balanced "who's who?" of #FOAMed and established world leaders. Rob and Andrew are relaunching the site before SMACC Dublin. Have a dig around the site. Have a think about what it might mean to the anarchic #FOAMed community. Have a think about what it might do for you. Then, perhaps, put your research where your mouth is and submit. Why shouldn’t new research or reviews not be put out for free and immediately on the web? Why Not have original Research on www.LifeintheFastLane.com ? It is a difficult thing they are trying to do. Not a penny is being made. Plenty of pennies have to be spent. "We are all in the gutter, but some of us are looking at the stars" Bird? Plane? Superman? Nope. (Watch out for the correct pronunciation of the word "Super" at the end. Always good to keep up with the Gold Standards of Elocution while you're having some Jellybeans.) Thanks to the peerless Northern Irish Punk Band The Undertones for making the track “Here comes the summer” and recording it with John Peel in 1989.(Sir John Peel, Saint John Peel, The John Peel.) www.criticalcarereviews.com/index.php www.criticalcarehorizons.net
Derek Angus; 15/15 on the Glasgow Conversational Scale. Derek is the lead author of the PROCESS trial. You may have heard him on EMCrit talking about that study. http://emcrit.org/podcasts/process-trial/ You may have heard that he is one of the Heavyweights invited to SMACC CHICAGO. So where does he come from, how did he get here, is he the right fit for that SMACC scene and will he be singing until 3am at FOAMaoke? I caught up with Derek in Wellington, New Zealand at the Paul Young curated “Down with Dogma” College of Intensive Care Medicine Annual Scientific Meeting and I won’t pretend; I really like him. Angus is a Prince of research. Do a Pubmed search for him if you don't believe me; there are literally hundreds of papers. He started out at Glasgow University. (I seem to have a thing for Glaswegians a.k.a. “Weegies”) He was aiming at neurosurgery but after his MRCP and became the first Commonwealth citizen to work for MSF back when MSF were much, much smaller. This conversation was just too interesting to stop around 10 minutes as Jellybeans usually are. Have a listen. I think you’ll like it. Derek went from MSF to working with Peter Safar no less. From his early papers co-authored by Safar he has gone onto publish nearly 300 article of all shapes and sizes. These do not focus on the minutiae of some esoteric area, they seem to cover almost everything. Can you be a research generalist? Talking to Scott Weingart he gave a restrained epidemiologically tight representation of what the PROCESS trial tells us. Many of the questions and comments on EMCrit.org blog were focusing upon “what should we do with our septic patients?” My understanding of the ProCESS trial is that it tries to answer a specific question; what part of this bundle actually works. Anthony Delaneys understanding is rather more important than mine though. http://www.intensivecarenetwork.com/index.php/icn-activities/icn-podcasts/906-process-delaneys-take Sepsis is just one small part of what he does; he has fingers in all sorts of pies from Social Justice to Disaster Management. But what I should have asked him was what he was doing when he worked at “Reanimation Medicale” Hopital Cochin in Paris? One of the best things that we talked about was heros, mentors and role models. Don't be afraid of these guys. If you've got a hero out there at least send them an email! This guy is seriously impressive; apparently you or I could be him!
Scott Weingart's lecture at SMACC-Chicago was on OODA loops and the supremacy of System I for resuscitation. Check more here
Fear, Flight, Fight. Ashley Liebig is a Screaming Eagle. So at SMACC Chicago you had a 101st Airborne Division Medic talking about feelings. SMACC Star Ashley Liebig, now a Texan Flight Nurse rocked one of the Pre-SMACC US Workshops with a difficult subject, talking about dealing with critical events as a human inside a big & nasty world. Ashley was also one of the Conference Organisers and did a lot to get the show on the road. This is the first of 4 guest interviewer Jellybeans. I want to thank my friend and countryman Matt McPartlin ( aka @RollCageMedic ) who, like Ashley, has been instrumental in a lot of pretty cool things, but usually without being the guy up front. I really appreciated him offering to do this. I’m calling Matt my Doppelschwätzer rather than Doppelgänger. (Our walk isn’t that similar but out talk is.) I wasn’t at SMACC Chicago. I could tell you where I was but you wouldn’t believe me I will be at SMACC Dublin. Will you?
Are you ready for this rumble in the urban jungle?? Chris Ho vs Joe Bellezzo in the no holds barred debate about whether ECMO CPR is a step too far? The next cage match from SMACC Chicago. The post EDECMO 26 – “ECPR is a Step Too Far” – Ho vs. Bellezzo: a SMACCback Chicago Cage Match appeared first on ED ECMO.
The management of the septic patient in ICU is a recurrent topic for debate amongst intensivists. The decision of if and/or when to give blood transfusions is one of the key sources of contention. Dr Anders Perner is one of the most qualified people to weigh in on this debate. In this talk from SMACC Chicago, he delivers his stance on when to pull the transfusion trigger.Dr Anders Perner is an Intensive Care Specialist at Rigshospitalet and a professor in intensive care at Copenhagen University. He is the chairman of the Scandinavian Critical Care Trials Group and the strategic research program “New resuscitation strategies in patients with severe sepsis’. The contents of this talk are based on the findings of the TRISS trial - Transfusion Requirements in Septic Shock. This trial, Lower versus Higher Hemoglobin Threshold for Transfusion in Septic Shock was published in the NEJM in October 2014. The aim was to evaluate the recommendations from the Surviving Sepsis Campaign regarding transfusion in septic shock. The recommendation is that after the first 6 hours, transfusion threshold should be a Hb
Simulation is one of the most important advances in healthcare education and skills training of our generation. We now have simulation mannequins that can blink, breath, or even give birth thus allowing us to practice scenarios and skills before we encounter them in real patients. However, these sim dummies are not real people and so it is all too easy to dehumanize the scenario. According to Dr Phil Hyde, Director of Children’s Major Trauma and Southampton Children’s Hospital, it is this lack of emotional attachment that makes pure sim inadequate for training health care professionals in the management of trauma – especially trauma in children. In his talk from SMACC Chicago, Dr Phil Hyde illustrates why he and his colleagues have developed an educational program that takes sim to the next level. The key difference in this sim program is the incorporation of volunteer children to play the roles of injured paediatric patients. Another key aspect of this program are the incorporation of multidisciplinary teams including undergraduate students for all scenarios.The benefits of such a program have been far reaching. For the health professionals involved, it humanizes the scenario and induces an emotional attachment to the training exercise which adds an essential component to the training. Furthermore, it teaches professionals from different fields (nursing, medicine, allied health etc) to work together in these scenarios as would normally occur in real life. For the children involved, it is a safe controlled environment where they can learn about the health professionals and the health system, they learn about primary prevention and they can provide feedback to staff from a different vantage point. The community benefits through the improved primary prevention which is the most important aspect of treating trauma, a “man made disease”. This is a simple, yet powerful program that has so many benefits beyond the training of doctors and nurses to manage children involved in trauma. This is an intriguing, innovative talk that everyone can take something away from. Southampton Children’s Hospital is part of the University Hospital Southampton NHS Foundation trust. It is one of the largest teaching trusts in the UK. All of the simulation programs developed by Dr Phil Hyde and his colleagues at Southampton are open access and available for all health professionals to incorporate into their practice.
Are you ready for this rumble in the urban jungle?? Chris Ho vs Joe Bellezzo in the no holds barred debate about whether ECMO CPR is a step too far? The next cage match from SMACC Chicago. Chris and Joe are the director and vice-director respectively, of Emergency Medicine at Sharp Memorial Hospital in San Diego, California. They are two of the leading experts in ECPR, with Joe being one of the key players behind EDECMO. On a day-to-day basis, they are friends and colleagues, working together in one of the very few centers around the world to deliver ECPR. However in this Cage Match, friends become foe and there are no limitations to how far each will go to prove their side of the debate. On the AFFIRMATIVE side, Chris Ho delivers a convincing argument for why ECPR IS a step too far. From lack of evidence to the cost of “re-animating the dead” and everything in between, Chris Ho delivers a practical approach to the argument and demonstrates without a doubt why we are not ready for this to be the next step in resuscitation. On the NEGATIVE side, Joe Bellezzo delivers an outstanding rebuttal to “Dr Ho’s Nutty Brown Bullshit”. In an inspiring argument filled with anecdotes and occasional facts, Joe Bellezzo makes it impossible to think the ECPR shouldn’t be the next step in our ALS algorithm. Despite strong arguments from either side, as in all debates, there must be a winner. Do you agree with the outcome? If you want to find out whether Chris and Joe were able to kiss and make up, check out the exclusive ICN interview with the two, where they discuss more on ECPR.
In this talk from SMACC Chicago 2015, Larry Chu takes a step back from the clinical side of things to discuss Innovating Medical Education. Dr Larry Chu is an Associate Professor of Anaesthesiology and the Executive Director of Stanford Medicine X. Medicine X is an initiative from the Stanford AIM lab. It is a project aimed at promoting new ideas for the future of medicine, healthcare and education using emerging technologies. It focuses on empowering patients to participated in their own healthcare and improving medical education and training to focus more on patient-centered medicine. Each year, Medicine X holds a conference in which they explore theses themes. In 2015 the team from Stanford held a spin-off conference called Medicine X Ed. This conference focused on the future of medical education and the role of technology in educational innovation as well as continuing the theme of the changes that are fundamental for establishing more patient-focused health care. This conference was held in September 2015. At SMACC Chicago, Larry Chu shared a sneak-peak into some of the exciting medical education innovations that were going to be explored at Medicine X Edu. During his talk, Larry Chu shared insights into why traditional teaching methods don’t work for millennials aka gen Y, the successful educational programs being used in the US for their anaesthetics trainees and new ideas for structuring the delivery of effective medical education. For all trainees, in particular those with impending exams, and for all teachers/lecturers/educators this is an interesting and thought provoking lecture to listen to! Yet again proving why SMACC is the most dynamic, well rounded, original conference around!
Mark Wilson hosts an all-star cast!Summary By: Mark Wilson Traumatic brain injury (TBI) is a hugely important topic in critical care. It is a major cause of morbidity and mortality throughout the world with hospital presentations totaling over 2million in the US, 1 million in the UK and 700,000 in Australia each year. Not only do they represent a huge proportion of injuries, but they are a unique in their potential to fundamentally change “who a person is”. As critical care and trauma practitioners there are many aspects of management that can change outcomes for patients in the short and long term. Dr Mark Wilson (@MarkHWilson) is a neurosurgeon and doctor for the Air Ambulance in the UK. In this session from SMACC Chicago entitled “It’s a Knockout”, he expertly leads a discussion which holds a magnifying glass to the current practice guidelines for managing TBI as taught in ATLS. On the discussion panel is a star-studded international cast including: Pierre Janin, Andrew Dixon (@DrAndrewDixon), Karim Brohi (@karimbrohi), Karel Harbig (@karelharbig), Deb Stein, Michael McGonigal, Bill Knight, John Hinds and Ralph the Janitor (who looks remarkably like Cliff Reid @cliffreid). In this discussion forum, international specialists from the fields of neurosurgery, intensive care, trauma surgery, emergency medicine and radiology engage in a discussion of the step-by-step management of a real case of a patient with a head injury. This discussion highlights the many management controversies including how to manage the c-spine, whether or not to oxygenate, whether or not to intubate, when to extubate, if and how to sedate the patient, when to CT and how to monitor the head injured patient. In typical SMACC style this discussion demonstrates the approach to the management of a patient from different vantage points and demonstrates why it is so difficult to come to a consensus of the approach to this type of injury. Panelists delve into the features of TBI that you won’t find in textbooks including impact brain apnoea, multi-compartment syndrome and more. Watch out for the a segue into the Good Sam App, a smartphone app which alerts registered medically trained personnel to nearby emergencies to minimize downtime when medical emergencies occur. This forum has everything you have come to love and expect from SMACC including international experts, heated debates, controversial #hashtags, guest speakers and more!
John Hinds shows us why he will be so dearly missed in this superb talk from SMACC Chicago. This is about resuscitative thoracotomy but really so much more.
SMACC BACK! with Dr Kevin Fong An interview with Kevin Fong following his talk on safety lessons from space at SMACC Chicago. He is a highly decorated speaker with qualifications in astrophysics, medicine, anaesthetics, engineering and ICU, as well as a regular TV guest star on BBC2 show Horizon, NASA advisor and co-founder, co-director of CASE medicine. He spoke to us about how we can protect ourselves and our patients from risk and how we can better our skills in medicine. We will be sure to catch him at SMACC Dub next year!
SMACC BACK! In the third interview of the series, Sophie and myself get the opportunity to discuss all things ECMO with leading experts of ED ECMO, Joe Bellezzo and Chris Ho. Following their highly entertaining cage match at SMACC Chicago in which Joe and Chris are forced to take opposing sides on ED ECMO, we get to hear their real opinions on how this equipment is becoming more and more accessible and valuable in the resus scenario. Between the friendly banter, Joe and Chris have some incredible insights into the future of ECPR. We hope to see a lot more of these guys at SMACC next year!
SMACC BACK! Scott Weingart takes time out between his entertaining and enlightening talks given at SMACC Chicago to chat with Sophie Connolly and Alice Young (ICU Residents from RNSH) about all things SMACC, the differences between training in the USA and Australia, advice for junior doctors and the origins of EMCRIT. Check out this interview as a prelude to the release of the talks given at SMACC Chicago.
The RAGE Podcast - The Resuscitationist's Awesome Guide to Everything
SMACC Chicago 2015 preview and The GoodSAM App Oxygen therapy: AVOID: Air Versus Oxygen in ST-Segment Elevation Myocardial Infarction and the HOT or NOT trial: HyperOxic Therapy OR NormOxic Therapy after out-of-hospital cardiac arrest (HOT OR NOT): a randomised controlled feasibility trial. John Hinds discusses Helicopter Emergency Medical Services Cliff Reid discusses IO access and handstands
Chris Ross & Oli Flower discuss the latest update on SMACC Chicago - an incredible cadaver workshop with small group expert tuition on a huge range of critical care procedures. At a hugely discounted price. This will sell out so get in there fast.
Iain and Simon talk about the upcoming SMACC conference in Chicago and do their very best to persuade you to come to the best conference in the world Visit the site for the full program here. http://www.smacc.net.au/ S DOI - Both Iain and myself are being funded to attend.
The RAGE Podcast - The Resuscitationist's Awesome Guide to Everything
Listen to this miniRAGE for key information on registration for SMACC Chicago 2015. and to find out what the RAGE team will be doing at #smaccUS.
Roger Harris & Oli Flower announce opening of registration for SMACC Chicago - 5th (US/UK) / 6th (AUS) November 2014. They explain why you need to get in quick: Save Cash Don't miss out on workshops Don't miss this unique event And much more. Go to smacc.net.au for more!
Are you planning to go to the USA for SMACC Chicago. Well we have the ultimate pre-SMACC workshop for you. And it is all in a good cause - help us help out a brother Ultrasound lover.
Roger Harris and Oli Flower talk about next year's SMACC conference - why the dates have been locked in for 23-26 June 2015 and what makes this conference different.
The St.Emlyn's choirmaster has asked Iain and Simon to deliver a sermon on the importance of attending the SMACC Chicago conference in May 2015. After their pilgrimages to Australia in 2013 and 2014 they came back enthused and at times rather annoying about how jolly marvellous it all was. We felt that it was important for them to share their thoughts and to ask if anyone wishes to join them on their planned trip to the Northern Americas next year. AS Choirmaster at St.Emlyn's I have reluctantly decided to give them some air time. I have the honour to be, as always, your most dutiful servants. Yours etc. The St.Emlyn's Choirmaster