Resuscitation is complicated, but the solutions don't have to be. Chris Hicks brings you four psychological strategies that will help you manage complex resuscitations. It is a fascinating time to be a resuscitationist with ROBOA, ECMO and EPR. Chris explains that as we learn more about critical illness, we learn more about the complexities of resuscitation. Therefore, we need ways to manage and constrain complexity and to simplify and organise problems that will see us through. Chris’s lessons ...
Aug 01, 2018•23 min
Neurologic airway manipulation is unforgiving; errors lead to hypoxia and secondary injury. Managing the airway with an eye towards success, the first time, every time, without allowing sats to drop below 90% is the holy grail of neuro airways. Selection of RSI techniques, DSI techniques, and pharmacologic management is critical for success. The TBI airway with ICP issues and the post tPA airway present unique problems and the failed extubation in the neurologic patient is as common as the day i...
Jul 26, 2018•17 min
Interprofessional issues in critical care Meeting of the Tribes brings together clinicians from a broad range of health professions, including medicine, nursing, social work and physiotherapy, to explore interprofessional issues in critical care. In addition to their clinical work, panelists have unique perspectives on education, simulation and resilience in healthcare. In discussing issues related to tribalism and their implications for interprofessional practice, the panel explore what it will...
Jul 22, 2018•1 hr 36 min
Ronan O’Leary discusses reversing coagulopathy in traumatic brain injury. The PATCH trial was a trial look at the use of platelets to reverse the effects of aspirin and clopidogrel in patients with spontaneous cerebral haemorrhage. Ronan asserts that overall platelets are harming patients. Through his talk he highlights many studies that have been inconclusive about the benefits of giving platelets in traumatic intracerebral haemorrhage. As one study eloquently described, “It was not possible to...
Jul 19, 2018•15 min
Moderate panel discussion on FOAM Open Access Medical Publishing Data sharing
Jul 15, 2018•1 hr 17 min
The door to needle time for acute stroke in Critical Care is a key variable when striving for good outcomes. Rhonda Cadena answers the question - Who should pull the trigger on tPA for acute ischemic stroke? Medical management of acute strokes has changed dramatically over the years. We used to rely on clinical exams for diagnosis, prescribe strange medications and undertake interventions that were scary! This has changed in recent times. We have now evolved to advanced imaging techniques, new m...
Jul 12, 2018•13 min
Claire Park delivers a riveting talk, bringing military trauma lessons from MERT (Medical Emergency Response Team) back home. Claire tells two stories from her tours in Afghanistan. The first begins in the early hours of the morning when the MERT team is tasked on a job. They receive word of five casualties including two above knee amputations and one unconscious without a radial pulse. On arrival to the scene the paramedics leave the helicopter to triage and bring the casualties aboard to Clair...
Jul 12, 2018•13 min
Join the debate between Bill Knight and Fernanda Bellolio as they go head-to-head, discussing diagnosing subarachnoid haemorrhage in neuro critical care headache. Should you rely on CT and lumbar puncture or, CT followed by CT angiogram. Why should you care? Acute headache accounts for 4% of all visits to the emergency departments. These patients will often describe the “Worst headache of life” – a phrase which can ring the alarm bells in the clincian’s mind. 88% of these will be from benign cau...
Jul 06, 2018•43 min
Prehospital high acuity transport by air rescue has the capability to deliver the sickest of patients to high quality, advanced care, and support. However, not all patients are transferred. Why? Per Bredmose tells the tale of Emma. Emma is a 12-year-old girl who developed a cough. She is admitted to local peripheral hospital, correctly diagnosed with pneumonia, and treated with IV antibiotics. Emma continues to deteriorate and is transferred to an ICU where she fails a trial of BiPAP and is intu...
Jul 04, 2018•11 min
Dr Suman Biswas is a UK based anaesthetist known for his musical talents. He and a fellow medical student began performing hilarious medical parody songs, perhaps the most famous is his 'London Underground song'. The two students were catapulted to fame as the "Amateur Transplants" but sadly parted ways in 2011. Suman works full-time as an NHS EnglandAnaesthetist. Here he performs live on-stage at the enormously popular medical conference SMACC (Social Media and Critical Care) in Berlin Germany ...
Jul 03, 2018•21 min
Clare Richmond discusses medical simulation and its ability to provide a safe working environment anywhere. Simulation is a tool which allows us to rehearse our skills and scenarios before they happen in real life, to real people, our patients. Many clinicians dislike simulation, they know it is good for them, but find it challenging to drop into a world of manikins, fear performing in front of their peers and find debriefs uncomfortable. This talk will consider the purpose of simulation and its...
Jul 01, 2018•15 min
Michelle Johnston presents her thoughts on acute myocardial infarction, thrombolysis and haemorrhage. She delves into David Foster Wallace, evolution, and what do when the thrombolysis bisque hits the fan. Michelle’s interest into acute myocardial infarction, thrombolysis and haemorrhage began one day when she received a call from a peripheral hospital. A local farmer has presented to the Emergency Department with what turned out to be a big anterior infarct. As Michelle points out, he quite app...
Jun 26, 2018•21 min
A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social work, women in medicine, medicine in the developed work, and the health of healthcare workers. It should be novel, it may get heated, and it is not scripted. Sometimes to comfort the afflicted you also need to afflict the comfortable. This is why no prisoners will be taken, no topic is out of bounds, and no ego will be pampered. It may even offend: you have bee...
Jun 20, 2018•15 min
For Trish Henwood, ultrasound use in resource limited settings is a perfect fit. Nowhere has Trish seen ultrasound have more of an effect on patient care and outcomes, and save more lives, than in resource limited contexts. Trish uses the example of a training program in Zanzibar to highlight the scope that ultrasound provides. Using ultrasound on a daily basis to the medical centre is able to screen for antenatal complications that may necessitate transfer to a setting with a higher level of ca...
Jun 14, 2018•12 min
Marcelo Amota makes the case for why driving pressures matter during mechanical ventilation in critical care. Sao Paulo, Brazil, experiences flooding every year. This exposes locals to Leptospira bacteria. The severe form of disease this causes – leptospirosis - sees patients end up on mechanical ventilators. These machines were traditionally complicated, with a huge number of settings and buttons. Marcelo Amato trained in this setting. He, alongside his colleagues, developed methods to halt ble...
Jun 05, 2018•25 min
The healthcare ethics of alcohol related harm and driving change by Diana Egerton-Warburton Diana Egerton-Warburton talks about how to be a hero by championing healthcare ethics of alcohol related harm and driving change through stories and data. Have you ever saved a life? Many doctors and nurses have. But, how do you save a life without putting scalpel to skin or picking up a laryngoscope… or even having to go to a hospital? Diana Egerton-Warburton answers this question through the powerful to...
May 29, 2018•20 min
Annet Alenyo Ngabirano was enjoying the community medical placement in the 4th year of medical school. Placed 60km from the nearest hospital, in the lush hills of Uganda, the days were filled with vaccination drives, local outpatient clinics and lazing about. That was until a frantic nurse burst into the room and rushed the three medical students to the bedside of a severely sick and dehydrated infant. There was no doctor. There was no senior nursing staff. They no training, no equipment, no bac...
May 22, 2018•22 min
Trial design is the biggest problem with Evidence Based Medicine in the Intensive Care Unit. Paul Young wants to change that paradigm completely. He argues for research as we know it to change and to focus on clinical care with systemised and optimised treatments that reliably improves outcomes over time for all patients. Mortality measured at a particular time point (landmark mortality) is often regarded as the gold standard outcome for randomised controlled trials in Intensive Care Medicine. A...
May 13, 2018•20 min
David Carr delivers an “old fashioned” talk, presenting his approach to the diagnosis and treatment of endocarditis in acute medicine. Whilst some may turn their nose up at what David describes as esoteric bedside medicine, the rare diagnosis of endocarditis is a bad diagnosis. It carries with it a mortality rate of between 15-30%. David attempts to rebrand endocarditis and make it sexy again. Who? There are four main suspects of getting endocarditis. If you turn up to David’s Emergency Departme...
May 06, 2018•21 min
A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social work, women in medicine, medicine in the developed work, and the health of healthcare workers. It should be novel, it may get heated, and it is not scripted. Sometimes to comfort the afflicted you also need to afflict the comfortable. This is why no prisoners will be taken, no topic is out of bounds, and no ego will be pampered. It may even offend: you have bee...
Apr 29, 2018•16 min
South pole...North pole, hot...cold, on earth...in space, below the sea...on Mount Everest, alone and far, far away. Gaynor Prince takes you to Union Glacier in the Ellsworth Mountain Range, Antarctica, to show you how useful ultrasound can be in extreme environments Gaynor relives the story of being in one of the most isolated places on Earth when she gets a Medivac alert. One of her clients, Jack, has become acutely short of breath. With her list if differential diagnoses including high altitu...
Apr 23, 2018•13 min
Medical education and clinical programs are designed with four pillars - clinical excellence, research, education, and administration. These apply whether you build and design an ultrasound program or division, a simulation program, a toxicology or pre-hospital program or even an academic department Resa Lewiss describes the four pillars of medical education and clinical programs using a quirky anecdote of four tragic, dramatic and ridiculous stories of childhood dog deaths. Clinical excellence ...
Apr 15, 2018•22 min
In this quick, five minute talk, Brandon updates us on Sinus Venous Thrombosis. This includes what it is, what it looks like and how to diagnose it. Brandon starts with a case – a 37-year-old woman, who is 8 weeks pregnant, presents with what she describes as the worst headache of her life. She has a history of migraines, so this is Brandon’s first thought and possible initial diagnosis. But... it turns out to be more than just a migraine... Brandon explains that what we should be looking for he...
Apr 12, 2018•9 min
Fernanda Bellolio guides the listener through an approach to the treatment of wake-up stroke in neuro critical care. What time did the symptoms start? This is one of the most common questions that is asked when taking a history from a patient. However, what happens when this can not be answered. This is the case with “wake-up strokes”. A wake-up stroke is when a person goes to sleep without symptoms and wakes up with deficits. Similar problems in management arise when a person cannot accurately ...
Apr 10, 2018•12 min
Rinaldo Bellomo is here to cause some trouble! He says that critical care physiology in resuscitation has problems! Whilst the rest of the medical field has advanced and evolved over time (we no longer routinely prescribe oxygen for an acute myocardial infarction), critical care resuscitation still relies on malfunctioning physiological paradigms. Critical care clinicians can change physiology with a number of tools. They can repeatedly, often, and mercilessly change physiological variables. Blo...
Apr 08, 2018•16 min
Autoimmune versus infective encephalitis by Ronan O'Leary
Apr 05, 2018•25 min
Brandon Foreman gives a practical approach to the diagnosis and workup of neuromuscular disease in neuro critical care. Neuromuscular diseases are common and include chronic autoimmune disorders such as myasthenia gravis, acute demyelinating disorders like Guillain Barre, paraneoplastic disorders, and toxidromes such as botulism. The presentation of many neuromuscular diseases can be subtle: diffuse weakness, subtle swallowing difficulty, or double vision. Many patients do not present until its ...
Apr 03, 2018•14 min
Sara Gray works in the Intensive Care Unit and sometimes connects with patients. This was especially true for a lady who was in her unit intubated due to pneumonia. When this patient experienced a failed extubation, a tricky re-intubation and subsequent tracheostomy, Sara was kicking herself. She says we have all been there… Have you ever dropped your phone? What was the internal dialogue in your head at the time? Sara calls this out inner voice. She used to think that our inner voice did not ma...
Apr 01, 2018•24 min
Rhonda Cadena explains the process of diagnosing and managing meningitis. It is a skill that involves rapid identification, workup, and treatment. In most cases, the diagnosis of meningitis is not a diagnostic dilemma, but the workup and treatment are not as straightforward. Meningitis is inflammation of the lining of the brain and spinal cord. This can be caused by bacteria, autoimmune process, drug reactions, viruses, and fungi. Rhonda delves deeper into bacterial meningitis. Worldwide there a...
Mar 29, 2018•14 min
Neuro Imaging Nibble: Subtle Subarachnoid haemorrhage on CT by Jordan Bonomo
Mar 27, 2018•10 min
