Sonowars continues to find new ways to make Ultrasound teaching exciting, inspirational and most importantly informative. The team of James Rippey, Matt Dawson, Mike Mallin and Andrian Goudie are back with an all-star supporting cast. Keep an eye out for the light sabre, simulating ultrasound guided venous canulation as well as the mechanical bull ultrasound challenge. Things are bound to get a little crazy when these guys get fired up.
The host response to injury is inflammation. The inflammatory response may have been naturally selected over millions of years of evolution to give the injured tissue the best chance of healing and recovering. On the other hand, over the last 50 years animal models of traumatic brain injury (TBI) suggest that fever, occurring as part of the inflammatory response, may be harmful to neuronal recovery. Some observational clinical studies support this. However we lack high quality clinical trials.At...
The master of Dogmalysis himself, Cliff Reid, challenges current practices in prehospital and emergency medicine. Warning listeners to be skeptical, Cliff dissects the dogma of acute crush injuries and spinal immobilization. He also explores the false dichotomy of “scoop and run vs. stay and play”. Cliff reminds us that “not to challenge current practice is intellectually lazy”.
Making Transitions of Care Safe - Pat Croskerry Summary by: Pat Croskerry It is now well recognized that transferring the care of a patient from one caregiver to another is a vulnerable point in a patient’s care and a potential threat to patient safety. There may be many intra-disciplinary and inter-disciplinary transition points in the ED during an individual patient’s care. The process requires that each participant communicates well with others to establish an accurate shared mental represent...
Kevin Fong is an astrophysicist, astronaut and anaesthetist who gives an incredibly entertaining talk about human space exploration and our dreams of a manned mission to MARS. This is a mission that stands on the boundary between science fiction and science fact. A mission that would be a minimum of 1000 days in length and which would be twice as long as any previous manned space mission. Fong focuses on the the incredibly destructive effects of such prolonged weightlessness on the human body. H...
A pair of outrageously high heels next to a pair of tattered combat boots, set the stage for Ashley’s talk on the stress of PHARM. Ashley draws on lessons learned in combat to support her theory of mental health survival. She emphasizes the importance of critical incident recognition, response and elimination of stigma associated with seeking help.
Bouncing Back from the Beach – Cutting to Air to secure an Emergency Surgical Airway Summary by: Thomas Dolven To handle airways means being prepared to handle them all the way. You need to be prepared for a cannot intubate cannot oxygenate CICO scenario. The common, final end point of airway management in a is the emergency surgical airway, the cricothyroidotomy. So how to prepare? Often, it is not being taught right. This is a rare procedure under high stress and time sensitive. And most impor...
Tox-Dogmalysis is a talk about evidence in Toxicology. It’s been said that 50% of what we learn is incorrect; we just don’t know which 50%. As the complexity of medicine increases, it is of the utmost importance for clinicians to be skeptical of old data and new data alike. Many in the FOAM community have made huge strides in busting myths that have persisted over time. However, sometimes we may declare myths busted too prematurely based on incomplete or misunderstood data. This talk will explor...
Fluids in Critical Care: Time to SPLIT With Normal Saline? Summary by: Paul Young Intravenous fluid therapy is a ubiquitous treatment for critically ill patients and has been used in clinical practice for over 175 years. Despite this long history, the majority of intravenous fluids have not been subjected to the same level of scrutiny as other drugs. That said, large-scale fluid trials evaluating albumin and starch solutions compared to 0.9% saline have been conducted and their results have chan...
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 practit...
Summary by: Paul Young The febrile response to infection occurs in most animals and is regulated by a common biochemical mechanism involving prostaglandin E2. This common mechanism suggests that the response may have evolved in a common ancestor more than 350 million years ago. As the febrile response comes at a significant metabolic cost, its persistence across a broad range of species provides circumstantial evidence that the response has some evolutionary advantage. Furthermore, it logically ...
What is it that enables some physicians to step into a high pressure situation with poise, presence, and consistently perform to their capabilities? What else is there beyond technical knowledge and clinical skill that can be developed to help immunize the person that is a physician from some of the more human challenges that can present? In a field so ripe with immense performance pressures, demands, and expectations what are those people doing who seem to thrive amidst it all? In this session ...
Kevin Fong is an astrophysicist, astronaut and anaesthetist with an interest in medical error and safety. In this talk he focuses on lessons learnt from his time at NASA which can be applied to medical practice. Fong believes that key to safer practice is in the collection of accurate data. He outlines some aspects of the famous communications between Sully Sullenberger (pilot) and the Le Gardia air-traffic control tower as Sullenberger miraculously lands a commercial airline on New York's Hudso...
Is the care you deliver to critically ill patients in your ED the same as the care delivered in your ICU? And if not, why not? Consider the challenges facing the delivery of excellent care in the ED, and be inspired to make changes at your hospital to improve your system. Learn ten strategies for optimizing the care of critically ill patients in your ED. References: 1. Learn more about ED-ICU’s at Scott Weingart’s excellent site http://www.emcrit.org 2. Consider a resuscitation fellowship like t...
When settings outside the hospital are taken into account (ED, primary care), the overall number must be considerably higher. While many factors contribute to diagnostic failure, a variety of sources suggest that physician’s thinking has a lot to do with it. Dual Process Theory describes how the brain makes decisions in one of two modes: through fast, unconscious, intuitive processes (System 1) or through slower, conscious, analytical processes (System 2). Mental short-cuts (heuristics) and bias...
The human circulation is a complex system that has evolved over millenia, primarily designed to promptly respond to conditions of stress - the fight and flight response. The traditional physiological approach focuses on the heart as a pump, adapting to changes in volume and metabolic states. These principles are underpinned by the Starling equation and incorporated into an adaptation of Ohm\'s law. These principles have been maladapted, punctuated by an increasing reliance on surrogate and deriv...
The Force is strong with this one… Despite years of research and new technology, the adjusted mortality rate for traumatic brain injury remains near 25%. Currently, primary injury occurs before we can intervene, and all our pre-hospital, ED and ICU care is directed towards preventing remarkably complicated and poorly understood secondary injuries. TBI is a heterogenous group of diseases often treated homogenously. You too can master the ways of the Force, by reviewing the Top 10 items you need t...
Neurologically intact recovery after out-of-hospital cardiac arrest remains dismal. In the United States, an 8% meaningful recovery rate is hopeful at best. The introduction of extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (CPR) is not new but has been shown to provide upwards of 27-30% meaningful recovery, when applied to the appropriate patient population. In 2011 we began extracorporeal CPR (ECPR) in our emergency department - a suburban non-academic center i...
Reuben Strayer takes us through the myriad uses of Ketamine, and dispells some myths in the process. A Special K classic.
Is Suspended Animation only in the realms of science fiction, or is this a realsitic treatment option? Mervyn Singer questions if we can prevent secondary reperfusion injury following cerbral ischaemia.
In Coping with Isolation - All alone on Kangaroo Island, Tim talks with brutal honsety about the reality of being a rural doctor.
Oli Flower brings lessons from cage fighting that are relevant to all health care professionals. Be open minded about this one!
Christine Bowles takes on the big issue of Sex in critical care. In 2015, why is sexual equality in the workplace even an issue and how can we address it?
Roger Harris shows us just how complex decisions about resuscitation can be and when stopping can be the right thing to do.
Chris Nickson challenges us to examine lessons that are 150 years old
ENT surgeon Georgie Harris takes you through a logical approach to managing the horrific scenario of a transcected airway
Guess or Gestalt? by Simon Carley. The secret to being a great Emergency Physician lies in Skill, Knowledge and Clinical Acumen!
Failure is a fundamental part of learning, and growing. Michelle teaches us about failing better and the benefits and freedom this brings.
Rob Orman drills down on what suicidal ideation really means and how you can tell if your patient really has it.
An all-star panel of world sepsis experts discuss the controversial areas. Expertly hosted by Scott Weingart and lubricated with on-stage alcohol.
