A little delay while I enjoy my holiday but here it is.
How does a critical care expert think? What exactly goes through his mind? That's the topic given to Scott Weingart as he did "Mind of the resuscitationist". One thing I am with : Preparation is all important, you can never over-prepare. Had a hood laugh over the slide "when do you call for a consult" Answer: "There are only 2 reasons to call for a consult: ask for a bed or ask for a procedure you can't do." Because really, you've not fully prepared yourself as a resuscitationist if you start asking for advice. But I will digress, cause everyone need to know when to call for help and I personally don't mind asking for advice nor dishing it. Real resuscitationists will sweat buckets, as Scott alluded to the fact, cos it's hard work and pretty involving too.
"How to be a hero" by Cliff Reid was as much personal as it was inspirational. Difficult to put in words such a great talk. The theme revolves around doing the right thing for the patient at hand. And often times it takes great courage, no personal gain and maybe even personal retribution to stand up for what is right.
The term meta-cognition was mentioned much during this conference. Chris Nickson explained it all in "All Doctors are Jackasses". This talk is really about the cognitive processes in critical thinking; namely the dual process theory (which I talked about in a previous post). All are encouraged to read up on the writings of Pat Croskerry. Luv this topic, and Chris did a good job of summarizing system 1 and 2 thinking. The analogy using Star Trek's Kirk and Spock as system 1 and 2 respectively was really hilarious. Will remember it always.
Are we diagnosticians? Many of us ED folk might think so, but according to Simon Carley in "Wrestling with Risk", we are more probabiliticians. Chasing that diagnosis can sometimes lead to more harm and I agree that the language we use as physicians need to reflect that uncertainty principle to the patients we treat.
Did you know, that the 10% chance of cross reactivity between penicillins and ceftriaxone is a - MYTH! Studies had shown that patients allergic to penicillin are also pretty much MORE allergic to anything. Pre-1980s manufacturers make penicillin and cephalosporins using the same mold and thus resulting in cross-contamination but not so anymore. AND it is not the b-lactam ring that've the culprit. That's not all, speaker Gerard Fennessy even did a Kermit the Frog in life threatening anaphylaxis song (actually Elmo, masquerading as Kermit turned red from allergy).
Again, SIMWARS was the highlight of the 3rd and final day. It was totally amazing and I have never seen simulation done in such competitive manner. Who could have imagined; fully dressed and equipped Sydney HEMS team members rappelling from the ceiling as an entrance? 3 teams competed in the final and Simon Carly's team from St Emlyn's came out tops. They were really cool under fire, though they had no clue as to how to treat a snake bite victim with obvious systemic envenomation. It was funny to watch, and yes, no snakes in Manchester is probably a good excuse.
SMACC was totally worth it. A lot of thought went into the plenaries, it's not difficult to see why; the crème de la crème of crit care bloggers & podcasters are also professionals at the top of their field. This conference is a wonderful expression of how tacit knowledge is shared amongst the thinkers and doers in the field of crit care, and the benefits are really for the rest of us. Be sure to check out emcrit, LIFTL, ICN etc for the podcasts to follow.
It's Brisbane March 17-19 for SMACC 2014. See you there.