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What was it?Questions I went withSome answersHighlights Some NegativesWhere is it all going?Gratuitous Tips
What was it?
60% EM, 20% ICU, 10% prehospital, anaesthetists, GPs (rural and remote)
EM/ Crit Care/ Pre Hospital MeducationSocial Media heroes
Podcasts/Vodcasts/PK Talks (screencasts)Digital PostersSimwars/SonowarsSMACC clubTwitter feeds (streamed)
Why I went..questions
These guys are great and I’m all for egalitarianism but..
Q1. How will quality be controlledQ2. Do these guys cut it live?Q3. How can I filter, assimilate (and curate) this
mountain of content?Q4. Am I relevant?
Q1. How will quality be controlled on the level playing field?
Still a work in progress GMEP.org - explicit votes - 5 votes down = out ( goes to review)Open peer reviewGood stuff is retweeted, reverberates and amplified.Crap dies a quick, natural death.
Q2. Do these guys cut it live?
Scott Weingart, Joe Lex , Victoria Brazil, Simon Carley, Cliff Reid, Mike Cadogan, Chris Nickson et al...
Passionate and informed+ engaging
Scott WeingartEMCrit
The pathway from novice to expert..– Novice - just don't want to look stupid – Advanced beginner can solve probs but can't see the
whole picture – Competent - noone says anything negative.
independent - can prob solve– Proficient – engages in reflection and incorporates
meta cognition – Mastery – conscious competence – able to teach
“Reading is fundamental”
“intuition = expression of subconscious knowledge”
“You need knowledge to be creative”“Practice Practice Practice”– Until you can't fail– Visualise– Verbalise
Law & Order & Social MediaJulian Walter
Rush + wide audience = troubleLegal concerns arising from social media are the
same as in the traditional worldInappropriate AdvertisingBoundaries & behaviour – sexual, financial, beliefsConfidentiality & consent
Rule of thumb: Would you post it in the hospital cafeteria?
Law and Order & Social Media
Disclosure - within the reasonable expectation of the patientonly use information if primary purpose is that for which it was primarily intended.
Images - Passing an image to one individual = assume global dissemination
General clinical images - written consent (images) not required
Images for research education – written consent is required
Sonowars
Bedside Echocardiography:Stick to big 4:
LV dysfunctionPETamponadeSepsis/ tox = Hyperdynamic low vol
Echo during CPR usefulContinue CPR until ready
Gadgets
Video LaryngoscopyCMAC v GlidescopeiMac
Ultrasound – Sonosite v PhillipsFibre Optic devices e.g. Ambu A-scope“cheap” Simulation softwareNon Invasive Cardiac Output Monitors
Time is Spinal CordOliver Flower
icn.org.au
ASIA = American Spinal Cord injury Association (see website)Standard definitions hereExcellent form for initial assessment
Pressure areas appear v quicklyGet off spine board ASAP
Transfer/ retrieve earlyMiami J collar or Philadelphia earlySoft collars only at RBH
Stroke ThrombolysisDomhnall Brannigan
http://underneathEM
“Hello” effect - A good story trumps the available evidence Evidence ReviewConclusion: Treatment squashes the outcome Bell curve - More bad ( death) and More good
*Del Zoppo et al neurology 2003
Mechanical ThrombectomyDr Ken Faulder
RNSH interventional neuroradiologist
Angiographic data demonstrates IV therapy doesn't open large proximal arteries eg ICA occlusion13% MCA 22%*Since 2009 - Effective mechanical device (2nd
generation)Better outcomes with proximal clots – (Recannalisation
> 96%)Window for benefit (IATx) currently 6/24 IV Tx better for more distal occlusions e.g. Perforators
CommunicationDr Victoria Brazil
“Communication is our most useful clinical tool”"Multitasking doesn't work““Building relationships over time sharpens
communication at the pointy end when it matters..”“Flip the classroom”Standardised Patient Simulation - Scenarios using live
modelsCreates conflict which challenges learners and
enables powerful feedback
Q3. Tips for assimilation/ curation of content
TweetdeckRSS feeders – Google Reader now defunctOthers: Netvibes/ Feedly (chrome/ firefox),
Newsblur, Feedler Pro etc..DropboxOthers...
Negatives?
ExpertiseDiscussion largely limited to TwitterInformation overload – retweetsSignal to noise ratioSoundbites and graphicsDistractionFast thinking ≠ quality thinking? ADHD
Q4. Am I relevant ?
Lectures ?(Self-directed e-)learning – guide (?)Case review/ reflection - probablyWatch a procedure on YouTube, Do one, then film ourselves doing one
and post it online as a vidcast for others to learn from...Supervised practice – yes Mentorship - hopefullyObserved Clinical Encounters - yesSkills sessions – yes..Simulation (partly)Feedback - yesAssessment - yes
Where is it all going?
Global Grand RoundsGlobal Journal ClubE-conferences#FOAM/ GMEP.org = here to stayThe textbook is dead – long live the textbook! Who knows...
Gratuitous Advice
This is a revolution - get involvedPick a few quality voices (start with 2 or 3)Think before you tweetGain consent before you disseminateThink about curation/ assimilate as you goDon’t neglect the Fundamentals/ SyllabusRemain sceptical
Be like a brewer....
“We are brewers and always have been and in our practice we have sought and we seek to ally the traditions and craftsmanship of the past with the best that science has to teach us.”
Rupert Guinness (via Domhnall Brannigan @dreapadoirtas http://underneathem.com)
Home viewing..
PK talk competition winner:http://vimeo.com/57874509
others:http://smacc.net.au/pk-smacc-talk/
SMACC channel:https://www.youtube.com/user/TheSMACCchannel