SMACC Chicago Registration miniRAGE

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.

I’ve reposted LITFL’s SMACC Chicago is coming… here:

smaccGOLD Opening ceremony

The programme for SMACC Chicago is now online for all to see. It has been a real joy to work on this — the opportunity to bring together the best people in critical care, to talk about the best topics in critical care, is one to be relished. We have assembled an awesome lineup — both behind the scenes to build the fire, and front stage to light it… as you will see in the programme.

Most importantly, registrations are opening very soon: 0800h November 6th (AEST). Check out the ICN post titled SMACC Chicago Rego Opens 5 November for equivalent opening times throughout the world’s time zones, and some important tips about registration.

The first 500 residents / registrars / paramedics / nurses / pharmacists / PAs (or other non-attendings / non-consultants) will be able to register at the discounted price of US$595. This is ‘cost price’, and is fully inclusive of all events in the 3 day program, the welcome reception, Gala night and all coffee and lunch breaks. The first 800 specialists/ attendings also get discounted prices and there are 250 student tickets at only $350. Also, to help avoid lumping you with transaction fees, you can pay by direct deposit in either USD, AUD or Euros, depending on where you’re coming from. Note that if you want to attend one of the more than 30 pre-conference workshops, you have to register for the conference first, then the workshop separately. Be warned, some workshops sold out within a couple of weeks at smaccGOLD.

Check out the SMACC program(me) online, or download the brochure here:

SMACC Brochure

Vive la FOAM!

NeuroRAGE Special Edition

NeuroRAGE is a special edition of the RAGE podcast featuring these special guests:

  •  Mark Wilson, prehospitalist with London HEMS and neurosurgeon with the NeuroTrauma unit at Imperial in London
  •  Oli Flower, intensivist and NeuroICU enthusiast at Royal North Shore Hospital in Sydney – co-organiser of SMACC and Intensive Care Network.

This edition is 82 min 03 sec long and includes:

  • Introduction, including a welcome to Mark and Oli, along with usual supsects Cliff and Karel… (starts 00:00 min)
  • ‘What’s bubbling up?’ (starts )1:31 min) — shout outs and interesting discoveries from the world of FOAM and elsewhere featuring the GoodSam app (again), A talk on transport of Ebola patients, SMACC Chicago, ESICM’s live feed of ‘Hot Topics’ such as the ARISE trial results, and Cliff Reid’s ‘through the rabbit hole’ experience with ketamine as a patient.
  • the NeuroRAGE participants discussing ‘Traumatic Brain Injury and a bit about the Spine’ (starts 17:13 min)
  • the NeuroRAGE participants discussing ‘ICP Monitoring’ (starts 45:22  min)
  • the NeuroRAGE participants discussing ‘Intracerebral haemorrhage and Subarachnoid Haemorrhage’ (starts 55:09  min)
  • the NeuroRAGE participants discussing a ‘smorgasbord’ of other neurocritical care questions, including the ‘cranial screwtop manoeuvre’ (starts 79:14  min)
  • ‘A blast from the past’ by Oli Flower on the origins of the EEG  (starts ? min)
  • ‘Words of Wisdom’ from Mark Wilson (starts 80:36 min)

The RAGE podcast is on  iTunes here and the RAGE podcast audio feed is available here.

Here are the show notes for the NeuroRAGE Special Edition:

Introduction

Ketamine-induced dysphoria and hallucinations:


Traumatic Brain Injury and a bit about the Spine

ICP Monitoring

Intracerebral Haemorrhage and Subarachnoid Haemorrhage

Smorgasbord

Blast from the Past

Words of Wisdom

  • just listen!

Thanks again for listening to the RAGE!

RAGEback: Swami on Adrenaline in Cardiac Arrest

Anand ‘Swami’ Swaminathan is an Emergency Physician in New York. He is one of the co-creators of EM Lyceum, and a major contributor to Lifeinthefastlane.com, primarily through R&R in the Fastlane and The LITFL Review, as well as other FOAM resources.

Swami is a skeptic of the benefit of adrenaline in cardiac arrest. This is his brief response to Scott Weingart’s Cutting Edge Intra-Arrest Care at smaccGOLD and Weingart’s subsequent discussion about intra-arrest meds with Rob Mac Sweeney on EMCrit.

For a summary of the articles discussed check out Swami’s ‘Epinephrine in Cardiac Arrest‘ post on emdocs.net, which includes links to all of the relevant studies. Scott Weingart also has another relevant discussion in EMCrit Podcast 130 – Hemodynamic-Directed Dosing of Epinephrine for Cardiac Arrest.

Thanks again for listening to the RAGE!

Bubbles in the Wilderness

There have been many discussions and debates about the role of FOAM (free open-access meducation) in medical education, the pros, the cons and whether or not it really is useful.

It may not be for everyone, yet for some individuals – especially those who are remote or isolated – FOAM has transformed how they learn, engage and enjoy medicine. A great example of this — one the RAGE team recommends you read — is Natasha Pirie-Burley’s account, Bubbles in the Wilderness: All about FOAM, published on the Adventure Medic blog.

“In 2007 I struggled to find my passion or heroes within my workplace. I listened to closed minds and wondered why everyone was, “just getting through it”. It was un-inspiring and at times depressing. I resigned from my job in the UK and headed to the wilderness of America, New Zealand, Nepal, and Australia. I was searching for heroes and inspiration relevant to my life. Then last year, by chance, I found that Mawson’s bravery, Shackleton’s leadership, Dean Potter’s composure and the family Robinson’s ingenuity were right here at my fingertips and living in these medical pioneers of FOAM.”
— excerpt from Bubbles in the Wilderness: All about FOAM by Natasha Pirie-Burley

Vive la FOAM!

Punk Rock, Top Gun and the Resus Room

Some time back I wrote about the amazing career of Deniz Tek in Top Gun and Punk Rock in the ER. So it was a real thrill when I contacted Deniz and he agreed to present at smaccGOLD.

Deniz gave an engaging talk titled ‘Punk Rock, Top Gun and the Resus Room’, one that he is uniquely qualified to give. He talked about the parallels between combat aviation complexity and care of the critically ill. He highlighted the importance of checklists (not just for the routine, but even more so for emergencies), communication, teamwork and being prepared to do what is necessary, when it is necessary.  Indeed, a recurring theme at smaccGOLD was that it is, paradoxically, the ‘unsexy’ stuff that matters.

What about the parallels with ‘punk rock’?… Listen to the talk to find out! Here is the audio (download mp3):

Deniz also inspired this creative description of the smaccGOLD conference itself by Jesse Spur on Injectible Orange:

“SMACCGOLD 2014 on the Gold Coast was like punk rock. Subversive, political, honest, rough at the edges and committed to thrashing out the issues that matter. Ironically, on further reflection, the second installation of Social Media and Critical Care Conference struck me as having parallels with one of my favourite speakers of the program, Deniz Tek himself – older and wiser than the Radio Birdman days, more accessible to the mainstream, less likely to punch you for disagreeing, but still able to excite, destroy unfounded dogma and put on a world class show.”

Jesse also had this footage of Deniz on stage in the SMACC lounge:

To listen to all the smaccGOLD talks as they are released subscribe to the SMACC podcast on iTunes or Libsyn. See you in Chicago — SMACC Chicago 23-26 June 2015.

 

References and links

Submassive PE on EMCrit

Back in RAGE Session Two we discussed ‘Thrombolysis for Submassive Pulmonary Embolus’. This was actually just before the PEITHO trial was published, though we were able to anticipate many of the findings thanks to the wonders of the web.

A great follow up to our discussion is EMCrit Podcast 128 – Pulmonary Embolism Treatment Options and the PEAC Team with Oren Friedman. This discussion reiterates many of the conclusions the RAGE team came to, with additional discussions about catheter-directed thrombolysis and reduced dose thrombolysis.

Meanwhile, the NEJM has just published correspondence in response to the PEITHO trial -it  includes a comment about half-dose thrombolysis by Rory Spiegel, myself and Ryan Radecki.

Cases from the Races

The RAGE team’s John Hinds gives the medical perspective on high speed motorcycle racing on closed private roads in Ireland at smaccGOLD. Of note, is the use of rapid response motorcycle medics to get to the scene fast, in the first few seconds of the dying process, to save lives.

This talk stole the show at SMACC, you are about to find out why.

Here is the audio (download mp3):

Here are the amazing slides:

To listen to all the smaccGOLD talks as they are released subscribe to the SMACC podcast on iTunes or Libsyn.

Resuscitation Dogmalysis

Just when you thought there could not possibly be anymore Cliff Reid to go round, the SMACC podcast has released another of his great talks from smaccGOLD.

This time Cliff takes on resuscitation myths, mistruths and misunderstandings – many of which are widely practiced. Do you agree? Are these pseudoaxioms? Do we need to stamp them out?

Here is the audio (download the mp3 directly here):

For the references and slides, go to Cliff’s page here on Resus.ME.

Here is the video:

Reid, Cliff — Resuscitation Dogmalysis from Social Media and Critical Care on Vimeo.

To listen to all the smaccGOLD talks as they are released subscribe to the SMACC podcast on iTunes.

miniRAGE: The ProCESS Trial

Relax, we didn’t really delete the discussion of The ProCESS Trial from RAGE Session Four… We just chopped it out to be published separately as a miniRAGE.

This is what we’re talking about:

ProCESS Investigators, Yealy DM, Kellum JA, Huang DT, Barnato AE, Weissfeld LA, Pike F, Terndrup T, Wang HE, Hou PC, LoVecchio F, Filbin MR, Shapiro NI, Angus DC. A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014 May 1;370(18):1683-93. doi: 10.1056/NEJMoa1401602. Epub 2014 Mar 18. PubMed PMID: 24635773. [Full Text] [Supplement]

So, following on from Haney’s comments on the Surviving Sepsis Campaign response to ProCESS, here is the RAGE team talking about what it all means for the management of septic shock.

Learn more here:

Thanks again for listening to the RAGE!