Category Archives: podcast

RAGE talks CRM Brindley-style and dasSMACC

The next RAGE session is here! (we’re no longer numbering them as the low numbers are depressing…)

This one is 95 min long and includes:

  • Introduction and ‘What’s bubbling up?’ (starts 00:00 min) — head rotation for effective ventilation, The Procedures Course, FOAM social capital and wellness, Tips for New Doctors..
  •  ‘Optimizing Crisis Resource Management’ (starts   14.29 min) — an interview with Peter Brindley followed by thoughts from Karel Habig
  • ‘dasSMACC reflections’ (starts  67.09 min)
  • ‘A blast from the past’ by Karel Habig on ‘John Scott Haldane’ (starts  87:55 min)
  • ‘Words of Wisdom’ from Peter Brindley (starts  92:36 min)

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

Here are the show notes for this RAGE Session :

Introduction

What’s bubbling up?

Optimizing Crisis Resource Management

dasSMACC Reflections

Blast from the Past

Words of Wisdom

  • “To be a better doctor, be a better human” — Peter Brindley

Thanks again for listening to the RAGE!

Three Men and a Microphone

‘Three Men and a Microphone’ is a special edition of the RAGE podcast (let’s face it, RAGE podcasts are so infrequent they’re all special!) featuring RAGE Resusciteer Cliff Reid in conversation with these special guest RAGErs:

  • Geoff Healy (prehospitalist/ retrievalist/ anaesthetist)
  • Brian Burns (prehospitalist/ retrievalist/ emergency physician)

This one is a monster – it is 2h 48 min 59 sec long!!!  It is NSFW (contains some profane verbiage) so don’t let your kids listen in…

Here is the run sheet so the you can skip to the bits you want:

 

Introduction
0:00 Intro: NSFW
2:38 Welcome – what we’re busy with at the moment
10:13 Highly functioning organisations
18:00 Airway audit
19:06 Operations research and A.P. Rowe
23:42 Role of SOPs, SOPs vs protocols

 

28:37 QUESTION: Describe training experiences that have shaped you
Anaesthesia in Australia -Geoff getting patronised
Trauma in Ireland – Brian being unsupported
EM in England – Cliff getting pimped
Importance of honesty and humility as a mentor
Mike Clancy’s public cerebration – teaching you how to think
Phoning a friend when you’re the boss
Calling the boss in – differences between the UK & Australia
3 reasons to call the boss: to let you know, to seek advice, to ask you to come in.

 

1:05:05 QUESTION: What is your experience of trainees, and what attributes of good and bad trainees do you observe?
The lurker, the stalkers, the shopper, the sharp-elbows
Our experiences as underconfident trainees
Turning yourself into the (mythical) shit magnet
John Hinds’ approach to keeping sharp
Consultants who are hummingbirds
Avoiding institutionalisation – getting experience in remote/rural units

 

1:29:24 QUESTION: Give your advice on how to be a good resuscitationist
The word resuscitationist
EMS Gathering in Cork and big wave surfers
Extending your training – fellow posts and other experiences
Acquiring experience with restrictions on working hours
The limitations of learning from textbooks and life support courses
Can we accelerate the acquisition experience using technology?
Lionel Lamault & prehospital ECMO
Comfort zones and task fixation
Geoff likes to ‘bosh’ people
Cognitive rally points
Unexplained different approaches to fluids in paeds resuscitation
Being treated as a gas monkey in ED
A new word  – resuscitationism
The Jason Bourne game and developing spider-sense
Too sick to be intubated?

 

2:07:30 QUESTION: What are you currently struggling with in your careers?
Being a coach
Having trainees who are better than we are / were
Top Gun pilot caution against overperformers
Thoughts for bosses who have trainees who are smarter or more skilled than they are: (1) They make you look good; (2) You might learn something; (3) The future is brighter for patients
The challenge of getting senior clinicians involved in simulation
Struggling to improve and get outside our comfort zones, and continue to evolve as consultants
A pantyhose anaesthetic
Work-life balance
Sustainability and recovery from travel and shift working as you get older
Family first
Stress vs passion and Simon Sinek
Misquoting Lincoln and sharpening the tree
Emptying your cumulative stress bucket
Risks of PTSD especially in paramedics
Debriefing

 

Thanks again for listening to the RAGE!

 

ECPR by Vincent Pellegrino

On August 17th 2016, Associate Professor Vincent Pellegrino, Head of the ECMO service at The Alfred ICU, discussed ECPR during an in-house education session.

His discussion included:

  • the difficulties with ECPR definitions and selection criteria
  • Approaches to ECPR, ranging from cannulation techniques and types of cannula, to role cards and the importance of teamwork
  • Outcomes for ECPR and the evidence for the technique

Listen to the talk to find out more – the podcast is 37 minutes long.

THE VIDEO

THE SLIDES

For more on ECMO check out INTENSIVE and EDECMO.org.

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

Thanks again for listening to the RAGE!

John Hinds Defends Direct Laryngoscopy

Here is the ‘bootlegged’ video footage of John Hinds’ defense of direct laryngoscopy in the prehospital setting.

John brings all his usual wit and mischievousness to the defence of the tried and true way of getting a tube between the cords anywhere and at anytime.

The audio has been released on the RAGE podcast, and is 7 minutes 30 seconds long.

For more John Hinds, go to RAGE’s John Hinds tribute page.

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

Thanks again for listening to the RAGE!

Steve Bernard’s Resuscitation Update 2015

On November 11th 2015, Professor Steve Bernard (@AmbVicMedic), Medical Advisor to Ambulance Victoria, presented a smorgasbord of ‘Updates in Resuscitation‘ at The Alfred ICU junior medical staff teaching session.

He discussed:

  • Recent data from registries on in-hospital and out-of-hospital cardiac arrest (OHCA), particularly from Victoria, and the reasons why OHCA results may be improving
  • Options for treatment of refractory VT/VF, including the CHEER2 trial
  • The RINSE trial: is intra-arrest cooling with ice cold IV saline for OHCA a good thing?
  • Highlights from the recently released updated ILCOR guidelines, which will form the basis for the next ARC guideline update

Listen to the talk to find out more – the podcast is 47 minutes long.

For more talks by Steve Bernard, check out INTENSIVE.

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

Thanks again for listening to the RAGE!

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!

RAGE Session Four

RAGE Session Four is here! (at last…. you say)

It is 61  min 46 sec long and includes:

  • Introduction, including a welcome to new RAGE team recruit John Hinds and apologies from Cliff… (starts 00:00 min)
  • ‘What’s bubbling up?’ (starts 01:16 min) — shout outs and interesting discoveries from the world of FOAM and elsewhere featuring regional anaesthesia, the GoodSam app, the Surviving Sepsis Campaign response to the ProCESS Trial, Brain Impact Apnoea and the ‘Tamiflu’ debacle.
  • the RAGE team discussing ‘Getting The Right Side Right: RV infarction and RV failure’ (starts 13:39  min)
  • the RAGE team discussing another ‘Humans in the Resus Room’ topic: ‘I Want to Stop, But Someone Else Doesn’t’ (starts 37:03 min)
  • ‘A blast from the past’ by me (Chris Nickson) on ‘Jack Barnes and the Irukandji Enigma’ (starts 55:07 min)
  • ‘Words of Wisdom’ from motorcycle legend Guy Martin via John Hinds (starts 59:14 min)

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

Here are the show notes for RAGE Session Four:

Introduction

What’s bubbling up?

Regional Anaesthesia

  • Beaudoin FL, Haran JP, Liebmann O. A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial. Acad Emerg Med. 2013 Jun;20(6):584-91. doi: 10.1111/acem.12154. PubMed PMID: 23758305.
  • Black KJ, Bevan CA, Murphy NG, Howard JJ. Nerve blocks for initial pain management of femoral fractures in children. Cochrane Database Syst Rev. 2013 Dec 17;12:CD009587. doi: 10.1002/14651858.CD009587.pub2. Review. PubMed PMID: 24343768.
  • De Buck F, Devroe S, Missant C, Van de Velde M. Regional anesthesia outside the operating room: indications and techniques. Curr Opin Anaesthesiol. 2012 Aug;25(4):501-7. doi: 10.1097/ACO.0b013e3283556f58. Review. PubMed PMID: 22673788.
  • Gadsen J. Regional Anesthesia in Trauma: A Case-Based Approach. Cambridge University Press; 1 edition (November 12, 2012) (website)
  • Wu JJ, Lollo L, Grabinsky A. Regional anesthesia in trauma medicine. Anesthesiol Res Pract. 2011;2011:713281. doi: 10.1155/2011/713281. Epub 2011 Nov 21. PubMed PMID: 22162684; PubMed Central PMCID: PMC3227428.
  • Mike Stone’s video showing how to perform a fascia iliaca block with ultrasound:

FICB Refresher from Mike Stone on Vimeo.

Other topics ‘bubbling up’:

Getting The Right Side Right: RV Infarction and RV failure

  • The ‘OH CRAP’ mnemonic for optimising oxygen delivery and haemodynamics: Oxygen, Haemoglobin, Contractility, Rate & rhythm, Afterload and Preload (for both the right and the left heart – need to do different things for each!)
  • Inohara T, Kohsaka S, Fukuda K, Menon V. The challenges in the management of right ventricular infarction. Eur Heart J Acute Cardiovasc Care. 2013 Sep;2(3):226-34. doi: 10.1177/2048872613490122. Review. PubMed PMID: 24222834; PubMed Central PMCID: PMC3821821.
  • Vandenheuvel MA, Bouchez S, Wouters PF, De Hert SG. A pathophysiological approach towards right ventricular function and failure. Eur J Anaesthesiol. 2013 Jul;30(7):386-94. doi: 10.1097/EJA.0b013e3283607a2d. Review. PubMed PMID: 23571479.
  • Right ventricular infarction (LITFL ECG Library)
  • Right Ventricular Failure (LITFL CCC)
  • Right Ventricular Function and Haemodynamic Assessment (LITFL CCC)
  • Pulmonary Artery Catheters (LITFL CCC)
  • Pulmonary Hypertension (LITFL CCC)

Humans in the Resus Room: I Want To Stop, But Someone Else Doesn’t

Blast from the Past

Words of Wisdom

Thanks again for listening to the RAGE!