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#SMACC report March 2013 Peter Jordan

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#SMACC report. March 2013 Peter Jordan . What was it? Questions I went with Some answers Highlights Some Negatives Where is it all going ? Gratuitous Tips. What was it ? . 60 % EM, 20% ICU, 10% prehospital , anaesthetists, GPs (rural and remote) - PowerPoint PPT Presentation

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Page 1: #SMACC  report

#SMACC report

March 2013Peter Jordan

Page 2: #SMACC  report

What was it?Questions I went withSome answersHighlights Some NegativesWhere is it all going?Gratuitous Tips

Page 3: #SMACC  report

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)

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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?

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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.

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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

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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”

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Weingart and tragic groupies

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“intuition = expression of subconscious knowledge”

“You need knowledge to be creative”“Practice Practice Practice”– Until you can't fail– Visualise– Verbalise

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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?

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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

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Sonowars

Bedside Echocardiography:Stick to big 4:

LV dysfunctionPETamponadeSepsis/ tox = Hyperdynamic low vol

Echo during CPR usefulContinue CPR until ready

Page 13: #SMACC  report

Gadgets

Video LaryngoscopyCMAC v GlidescopeiMac

Ultrasound – Sonosite v PhillipsFibre Optic devices e.g. Ambu A-scope“cheap” Simulation softwareNon Invasive Cardiac Output Monitors

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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

Page 15: #SMACC  report

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

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*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

Page 17: #SMACC  report

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

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Q3. Tips for assimilation/ curation of content

TweetdeckRSS feeders – Google Reader now defunctOthers: Netvibes/ Feedly (chrome/ firefox),

Newsblur, Feedler Pro etc..DropboxOthers...

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Negatives?

ExpertiseDiscussion largely limited to TwitterInformation overload – retweetsSignal to noise ratioSoundbites and graphicsDistractionFast thinking ≠ quality thinking? ADHD

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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

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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...

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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

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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)

Page 24: #SMACC  report

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