TechTool Thursday 058 Presentain

TechTool review Presentain

Presentain aims to provide a fresh approach to delivering presentations. The idea is to make your presentations interactive and accessible. You can still create your own slides in the normal way (using PowerPoint, for example), and then use Presentain to show them to the audience. I tried it out recently for a conference presentation. It didn’t all go smoothly…

Website: – Presentain.com

How does it work?

Upload your slides to the Presentain website and then when delivering your presentation, your audience can view the actual slides on their own device. On each slide, there will be a website address at the top – your audience can look this url up on their own mobile/tablet to follow along.

What else can it do?

  • One of the great features is that your mobile phone can act as a slide clicker – simply press a button on your mobile to move to the next slide. You can view the current and upcoming slides on your phone.
  • There is also the option to record your voice along with the slides as you give the presentation. This can then be uploaded and published/shared.
  • And at the end of the talk it’s possible to view some stats about the number of people who accessed the slides.

What are the interactive features?

  • There is the opportunity to use polls in your presentation. These can be set up beforehand (i.e. question with a multiple choice answer) and they can be shown on screen at any point in the presentation. Audience members following along on their own devices will be able to select an answer on their screen, and the poll results are displayed in a pie chart.
  • Secondly, audience members can submit questions via the website. An alert appears when a question is submitted and these can be read on your phone during the presentation. If you want to display them on the big screen for the audience then you can do that too.

So, how does it work in practice?

I decided to try it at a conference presentation, even though I did feel slightly nervous about doing so. I had set up a few polls beforehand, but was worried about how many people would actually be accessing Presentain on their devices, so I bottled out of using the polls in the end. It was not a tech conference, and most people there would not have been particularly tech savvy.

Here’s a few things to bear in mind:

  1. Internet access. Using Presentain does rely on having internet access. To get the presentation started you need to connect the computer to your mobile and this requires an internet connection. And you need data on your phone to move the slides forward. As it turns out, being in a large conference centre does not guarantee decent internet access, so I ended up using my own phone data and used my phone as a wifi hotspot. It wasn’t ideal, but it did actually run well, and internet access didn’t hamper the presentation
  2. Audience engagement. It only works if your audience actually accesses the presentation on their own computers/tablets/phones. That’s how they vote in polls. I didn’t think people were doing it, which was why I didn’t attempt my polls. However, the stats at the end showed me that out of an audience of 70 people, 33 accessed the presentation. That’s pretty good for a first effort.
  3. Software. The audience needs to work out how to use the other features themselves e.g. voting, asking questions, sharing slides, requesting contact info. I didn’t explain how to use the app, other than to provide my presentation url. About 15 people requested a copy of the slides via Presentain and one person asked a question via Presentain (which I forgot that I could display on screen). Again, not a bad outcome.

Cost:

  • There is a free package which allows 5 presentations and 3 polls.
  • Other subscription options are $9.99/month or $29.99/month for higher or unlimited presentations and pool.

Will I use it again?

Overall, I think Presentain is great and I will be using it again. It’s good to try something different to engage your audience, and although some of the features are a bit gimmicky, as long as they don’t detract from your main message, then the interactivity and accessibility really can be an asset.

//www.youtube.com/watch?v=UN9a7XIvxW8

The post TechTool Thursday 058 Presentain appeared first on LITFL.

TechTool Thursday 058 Presentain

TechTool review Presentain

Presentain aims to provide a fresh approach to delivering presentations. The idea is to make your presentations interactive and accessible. You can still create your own slides in the normal way (using PowerPoint, for example), and then use Presentain to show them to the audience. I tried it out recently for a conference presentation. It didn’t all go smoothly…

Website: – Presentain.com

How does it work?

Upload your slides to the Presentain website and then when delivering your presentation, your audience can view the actual slides on their own device. On each slide, there will be a website address at the top – your audience can look this url up on their own mobile/tablet to follow along.

What else can it do?

  • One of the great features is that your mobile phone can act as a slide clicker – simply press a button on your mobile to move to the next slide. You can view the current and upcoming slides on your phone.
  • There is also the option to record your voice along with the slides as you give the presentation. This can then be uploaded and published/shared.
  • And at the end of the talk it’s possible to view some stats about the number of people who accessed the slides.

What are the interactive features?

  • There is the opportunity to use polls in your presentation. These can be set up beforehand (i.e. question with a multiple choice answer) and they can be shown on screen at any point in the presentation. Audience members following along on their own devices will be able to select an answer on their screen, and the poll results are displayed in a pie chart.
  • Secondly, audience members can submit questions via the website. An alert appears when a question is submitted and these can be read on your phone during the presentation. If you want to display them on the big screen for the audience then you can do that too.

So, how does it work in practice?

I decided to try it at a conference presentation, even though I did feel slightly nervous about doing so. I had set up a few polls beforehand, but was worried about how many people would actually be accessing Presentain on their devices, so I bottled out of using the polls in the end. It was not a tech conference, and most people there would not have been particularly tech savvy.

Here’s a few things to bear in mind:

  1. Internet access. Using Presentain does rely on having internet access. To get the presentation started you need to connect the computer to your mobile and this requires an internet connection. And you need data on your phone to move the slides forward. As it turns out, being in a large conference centre does not guarantee decent internet access, so I ended up using my own phone data and used my phone as a wifi hotspot. It wasn’t ideal, but it did actually run well, and internet access didn’t hamper the presentation
  2. Audience engagement. It only works if your audience actually accesses the presentation on their own computers/tablets/phones. That’s how they vote in polls. I didn’t think people were doing it, which was why I didn’t attempt my polls. However, the stats at the end showed me that out of an audience of 70 people, 33 accessed the presentation. That’s pretty good for a first effort.
  3. Software. The audience needs to work out how to use the other features themselves e.g. voting, asking questions, sharing slides, requesting contact info. I didn’t explain how to use the app, other than to provide my presentation url. About 15 people requested a copy of the slides via Presentain and one person asked a question via Presentain (which I forgot that I could display on screen). Again, not a bad outcome.

Cost:

  • There is a free package which allows 5 presentations and 3 polls.
  • Other subscription options are $9.99/month or $29.99/month for higher or unlimited presentations and pool.

Will I use it again?

Overall, I think Presentain is great and I will be using it again. It’s good to try something different to engage your audience, and although some of the features are a bit gimmicky, as long as they don’t detract from your main message, then the interactivity and accessibility really can be an asset.

//www.youtube.com/watch?v=UN9a7XIvxW8

The post TechTool Thursday 058 Presentain appeared first on LITFL.

TechTool Thursday 058 Presentain

TechTool review Presentain

Presentain aims to provide a fresh approach to delivering presentations. The idea is to make your presentations interactive and accessible. You can still create your own slides in the normal way (using PowerPoint, for example), and then use Presentain to show them to the audience. I tried it out recently for a conference presentation. It didn’t all go smoothly…

Website: – Presentain.com

How does it work?

Upload your slides to the Presentain website and then when delivering your presentation, your audience can view the actual slides on their own device. On each slide, there will be a website address at the top – your audience can look this url up on their own mobile/tablet to follow along.

What else can it do?

  • One of the great features is that your mobile phone can act as a slide clicker – simply press a button on your mobile to move to the next slide. You can view the current and upcoming slides on your phone.
  • There is also the option to record your voice along with the slides as you give the presentation. This can then be uploaded and published/shared.
  • And at the end of the talk it’s possible to view some stats about the number of people who accessed the slides.

What are the interactive features?

  • There is the opportunity to use polls in your presentation. These can be set up beforehand (i.e. question with a multiple choice answer) and they can be shown on screen at any point in the presentation. Audience members following along on their own devices will be able to select an answer on their screen, and the poll results are displayed in a pie chart.
  • Secondly, audience members can submit questions via the website. An alert appears when a question is submitted and these can be read on your phone during the presentation. If you want to display them on the big screen for the audience then you can do that too.

So, how does it work in practice?

I decided to try it at a conference presentation, even though I did feel slightly nervous about doing so. I had set up a few polls beforehand, but was worried about how many people would actually be accessing Presentain on their devices, so I bottled out of using the polls in the end. It was not a tech conference, and most people there would not have been particularly tech savvy.

Here’s a few things to bear in mind:

  1. Internet access. Using Presentain does rely on having internet access. To get the presentation started you need to connect the computer to your mobile and this requires an internet connection. And you need data on your phone to move the slides forward. As it turns out, being in a large conference centre does not guarantee decent internet access, so I ended up using my own phone data and used my phone as a wifi hotspot. It wasn’t ideal, but it did actually run well, and internet access didn’t hamper the presentation
  2. Audience engagement. It only works if your audience actually accesses the presentation on their own computers/tablets/phones. That’s how they vote in polls. I didn’t think people were doing it, which was why I didn’t attempt my polls. However, the stats at the end showed me that out of an audience of 70 people, 33 accessed the presentation. That’s pretty good for a first effort.
  3. Software. The audience needs to work out how to use the other features themselves e.g. voting, asking questions, sharing slides, requesting contact info. I didn’t explain how to use the app, other than to provide my presentation url. About 15 people requested a copy of the slides via Presentain and one person asked a question via Presentain (which I forgot that I could display on screen). Again, not a bad outcome.

Cost:

  • There is a free package which allows 5 presentations and 3 polls.
  • Other subscription options are $9.99/month or $29.99/month for higher or unlimited presentations and pool.

Will I use it again?

Overall, I think Presentain is great and I will be using it again. It’s good to try something different to engage your audience, and although some of the features are a bit gimmicky, as long as they don’t detract from your main message, then the interactivity and accessibility really can be an asset.

//www.youtube.com/watch?v=UN9a7XIvxW8

The post TechTool Thursday 058 Presentain appeared first on LITFL.

TechTool Thursday 058 Presentain

TechTool review Presentain

Presentain aims to provide a fresh approach to delivering presentations. The idea is to make your presentations interactive and accessible. You can still create your own slides in the normal way (using PowerPoint, for example), and then use Presentain to show them to the audience. I tried it out recently for a conference presentation. It didn’t all go smoothly…

Website: – Presentain.com

How does it work?

Upload your slides to the Presentain website and then when delivering your presentation, your audience can view the actual slides on their own device. On each slide, there will be a website address at the top – your audience can look this url up on their own mobile/tablet to follow along.

What else can it do?

  • One of the great features is that your mobile phone can act as a slide clicker – simply press a button on your mobile to move to the next slide. You can view the current and upcoming slides on your phone.
  • There is also the option to record your voice along with the slides as you give the presentation. This can then be uploaded and published/shared.
  • And at the end of the talk it’s possible to view some stats about the number of people who accessed the slides.

What are the interactive features?

  • There is the opportunity to use polls in your presentation. These can be set up beforehand (i.e. question with a multiple choice answer) and they can be shown on screen at any point in the presentation. Audience members following along on their own devices will be able to select an answer on their screen, and the poll results are displayed in a pie chart.
  • Secondly, audience members can submit questions via the website. An alert appears when a question is submitted and these can be read on your phone during the presentation. If you want to display them on the big screen for the audience then you can do that too.

So, how does it work in practice?

I decided to try it at a conference presentation, even though I did feel slightly nervous about doing so. I had set up a few polls beforehand, but was worried about how many people would actually be accessing Presentain on their devices, so I bottled out of using the polls in the end. It was not a tech conference, and most people there would not have been particularly tech savvy.

Here’s a few things to bear in mind:

  1. Internet access. Using Presentain does rely on having internet access. To get the presentation started you need to connect the computer to your mobile and this requires an internet connection. And you need data on your phone to move the slides forward. As it turns out, being in a large conference centre does not guarantee decent internet access, so I ended up using my own phone data and used my phone as a wifi hotspot. It wasn’t ideal, but it did actually run well, and internet access didn’t hamper the presentation
  2. Audience engagement. It only works if your audience actually accesses the presentation on their own computers/tablets/phones. That’s how they vote in polls. I didn’t think people were doing it, which was why I didn’t attempt my polls. However, the stats at the end showed me that out of an audience of 70 people, 33 accessed the presentation. That’s pretty good for a first effort.
  3. Software. The audience needs to work out how to use the other features themselves e.g. voting, asking questions, sharing slides, requesting contact info. I didn’t explain how to use the app, other than to provide my presentation url. About 15 people requested a copy of the slides via Presentain and one person asked a question via Presentain (which I forgot that I could display on screen). Again, not a bad outcome.

Cost:

  • There is a free package which allows 5 presentations and 3 polls.
  • Other subscription options are $9.99/month or $29.99/month for higher or unlimited presentations and pool.

Will I use it again?

Overall, I think Presentain is great and I will be using it again. It’s good to try something different to engage your audience, and although some of the features are a bit gimmicky, as long as they don’t detract from your main message, then the interactivity and accessibility really can be an asset.

//www.youtube.com/watch?v=UN9a7XIvxW8

The post TechTool Thursday 058 Presentain appeared first on LITFL.

Palliative Care in Emergency Medicine

Applying some principles learned in Palliative Care to every-day Emergency Medicine practice – a guest post by Professor Ian Rogers FACEM, of St John of God Murdoch Hospital and University of Notre Dame in Perth, Western Australia

Earlier this year I did a sabbatical in Palliative Care. I deliberately chose to work with a purely consultative service based in a tertiary teaching hospital. They did not admit under their own bed card nor was there a hospice on site to admit to. We saw patients from all across the hospital; from outpatients to ED, from ICU to slow stream rehabilitation. My aim was to gain an understanding of Palliative Care practiced in these acute settings and take some of the principles I learned back to Emergency Medicine.

Most days in our own EDs we see patients with exacerbations of COPD. We can all picture a barrel chested man in his mid-70’s wheeled into the resuscitation bay with a nebuliser running. He is sitting bolt upright, intensely focussed on his next breath which will finish with a long expiratory wheeze just like the last. There isn’t much doubt that this is an exacerbation of his COPD just every other time he has presented. He can speak in short phrases at best, but no matter as you don’t really need to speak with him to know what to do. The medicine is easy; nebulised bronchodilators, steroids, some biPAP and perhaps some antibiotics. It worked last time so well that he got by with a few days in the respiratory HDU and didn’t need to go to ICU. So there we have it; a plan of sorts. Emergency medicine is all about disposition and he has a plan of disposal. Next patient please.

But is this really what he wants or needs? This is where it gets hard for Emergency Medicine. To fully understand a patients perspective of what they want takes time, a scarce resource in ED. The task itself made even harder by the patients being so unwell that staying alive, is at the moment, a greater focus than being understood.

You need to allow patients the time to tell their story so that you can understand it properly

In your mind you expect a good early response to treatment and that he is likely to recover from this current problem of an acute exacerbation of his chronic obstructive lung disease. You tell the respiratory team that as you neatly hand him over. With what little breath he has he makes clear though, that his biggest concern at the moment is dying, and in particular dying alone. Wanting to allay his fears you tell him he needn’t worry about that. Things will be fine.

Accept the patients stated problems and concerns at face value, being cautious about putting your own interpretation on them

He is still too short of breath to easily engage in a long conversation with you so you go off to speak with his two daughters. You provide the usual information about what you think is going on, how you are treating him and your expectation that he will recover from this episode. For them the major concern is that he is no longer safe to look after himself at home on discharge. They provide him with a lot of support already and are not sure what else they can do. Although they recognise his illness is serious, he has got better every time so far and it is clear there has never been a discussion about prognosis or limits of care in the future. The disconnect between what your patient is saying and thinking and what is going through the minds of his family is clear.

The treatment ‘unit’ is more than just the patient in front of you. It includes relatives, friends and carers. Involve this expanded treatment ‘unit’ in discussions, but be conscious of not neglecting the patient at the centre of all this

Nearly an hour has passed since he arrived and you reassess his progress at the bedside. biPAP seems to be having some effect on his distress but you can find little objective evidence of improvement. He continues to retain carbon dioxide, is requiring oxygen around 40% to maintain a barely acceptable saturation and his gas trapping and prolonged expiratory phase remains obvious. Holding your hand he thanks you in a few words: “You said you would help my breathing and you have”. You are frustrated that this is a disease you can’t cure, while he on the other hand is thankful that some of his acute distress is being relieved.

Treatment ‘success’ is defined by the goals you set and not by cure

His admission is arranged under a Respiratory team that has strong links with the Palliative Care service. The Respiratory team recognise the trajectory that this patient is on: inevitable further declines, major issues with control of dyspnoea symptoms and a likely future precipitous decline from which he will die. They have asked the palliative care team to review him soon, even though they anticipate recovery from this episode which they are going to aggressively treat in the respiratory HDU. In their experience early Palliative Care involvement not only greatly aids in symptom control but often seems to be associated with longer life expectancy.

  • Disease specific and palliative treatments can comfortably co-exist
  • Palliative care isn’t just about cancer care, end-of-life care or care of the imminently dying
  • Palliative care is best introduced early, not at the end of an illness
  • An active palliative approach may actually prolong life while controlling symptoms at the same time

Palliative Care review your patient in ED and their first orders from are for hourly PRN midazolam 2.5mg SC and/or morphine 2.5mg SC. Your ED nurses are a little bit perturbed, even when told this is common Palliative Care prescribing. Surely benzodiazepines and opiates aren’t going to do much good for this man’s essential respiratory drive? Their order seems to be at odds with spontaneous ventilation on biPAP.

Palliative care can teach us about old drugs rediscovered, new drugs, and new ways of using drugs both old and new

You can see that he is likely to improve from this episode but can also see that in the short-term things could go horribly wrong, whether from progressive Type II respiratory failure, severe pneumonia or a pneumothorax. The family now seem to understand the gravity of the situation but look to you for a more accurate assessment of his immediate prognosis. Your first instinct is to avoid this conversation but you recognise they have a real need to have this information as they come to terms with their father’s mortality.

Prognostication in palliative care can be difficult. Giving too short a time isn’t always bad; patients and relatives may be grateful for the extra time they have been granted

Looking back through the notes you realise that this is the third time that you have treated this man in ED over the past 2 years. He has had other ED attendances in addition to those. Although he has recovered each time and ultimately been discharged home, there is an obvious trend of increasingly severe exacerbations occurring at shorter and shorter intervals. There is clearly no prospect of a cure and while he currently continues to live with his disease it is anticipated that in the future he is likely to die from it. The conversations you have had with him, his daughters and the Palliative Care team have brought this into focus for you. One day he will die of his COPD and it isn’t hard to imagine that you might be the ED clinician who has to provide care for him as he is imminently dying. As a rule you try to put a professional distance between you and your patients but it isn’t always possible. He reminds you of your own father and many of his friends. Accepting you might “lose” him even while you are actively treating him isn’t easy.

  • Be self-preserving when providing palliative care. It is necessary to give yourself permission to grieve the patients you will lose
  • Recognise the privilege of providing attentive and reverential care to the dying

And the last thought that I really want to finish with, one that has been the focus of Palliative Care Australia’s public advocacy campaigns and my real motivation in writing this post is that it is no longer right to avoid discussing palliative care. It is something that we all need to consider openly and honestly. It truly should be part of Emergency Medicine practice

Palliative care is everyone’s business both in the community and throughout the healthcare system

The post Palliative Care in Emergency Medicine appeared first on LITFL.

Ebola, the Perfect Political Pathogen

Though more of a bacterial man, I have written about viruses in the past, and now feels like a good time to write about one again.

An enveloped, filamentous virus with a negative stranded RNA genome is doing the rounds in a distant part of the world. Spread by close bodily contact, this mode of transmission poses an impediment to the virus’ dissemination, in spite its high viral titres. Cultural practices and poor health infrastructure were the only allies of the virus in West Africa.

Despite its difficulty in transmitting, ebola hysteria has been blown completely beyond any rational proportion. Ebola essentially represents our fear of the unknown. An exotic unfamiliar virus that stereotypically manifests in uncontrolled bleeding and a very unpleasant way to die. To date, single cases of ebola have accidentally slipped through into the US and Australia, and as a result only a handful of people have become infected. However, the clinical outcomes couldn’t be more divergent from our fear, in the first world setting none of these secondary cases have died. The virus is realistically a non-issue, but these facts will not assuage the public’s primal fear of the unknown. Despite not claiming or realistically being able to claim as many lives as respiratory pathogens in our developed society, our lack of personal familiarity with hemorrhagic fevers drives our fears. Unfortunately, fear sells stories that audiences read, in turns this creates and confirms fears ; the cycle continues.

Fear creates opportunities for others to exploit. Electoral politics is the art of posturing and appearing strong in the face of threats. Unfortunately, our disproportionate fear of ebola has played into the hands of political opportunists. Unjustified ebola panic has given reactionary “tough on ebola” hardliners political capital to push measures that may well prove counter-productive to control efforts at home and overseas. These measures include border closures and mandatory quarantines. The simplicity of such policies is that logically, if all comply, they should work. The reality is that overly tough measures risk sacrificing the only ally of contact and case tracing, cooperation and compliance. We’re in an interconnected, international community with many means of entering and exiting countries. Sacrificing compliance risks exacerbating ebola’s spread and limits our ability to trace contacts, and that would be a public health nightmare.

The negatives of these policies do not outweigh the positives these measures provide to decision makers, votes. This is the perfect issue to politicise, proposed policies here and in the US are bandaids, measures that makes it seem you’re tackling a large concern. In this case our concern is a hard to transmit; rarely encountered disease. Because of the rarity of each event (secondary cases at home), there can be no metric to test how effective these measures would be above a baseline. This is in essence, the very epitome of a perfect political policy: one that will appear successful, but ultimately the same result would have been achieved without the intervention.

Ebola doesn’t present as big a threat to us as swine flu did. Though many of us are quick to dismiss the flu, those on the front lines of medicine were witness to the incredibly destructive potential possessed by a small segmented RNA virus that we take for granted. Though scary and exotic, lessons from abroad teach us that fear is the greatest risk factor for ebola’s dissemination. A hard to transmit disease that many of us will likely never encounter, endorsing policy out of fear is counter-productive. If we want to control ebola, we must act rationally and follow the advice of experts and not cynical reactionaries.

Ebola headlines

The post Ebola, the Perfect Political Pathogen appeared first on LITFL.