RCEM ’15 in Manchester has been a sell out! For those of you that weren’t lucky enough to be here, here’s what’s been going on on Day 3!
- there is a “resilience quotient” that you can check online
- there’s mindfulness
- there’s yoga
- simple things like writing down three positive things at the end of every shift (instead of focussing on the single missed minor fracture)
- Amy Cuddy on how body language affects who you are.
- Read some Croskerry
- Read 7 Habits of Highly Effective People
- Read some Kahneman
This morning RCEM15 had a reasonably well-packed presentation on FOAMed, where people who were plugged-in or wanted to plug-in after Scott Weingart’s (@emcrit) inspiring talks about being an excellent physician with a “thirst for learning”, were given ideas about how to go about it.
The first presenter was pretty disappointing of course (you wouldn’t expect much from our very own Simon Laing) (@laing_simon).
If you’re not that savvy with British humor, I (Nikki Abela) do apologise, but you should notice by now that when I say it was excellent, there is likely an element of bias (but really, bias aside, it was super).
Talking about bias though, you probably are already a FOAMed fan if you’re reading this, but I do suggest you have a listen to Simon on this podcast so that you can nod away and feel better about yourself for keeping up with the current trend in medical learning. (fashionistas have nothing on us)
Talking about trends though, Natalie May (@N_May) followed and asked if this FOAMed stuff is “just a fad”? While you have a think about that, I do suggest you go on the St.Emlyn’s website to have a read and listen to the tips she gave on keeping up to date with the tons of medical literature/education there is out there. (Yes, she’s very trendy, and had her presentation go live as soon as she finished the talk).
Salim Rezaie (@srrezaie), one of the top international academic FOAMers, told us how FOAMed helped his academic career take off.
According to him, academic FOAMed should meet 5 criteria:
- It has to be new idea
- It has to benefit the field
- It needs to be appraised
- It should be archived
- It should be open to feedback
I’m not going to tell you how he applied this to kick-start his now international career, however,I will share with you the following advice he gave us as a parting thought:
“You will get there whether you’re on FOAM or not, but technology will get you there faster”.
An avulsed tooth is a medical emergency
Serpil Djamal from dentaltrauma.co.uk spoke to us about avulsed teeth. This may not be considered by many to be the sexiest topic, but Serpil definitely had some good take home messages.
-Look for it immediately (if you can’t find it, do a CXR to make sure the tooth hasn’t been inhaled) and aim to re-implant it asap (except baby teeth, neglected mouths, gum disease):
-Hold the tooth by the crown only (holding it by the root may damage it), then hold it in place by biting on cotton wool/tissue.
-Wash it with saliva or plain water
-If it can’t be implanted immediately, place the tooth in milk
-Cover with doxycycline (pen V or amoxicillin if <12)
-Once it is in the socket, refer the patient to maxfax/on-call dentist where the tooth will be temporarily splinted before they can be discharged
“Pick it, lick it, stick it.”
- Complication rate is low at 6.1%
- Delayed bleeds low at 0.16%
- Risk of complications significantly increased in alert patients who have amnesia, vomiting, LOC and, to a lesser extent, headache
- INR was not found to be associated with a poor outcome
Making Good Judgements
Prof. Simon Carley (@EMManchester) gave a talk on making good judgements. Taking a reflective look on how we think and perform in the emergency department. He pointed out that bad decisions don’t always lead to bad outcomes — but this is called luck. He had some suggestions to how we can improve ourselves in the ED environment:
The Essence of Emergency Medicine
Salim Rezaie (@srrezaie) then gave us a bit of a ‘pat on the back’ during his talk on the essence of Emergency Medicine – or as he renamed it ‘The Modern Day Superhero’ with our super powers of mastery of the undifferentiated patient, our ability to risk stratify (or as Simon Carley called it, being ‘probablasticians’), to see anyone, anytime, anywhere, and to do it all with compassion and superior communication skills. However, with great power comes great responsibility and we need to continue to train ourselves, be adaptable, and make ourselves a Jack of all trades, and a master of them all.
In short, what we do matters, we rock, keep up the good work.