Pick Me! Getting Selected to Speak in Medicine

ACEP’s New Speaker’s Forum fills up within hours of opening every year, and many aspiring speakers are discouraged not to get one of those coveted slots.  However, you can build your speaking reputation and make it to emergency medicine’s biggest stage through other pathways.  Here are some tips to launch your speaking voyage.

Brand Yourself

Spend some time thinking about what you would like to build as your personal brand.  Are you fellowship trained?  You may consider lecturing on areas in your fellowship or research interests.

If you are a rank and file doctor, however, you can still offer fascinating lectures.  Think about what makes you unique or passionate, and build your topics from those sources.  If you work in a rural hospital, create a talk on the unique challenges of critical access medicine.  The ivory towers of academia have no idea what it takes to work in the boonies; this is your chance to tell them.  Are you passionate about advocating for vaccines?  Discuss how vaccine uptake rates affect you as an emergency medicine physician, or talk about re-emerging infections that are presenting to EDs across the country.

Audiences also love interesting formats, so think beyond the standard lecture format to workshops, moderated panels, or demonstrations.

Find Calls for Speaker Submissions

Large conferences like ACEP have their call for submissions usually a year before the conference.  Make note of deadlines, because the first step is getting in before the doors are locked.  You can also contact organizations throughout the year and express interest.  Request an email when speaker submissions open, and you are less likely to miss the deadline.

Do Your Homework

Course planners spend a tremendous amount of time vetting speakers.  No one wants to put someone on stage who is going to read verbatim from slides or freeze and run panicked from the room.  The larger the conference, the more exacting the course planners will be for prior experience.

If you have never spoken before, your chances of being selected for large conferences like ACEP are slim.  Speaking at smaller conferences can build your reputation and skill.  Offer to give a talk to your local medical society.  Teach your parent teacher organization about the importance of CPR.  Submit to speak during your state chapter’s meeting.  These are great stepping stones to gain experience.

You can also join ACEP’s Spokesperson network.  Media training opportunities are available at ACEP conferences, which help you hone your craft.  As an official ACEP spokesperson, you can speak on behalf of the College for news media interviews and other speaking opportunities.

Record your talks, even if you can only obtain audio files.  Upload these files to your LinkedIn profile or personal website so conference organizers can see your work and the list of where you’ve spoken before.  This builds your credibility; think of it as your public resume for speaking.

Submitting Your Ideas

When speaker submission open, go to the website and enter your proposed topics.  Don’t be afraid to submit several ideas, even if they are similar.  For example, you can submit a lecture on fever in the returning traveler, and also offer a talk about tropical infections moving to our shores like zika and chikungunya.  They are similar topics, but to a course planner, those are going to look and market differently, and gives you a better chance to get picked up.

The section that asks for a brief description is what will end up in the catalog for people to choose your lecture, so this needs to be a catchy title and blurb.  Don’t be afraid to explain why you’re the right person to give this talk.  If you don’t state your case eloquently, people are unlikely to select your lecture from the hundreds of options.

For every submission, save the title, blurb, and objectives so you can submit it again.  I save my lecture submissions so next year, I can easily resubmit what doesn’t get picked up this year, or offer to another outlet.  I also save the lecture confirmation, so I remember where I’ve already offered that lecture. You will also get feedback from the course planners on why a lecture doesn’t get picked up, so note that down in your file so you can improve the submission for the next time.  Sometimes the answer is “We just did this, but try again next year” so it’s nice to have it easy to recycle.  Once a submission is picked up, I move it to a different folder where I store the source documentation, outline, and slides that I’ve developed for that lecture, as well as feedback I receive after the lecture so I can improve it for the next offering.

Any topic you can tie into a conference theme is more likely to get picked up as well. For example, for next year’s 50th anniversary of ACEP, a fun history tie in is more likely to get picked up based on the conference theme.  SimWars this year at ACEP had a zombie resurrection in honor of Halloween; fun unexpected twists will get you noticed.

Follow Through

You will be notified that you were selected a few months after submissions are due. Once you’ve been selected once, you want to make sure that you get invited back to speak in the future.  Be easy to work with.  When they send you forms, get them back in on time.  Upload things when you are asked. Respond to emails.  If you aren’t easy to work with, you can be the greatest speaker in the world, but you won’t be invited back because it’s too much work for the organizer to deal with you.

Once you are selected, enjoy the experience!  Speaking at ACEP is a tremendous thrill.  It’s intoxicating to be able to share your ideas with people who are passionate about the same things you are.  My husband refers to ACEP as my “nerd herd,” and I love my herd mates!

Now that you’ve finally made it, reach back down and pull up another speaker.  There are so many topics, and so many great voices, we will not run out of places to put them.

Dr. Torree McGowan, MD, FACEP is an Air Force veteran, and has deployed to both Iraq and Afghanistan. She is a nationally recognized speaker and expert on mass casualty response and is a practicing emergency physician with St Charles Medical Group in central Oregon.  See more of her work at www.erdisasterdoc.com or follow her on twitter @erdisasterdoc.

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Video Laryngoscopy (VL) Or Direct Laryngoscopy (DL) in the ED

Background:Endotracheal intubation is a common occurrence in the ED. Many patients requiring airway management are at a higher risk of hypoxia due to deranged respiratory physiology (i.e. decreased functional residual capacity and/or increased shunt fraction).  Advocates of video laryngoscopy argue that it provides better visualization of the airway anatomy, but it is less clear if better visualization correlates with better patient oriented outcomes. Good preparation, pre-oxygenation, and having a plan A, B, and C prior to intubation are essential requirements in 1st pass intubation success rate and decreased intubation time.  What is less clear is should plan A be VL or DL?

What They Did:

  • Meta-analysis of randomized controlled trials evaluating video laryngoscopy (VL) vs direct laryngoscopy (DL) in adult patients in the emergency department undergoing endotracheal intubation

Outcomes:            

  • Primary: First pass intubation success rate (An intubation attempt began when the laryngoscope entered the mouth and ended when it was removed. An intubation attempt was considered successful when confirmed by capnography and additional standard techniques.)
  • Secondary:
    • Overall intubation success rate
    • In-hospital mortality
    • Esophageal intubation rate

Inclusion:

  • Randomized controlled trials
  • Adult patients presenting to the ED

Exclusion:

  • Trials on cadavers
  • Trials on manikins
  • Simulated reviews
  • Non-English publications

Results:         

  • 1250 patients from 5 RCTs

Strengths:

  • Included on only RCTs
  • A number of databases were reviewed for appropriate articles (Cochrane, CENTRAL, etc…)
  • Asks a clinically important question
  • Followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
  • Cochrane questions were used to assess methodological quality of included studies

Limitations:

  • The protocol for this meta-analysis was not registered
  • There was no blinding of participants and personnel in the individual studies, potentially causing a performance bias
  • All included studies were small
  • There is a wide range of heterogeneity most likely due to differences in patients and operator expertise levels
  • Incidence of hypoxemia was only reported in one trial and therefore not able to be evaluated in this meta-analysis
  • Most of the included studies excluded patients with potentially difficult airways. It is this population where VL may have an advantage over DL.

Discussion:

  • In the 5 trials included, 3 trials were a comparison of C-MAC VL vs the Macintosh blade and in the remaining 2 trials Glidescope VL vs the Macintosh blade were compared
  • Potential reasons why VL was not superior to DL:
    • Limited experience with VL
    • RSI medications may not have been optimal during emergency intubation
    • VL may have had a poorer alignment of oral, pharyngeal and laryngeal axes (Not all VL is the same. There are hyperangulated blades as well as standard geometry blades)

  • Finally, my thoughts on the VL vs DL debate are summarized in the image below

Author Conclusion: “Use of video laryngoscopy for emergency endotracheal intubation in adult patients is associated with reduced oesophageal intubation over direct laryngoscopy. However, no benefit was found in terms of overall intubation success.”

Clinical Take Home Point: Although there is no difference in 1st pass intubation rate, overall intubation rate, time to intubation, and in-hospital mortality, all of which are clinically important outcomes when comparing video laryngoscopy to direct laryngoscopy, better airway anatomy visualization with video laryngoscopy does reduce esophageal intubation rate compared to direct laryngoscopy.

References:

  1. Bhattacharjee S et al. A Comparison Between Video Laryngoscopy and Direct laryngoscopy for Endotracheal Intubation in the Emergency Department: A Meta-Analysis of Randomized Controlled Trials. J Clin Anesth 2018. PMID: 29549828

Post Peer Reviewed By: Anand Swaminathan (Twitter: @EMSwami)

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