Authors: Craig Davidson, Chris Connolly, Nikki Abela, Simon Laing / Code: / Published: 21/09/2016
The second day of the conference started a new chapter for the college as the new president, Taj Hassan, addressed the audience. We would have liked to get Taj to speak to us exclusively for the podcast, but he was quite elusive (and probably rightfully very busy), but we will try again tomorrow.
NICE Trauma
EM Consultant emeritus David Skinner followed, talking about the NICE Trauma guidance (..and other things). If you haven’t caught up with the updates, The Resus Room has a nifty podcast that will bring you up to date. “Keep the spine in line”, Skinner warned, going against the trend of online debates on cervical spine collars.
Mind over Matter and PHEM
The late morning session had some great tracks which had us wishing we could split ourselves into two (or three).
James Tooley argued that the “Children are not Young Adults” perspective could leave practitioners paralysed with fear. “Go back to your ABCD approach and tackle that first,” he said, pointing out that we could then take a step back and think about other processes which may be specific to children.
Those in the Neuro stream were entertained by another practical lecture by Francis Morris and other great speakers. Jason Kendall talked about thrombectomy in acute ischaemic stroke, a major advancement in neurology which is likely to be something we may be seeing more of in the Emergency Department. The recent Lancet meta-analysis has provided evidence that this is something we should be thinking of and is already happening in North Bristol.
Jason Kendall #RCEM16Beach
Indications for stroke thrombectomy currently happening @NBTresus pic.twitter.com/9pIt9BEg2j
— TheResusRoom (@TheResusRoom) September 21, 2016
If you want to go over the evidence, you probably should. EMNerd (EMCrit) has an excellent blog on the topic to start you off.
Neuro Intensivist Andy Eynon continued on the neuro stream saying the neurosurgical SpR should not be the gatekeeper for severe head injury patients.
According to NICE, he said, all severe head injuries should be managed at a regional centre. However, when asking for a show of hands from the audience, it seems like it was not the EDs who had the ability to push for this.
Automatic acceptance pathways to MTCs were the way forward, he said.
He also directed us to an excellent online resource for guidance on neuro intensive care patients produced by Wessex neuro ICU.
Feeling a bit cognitively overloaded?
That shows great awareness on how you think. David Martin gave an excellent thought-provoking talk on our thought processes and biases, encouraging us to look up and reflect on practises which may affect our care.
Don’t know where to start? St. Emlyn’s have a great blog on the Illusion of Frequency and Neel Bhanderi has written an excellent post (although we may be a bit biased.. pun intended) on Normalisation of Deviance in Medicine, which we hope to publish on this site soon, so watch this space.
That’s it from us for today, we hope this has been helpful. This is of course only a short snippet of what happened in sunny Bournemouth, tune in tomorrow for more updates.