#Formistemporary

# Form is temporary

Form is temporary…. KNOWLEDGE is forever..

Or something like that..

Just because I haven’t been around doesn’t mean that the KNOWLEDGE should stop…

And just because my brain cells (and hair follicles) are being destroyed by the inability of 2 small people to sleep efficiently.. doesn’t mean Bartram should take his finger off the pulse or ear away from the ground…

So here are some interesting little reads… [1]….[2]….[3]….you may have already come across - to keep you on the straight and narrow until we formally embrace Wednesday KNOWLEDGE club again…

Vive

Cheers

Bartram

Sedation and swelling

2hrs of (at best) mediocre..... KNOWLEDGE busting today team...

 

A review of anaphylaxis and a question of whether giving older patients adrenaline MAKES THEIR HEART EXPLODE??.... 

Then safe sedation.... how does the old orthopaedic favourite midazolam compare to propofol???..which will lead us nicely into sedation documentation and our NEW departmental guidance....

 

KNOWLEDGE right in your very face

 

Boom

Cheers,

BARTRAM

Play your cards right.....Higher, higher...Lower, lower

How's your Bruce Forsyth impression??

 

What is your answer to the questions - "This patients BP is 220... is that OK? Do we need to Lower it?"...???

 

 

Lets consider BP management in intracranial bleeds.... 2 papers that make things as clear as mud... perfect

 

Both in the NEJM...

INTERACT2

ATACH-2

Read and enjoy

 

Bring the KNOWLEDGE

 

Kapow

 

Bartram

Dogma bashing....

Your minding your own business in the ED when a child comes in with a fever.... "give them paracetamol and ibuprofen" you say.... "but they've got asthma doctor"....

 

Hmmmmm....

 

Here's something interesting from the NEJM which starts a conversation about this age old dogma....

 

We are going to be joined by some FY doctors an lunch will be provided... AND as a special treat I might even do a presentation on our approach to journal club

 

Awesome... bring the KNOWLEDGE

 

Bartram

24hr Brain injury people...

24hr Party people... 

 

It's summer party season in Oldham...  hooray...

 

But with the party comes the booze and the fighting... awesome.

 

Now when it comes to head injury awareness and our KNOWLEDGE of diagnostics for intracranial injury when we see patients within 24hrs, we are not too shabby... there is NICE guidance and EMOldham guidance available right here...

However.. how is our KNOWLEDGE on the late presenting head injury?? Who would you blast with gamma radiation and whom would you not??..

 

Rick Body of the central Manchester parish has been at the helm of the EMJ this month and published THIS ARTICLE... which may give us some answers?!?! or maybe not...

As its coming up to Critical appraisal time I expect your bullshit antennae to be up...

 

see you soon 

 

Bartram

Euro KNOWLEDGE

What can I say...

 

No baby yet. The wait continues for Bartram 2.0

But much more excitingly ... we have got KNOWLEDGE coming right into your ears for the next couple of GEEK sessions..

 

Our intrepid team have braved travel across the Irish sea and dared set foot in a European country - with the euro and everything.... ... They bring back KNOWLEDGE of the highest order

Team...engage the neurons, bring an open mind and join the discussion

Quality vs Performance... and LVH

So we are T minus zero for the arrival of Bartram le deux.... good luck everybody.

But that will not stop the KNOWLEDGE.

 

There's an interesting article this week from the mayo clinic team which will hopefully give us something to talk about.... quality of care versus performance and also some clinical stuff about the ECG...

 

In the meantime prepare yourselves for sleep deprived Bartram - round 2

 

PS... GEEK club NOW AT NOON!!!!

Clubbers...

Team KNOWLEDGE... its been a long time...

 

luckily we've got 10 weeks left until the end of term and lots to learn.

 

KNOWLEDGE thrusters set to maximum then..

 

The website is now home to a KNOWLEDGE calender and links to the relevant details for each weeks teaching... bonjour.

 

Look under education then GEEK club or GEEK club calender.

 

 

This week - a catch up on hot topics in EM with a browse through the EMrap podcast... then a lesson learnt session with JT at the helm...

 

 

Good luck everybody.

 

Bartram

Re-invigoration

Re-invigoration…. thats what its all about this week… RE-invigoration…

 

Get Bartram back into the swing of things and see if we can Re-invigorate the KNOWLEDGE experience for everyone…

 

SO check out the EMOldham website … under teaching … look for GEEK club and find out whats coming up and look back at what has been before…

 

This Wednesday apart from general gossip we will have a look at the study protocols for HALT-IT, CRASH 3 and IONA…. hopefully a discussion of trial design… AND we will get everyone started on the road to getting your GCP done so that we can recruit more…. Re-invigorate recruitment!!

 

RE-INVIGORATE… imbibe the KNOWLEDGE

Bartarm

No I in TEAM

 

Team...

How are things?? 

I hope your massive brains are full of KNOWLEDGE that I can access and use..!?!

There is no paper to read this week... Instead, I want you to focus your skill, experience and KNOWLEDGE on the following questions...

How do you run the perfect Resus team?

Can you visualise the way in which you want your team set up and the actions they are going to perform?

When the call comes for us to manage a patient in cardiac arrest or a trauma, we are probably the COOLEST heads in the hospital... But I want us to be better...

We are going to bring our neurons together and discuss all aspects of resus teams, I want you to think team leading, human factors and checklists.... Bartram (for his part) has got a new whiteboard and is not afraid to use it.

See you on Wednesday

Bartram

Ps If you have some amazing brain waves or have seen THE PERFECT rests team in action... and want to share KNOWLEDGE and ideas - email me directly or reply to the group with your thoughts.....

Next shift YOU will be the team leader....


Silver Trauma

Team…

The Silver Tsunami is coming and we are going to have to surf the wave…

One minute the old person is up a ladder …. the next they are being poorly triaged by NWAS and arriving on our doorstep

KAPOW

I for one have been caught out by the frailty of the elderly trauma patient and have been slightly (over)cautious ever since…

Here is an interesting read from the Annals (always makes me snigger - thanks emrap) of Emergency Medicine…

A few things to dissect and discuss - remember we are all going to live until we’re 120!

Dust off your walking frames and I’ll see you on wednesday

Bartram

ROCK em..... SEPSIS

Sunday mornings.....

Now the ironman preparation is behind me this means coffee, croissants and critical appraisal for Bartram..... life is SWEET......

There are some exciting articles and topics coming up and an improved format.... 

Now - some of you will be moved on to pastures new by then and you'll be saying "Where's Bartram?? This new department sucks... I need ROCK...!"...
Bartram can't be everywhere - but if you still want to keep in touch, keep reading what we're reading and even contribute to the KNOWLEDGE.... (or if you know of better ways than Bartram)....  You are welcome to stay on the mailing list/visit the website... let me know. (especially about any improvements I could make - I am open to all progress and learning and KNOWLEDGE!!!!!!).......


So this week we will look at the sepsis paper that was sadly overlooked a couple of weeks ago.... 

Last week we had a really useful session on one time critical ED presentation (ischaemic heart disease).... NOW we need to raise the profile of sepsis..... and keep our critical appraisal skills RAZOR sharp...


It's been emotional


Bartram

Journal Club July 2nd...Let's R.O.C.K.!

Over the next 2 weeks Tom B is away and Gabby M and I have been charged with the ominous task of filling his shoes and nurturing the newly repackaged Journal Club (Review of Current Knowledge....ROCK!) through its first baby steps.

It seems only fitting, but this week we are going to celebrate the rebirth of our beloved JC into its new format of ROCK by going back to where it all began, we will have another look at the Targeted Temperature Management Trial.

What temperature should we be cooling our post cardiac arrest patients to? Should we be cooling them at all?

Read, digest and bring your thoughts and considered opinions along for a heated (?) discussion on wednesday.

 

Mark

Journal Club 25th June... SPICE

Hola....

Slam it to the left
If you're having a good time
Shake it to the right
If you know that you feel fine.....

THAT is right ..... SPICE up your life journal club people.....


This week we will be looking at the article which is HOT right now in critical care circles... and directly effects how we should care for our unwell ITU patients in the ED...


All the way from the antipodes.... the SPICE team present the catchy titled: "Early intensive care sedation predicts long-term mortality in ventilated critically ill patients"

Is it a trial? is it a cohort study?? Is it important?............

See you all on wednesday 2pm ...... and with all your insightful comments here on the website..

SPICE UP YOUR LIFE
Uh Uh Hai Sí Ja Hold Tight!!!!

Tom B

Journal club 18th June... anti emetics and more...

Word up Knowledge fans.......

2 things this week....

1. Journal club this Wednesday 18th June 2-4pm - the subject is .... Anti-emetics in the emergency department.. Are they any good? are they??? It's RCT time so get you bias sensors on.....attachment below

2. Journal club needs a new name .... because "Journal club" is dull...... put on your thinking caps and your pun capes......

Remember it's all available on the website and the summaries will be available soon...
Also coming will be a dictionary of critical appraisal definitions - so we all know what the heck we're talking about.


Comments welcome - either by email or website 


See you soon

Bartram


HOLD everything..... as a knowledge BONUS an extra interesting paper on abscesses..... mmmmm mmmm we all love pus..... 

Journal Club 11th June .... JAMA: SAH decision rule

LET'S TALK KNOWLEDGE.....

 

Journal club was postponed last week because of few staff and many patients. But this week we are ON!!!

 

The journal is JAMA... the subjected is SAH decision rules... (that bit in blue is the link to click)

 

This was only published in the last 6 months and by a BIG name in the field.... It also featured on EM:rap recently..

 

For the pure critical appraisal geek in you it's amazing... you will love it... appraisal of decision rules...yes please...... 'cor, look at the validation on that

 

For the clinician.... just a useful look at a difficult topic.

 

Journal club meeting will be wednesday afternoon at 2pm...... BUT ALSO remember you can get involved with ongoing discussions on the website.....

 

 

ALL ARE WELCOME..... spread the love .... share the KNOWLEDGE.

 

 

See you soon

 

Tom B