Fri, 18 December 2015
Just a quick one to wish you all a happy christmas...thats all! |
Mon, 30 November 2015
Dorothy Wade works as a chartered health psychologist in the Critical Care Unit at UCH. She is registered as a practitioner psychologist with the Health and Care Professions Council, and has a PhD in psychology and health care evaluation from University College London. She is available to support patients, families and staff in Critical Care. PTSDPost traumatic stress disorder is defined as a condition of:
and its something the critical care patient can experience after discharge from the department. Dorothy and I discuss many of the issues involved and some of the things we can do to help minimise this problem. |
Tue, 24 November 2015
This episode features a chat with Fiona Moffat who is a lecturer in Physiotherapy and practising physiotherapist. She was involved in some LEAN thinking and is now interested in early mobilisation in the critical care world. As a social scientist she is also interested in how we get to normalise new technologies or interventions in health care and what are the barriers to those interventions. She is presenting at the ICS State of the Art conference 2015 and so it was interesting to get to chat to her about some of the issues. Demystifying theory and its use in improvement Davidoff et al. |
Thu, 5 November 2015
TEAM is a program of research to evaluate the effect of early mobilisation to assess functional recovery and patient-centered outcomes of ICU survivors. Carol Hodgson is one of the lead clinicians in this project, She will be presenting at the 2015 Intensive Care Society State of the Art conference, so this is an opportunity to hear some of the areas she is concerned with. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Schweickert, W. et al The Lancet. Vol. 373, No. 9678, p1874–1882, 30 May 2009 Physiotherapy in the Intensive Care Unit Netherlands Journal of Critical Care 2011 Cycle Ergometry Early rehabilitation in critical care (eRiCC): functional electrical stimulation with cycling protocol for a randomised controlled trial. Parry, S. et al. BMJ 2012 Early Physical Rehabilitation in the ICU: A Review for the Neurohospitalist Mendez-Tellez et al, Neurohospitalist. 2012. Characterization of the use of a cycle ergometer to assist in the physical therapy treatment of critically ill patients Pires-Neto et al. Rev Bras Ter Intensiva. 2013 |
Wed, 14 October 2015
Myself and Tracey Starkey-Moore (@TraceyStarkeyMo) led a @WeNurses chat on the 1st October about Advanced Practitioners. You can find the Summary on the discussion on the WeCommunities website with the relevant key word clouds. Tracey and I then got together with Gavin Denton (@DentonGavin) and Jemma Owen (@JemmaOwen1) to discuss some of the key issues that came up on the night. I think we highlight some interesting issues in the development of Advanced Practice RCN Guidelines on Advanced Nurse Practitioners The role of advanced nurse practitioners. Development of Advanced Care Practitioners in Emergency Services The National Education and Competence Framework for Advanced Critical Care Practitioners. Royal College of Emergency Medicine Curriculum for Emergency Care Practitioners |
Wed, 7 October 2015
In this episode I talked to Jennifer Cotton (@sonomojo) who runs the website Sonomojo which is a guide to ultrasound education and she talks about her reasons for setting up the site. The aim of the site is about connecting people to resources about ultrasound. Jennifer is just about to become a doctor and has worked with colleagues such as Matt Dawson from the www.ultrasoundpodcast.com website as part of her training to become more competent at this skill. She also promotes the Ultrasound Interest Groups (USIG) which is way of developing groups that can focus on student organised, faculty led workshops. http://sonomojo.org/ http://www.ultrasoundpodcast.com/ http://emcrit.org/rush-exam/ |
Thu, 17 September 2015
Lynn Schallom is a research scientist at the Barnes-Jewish Hospital in St. Louis. She published a paper 'Head of Bed Elevation and Early Outcomes of Gastric Reflux, Aspiration, and Pressure Ulcers' in the American Journal of Critical Care in January 2015. Head of Bed ElevationThere is a conflict between the need to keep a patients head elevated to reduce the incidence of oesophageal reflux and consequent pneumonia, and the prevention of pressure ulcers. Can we do both? In her very small study Lynn seems to show that head of bed elevation is important and that we can. She also highlights some other areas of concern, one of which is the use of the trendelenberg position when sliding patients up the bed. This would seem to put patients at increased risk of aspiration as their secretions are encouraged to run in the 'wrong' direction! |
Thu, 3 September 2015
"Have you ever wanted the speaker to fail?"In this episode of the podcast I speak with Dr Ross Fisher (@ffolliet) about presentation skills. Many of us have sat through 'death by powerpoint' and have come away non the wiser afterwards. Having watched a lot of TED talks I can testify that a good presentation can make a massive difference to what you learn and whether you will be back for more. Ross tells us some very simple techniques to help us improve the way we put our message across. I think you will find a lot of useful pointers. I include below some of the books that we mention as well. I have read them all and I can highly recommend them. You can find Ross's website at prezentationskills.blogspot.co.uk/ |
Mon, 15 June 2015
Break for Summer Holidays! |
Mon, 18 May 2015
In this podcast I carry on my conversation with Ollie Poole (@respreview) about some of the issues with mechanical ventilation. We talk about the different types of breath and why we use them. This then helps us identify some of the very confusing terms the ventilator companies use when describing their ventilator modes. We somehow manage to bring some puppies into the conversation too!! If you want more from Ollie then go to his fantastic YouTube site where he covers other subjects too. Thyroid Storm Chapter: Review of Diagnosis and Treatment of Thyroid Storm - emcrit http://t.co/v8qQMMZh35 #FOAMed — foambase (@foambase) May 17, 2015 Thyroid StormDr Scott Weingart (@emcrit) does his usual brilliant job over at EMCRIT explaining some of the issues in this condition. This is one I have encountered in ITU so I found particularly interesting.
Are you an Advanced Practitioner in any specialty? Then you need to come to this meeting. This is the 3rd year this has been held in Coventry and gives us all a chance to network. Also priced very reasonably so you have no excuses. Some good speakers lined up talking about: An Analysis of UK wide advanced practice programmes. Advancing Nursing in gerontology. Challenges of Advanced Practice across primary and secondary care. In the afternoon there are going to be chances to have a chance to review your anatomy of various systems using the state of the the art Surgical Training centre, followed by workshops in writing a publication, presenting a business case and undertaking research. Come along and help mold the changes we are all making.
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Wed, 6 May 2015
Wendy Sinclair (@wlasinclair) is a lecturer in childrens nursing at Salford University and has been there for the last eight years. She started using Twitter about a year ago as a way of engaging the Salford Nursing Students. Also to see how they could use social media in both a professional and social capacity. She is also working towards a PhD in Social Media and Professional Conduct. We are also joined by Neil Withnell (@neilwithnell) is a senior lecturer in mental health nursing and Moira McCoughlin (@levylass) who is a childrens nurse and senior lecturer. An interesting discussion is had by us all about the benefits of social media when used well and the empowering of their students. This is a model that others should follow. I also want to point out a conference which is happening in Coventry in July. This is the 3rd National Advanced Practitioner conference. You can click on the image below for a link to the application form. This is not an expensive day and it would be great to be able to network with other practitioners. I am pushing people to go from my trust, so lets all the do the same. See if we can overwhelm them with interest. I am hoping that I will be able to let you all know the format of the day by the 11th May. So watch out for my tweets! #FOAMed has been helpful as always. Salim Rezaie has put together a great post about Seepsis and some of the current practices, along with a podcast and his slides which he used at a recent conference. Click on the copy of the tweet below from @drwillangus.
I am also tweeting like fury about this years Intensive Care State of the Art meeting in December of this year. Its going to be a good one I think and I hope to be well involved on the social media side of things via @ganesh_ICM who is doing a fabulous job of putting things together. Click on the tweet below to see what he is up to, and please retweet if when you see it! Go to http://t.co/KrRBCgdWtL live now! To register for this years ICS State of the Art conference. #icssoa2015 pic.twitter.com/U8kc4lQbnd — Jonathan Downham (@ccpractitioner) May 6, 2015
[Stitcher_Radio_Logo] [get_in_touch_with_jonathan] |
Thu, 16 April 2015
Kirsten Kingma (@surferkirst) is currently a medical student who started her health care career as a paramedic We start by talking about the role of the paramedic in South Africa and how the different funding system impacts upon health care. We also talk about the medical staffing issues in South Africa and then finish up agreeing about how wonderful Twitter and FOAMed is for the ambitious practitioner. I think I may have persuaded her to come back for more in the future as my South Africa correspondent! FOAMedAnother article has been highlighted via twitter which further advances the cause for the practice of NODESAT or the use of nasal oxygen during rapid sequence induction. This is a simple thing to do for the patient and it has been shown to be effective and not uncomfortable for the patient: Use of High-Flow Nasal Cannula Oxygen Therapy to Prevent Desaturation During Tracheal Intubation of Intensive Care Patients With Mild-to-Moderate Hypoxemia Miguel-Montanes, R., Hajage, D., Messika, J., Bertrand, F., Gaudry, S., Rafat, C., … Ricard, J.-D. (2014). . Critical Care Medicine Apneic oxygenation via nasal prongs at 10 L/min prevents hypoxemia during tracheal intubation for elective surgery. Christodoulou, C., Rohald, P., Mullen, T., Tran, T., Hiebert, B., Lee, T., & Sharma, S. (2013). Eur. Respir. J. A Randomized Trial on Subject Tolerance and the Adverse Effects Associated With Higher- versus Lower-Flow Oxygen Through a Standard Nasal Cannula. Brainard, A., Chuang, D., Zeng, I., & Larkin, G. L. (2015). . Annals of Emergency Medicine, .2014.10.023
Evidence Based Preoxygenation from Rob from ercast on Vimeo.
OslerI had a very interesting conversation with one of my Twitter contacts last week, Dr Todd Fraser (@Sunnydoc72). He has become concerned over the years that health care professionals seem to have no consistency over the benchmarking and recording of their skills. As a consequence he has started a crowdfunding campaign to try to get the necessary finance together to produce. Osler is a digital technology that will allow you to benchmark your performance against others in a similar position providing you a report card of procedural and clinical capability. There will be access to a learning platform with multimedia, interactive and patient focused learning resources. You can keep up to date with the latest literature and Osler Knowledge will give access to a database of latest research, which it will search for you depending on the question you ask. You will also be able to connect with your peers to help you understand difficulties you maybe having. There will be an authentication process throughout all of this so that you can be sure that the information you get is reliable and the people you are interacting with are trustworthy. The crowd funding process asks that you make a financial promise. It aims to reach a target of $300,00 within 30 days. You can pledge as little as $10 all the way up to $5000. This money will not be taken from you until the target is reached. If you pledge then there are some incentives offered. I think this looks like a fantastic idea, but will need some support to get it off the ground. Todd has clearly worked very hard at this and is very passionate. Worth a few dollars I think.
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Wed, 25 March 2015
PLEASE go to www.life-saver.org.uk to see the fantastic job this podcasts interviewee has done of making the teaching of basic life support so much easier. I was blown away when I came across it, even as an experienced ALS team member. It sucks you in and gets you involved. To the novice it is a wonderful learning resource, to the experienced it is great revision. Martin Percy was the director and we talk about some of the barriers he came up against when raising the funding and one or two great stories that came about. One of those stories gives this episode its title! #FOAMedThe results of the PROMISE trial are out and rather than redo what everyone else has already done I will just point you in the direction of my colleague Simon Laing (@laing_simon) who has summarised it nicely on the HEFTEMCAST podcast. I will also quote from Steve Mathieu (@stevermathieu75) on The Bottom Line:
A point I seem to remember making on a podcast with the ARISE trial authors some months ago. The guys over at FOAMCast have just released a podcast that tries to explain some of the confusing research terms. If you are like me, then any research term can become confusing. This is a good episode and I am hoping that they will add more in the future. Antibiotic sensitivity spectra is the focus of a tweet by Pietro Isotti, (@pietroisotti) a nursing student in Italy. This is a nice PDF of the range of sensitivities and the antibiotics used. |
Wed, 11 March 2015
This podcast is a discussion with one of the main organisers of the SMACC event later this year, Oli Flower (@OliFlower). The conference is looming fast, in June of this year in Chicago. We discuss the past conferences and the ethos behind them and the upcoming one. Oli is also involved with the Intensive Care Network website. There is also a mention of two other podcasts in the episode, Jesse's (@Inject_orange) Injectable Orange podcast and Brians (@erNURSEpro) ER Nurse Pro podcast. Both excellent giving some different perspectives. |
Tue, 24 February 2015
The third in the series with Ollie Poole (@RespReview) on mechanical ventilation. Ollie goes into some more detail on the phases of the breath. This requires some visualisation of the waveform involved. Below is the video from YouTube that Ollie originally produced which should help with that.
Irma Bilgrami does a great job of breaking down some of the principles of mechanical ventilation in her SMACC talk. She approaches it in a similar way to analysing the ECG waveform. #FOAMedDelayed Sequence Intubation-
A new study in Annals of Emergency Medicine seems to support the process of delayed sequence intubation in those patients that will not tolerate pre-oxygneation or peri intubation procedures. EmCrit has a nice algorithm on his site (he was involved in this study) which breaks the process down simply and The Bottom Line has reviewed the paper in question. Scott has also done is usual great job in helping us understand this through his podcast:
Life in the Fast Lane breaks the process down in some more detail. Cervical Collars-
ILCOR (International Liaison Committee on Resuscitation) have published some draft guidelines on the use of cervical collars which does not recommend their use. Scancrit covers some of this in his blog and, like him, I will quote what they actually say:
Intensive Care Society State of the Art Meeting December 2015
I have had the recent privilege of being introduced to Ganesh Suntharalingam (@Ganesh_ICM) who is involved in the committee with the Intensive Care Society for the State of the Art meeting later this year. He is gathering a team around him who will help make some changes to the format of this excellent conference. He tweeted some results from a survey he published which makes some very interesting reading. What I found exciting is that others feel, like me, that publication of some of the presentations for those not able to attend would be valuable. This is the FOAMed principle in practice. You can continue to add your own views via this link. Advanced Critical Care Practitioner Conference-
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Thu, 19 February 2015
I love the world of social media. It was through the medium of Twitter that I was able to connect with James DuCanto (@jducanto)who is an anesthesiologist at Aurora Health Care in Wisconsin. Gavin Denton (@DentonGavin) and I picked his brains about some of the pitfalls in intubation especially for those not so experienced but who may well still find them in a situation where they may have to perform the task. James has produced a few teaching videos around some of his ideas, some of which you can see on Minh LeCongs (@ketaminh) PHARM site, so I won't reproduce them here. just follow the link. I did ask him about cricoid pressure and his answer was interesting. If you want to hear the discussion I had with Minh about this then go listen to CCP Podcast 010. Life Form Airway Simulation Trainer Laerdal Difficult Airway Trainer Glidescope Titanium Video Laryngoscope. |
Wed, 11 February 2015
CCP Podcast 026 was myself and Ken Spearpoint (@K_G_Spearpoint) talking about some of the issues around Crew resource Management. we continue the conversation in this episode and maybe even arrive at some conclusions....maybe!! |
Sun, 1 February 2015
Ken Spearpoint and I talk about Crew resource management as it relates to the cardiac arrest scenario. I love talking with Ken as he is so knowledgeable and puts his points across so well. i found it really interesting to chat with him about this. I have broken it down into two parts as we both had so much to say, so the second part will be podcast 027 next time.
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Mon, 26 January 2015
I am lucky enough to get to chat to Teresa Chinn from @WeNurses. I first spoke with Teresa on my very first podcast and since then we have both grown our various enterprises. Teresa has been awarded an MBE in the New Years honours list this year and it is thoroughly deserved for all her services to nursing. We talk about her visit to Parliament and to the Health Select Committee. An informal process she said, but it sounded much more than that. She also talked about how the website is developing so that they can use all of the information they are collecting and use it more effectively. |
Sun, 18 January 2015
This is the second of a series of podcasts with Ollie Poole who was a respiratory therapist in Canada and is now doing his medical training. You can listen to the first episode if you wish... CCP Podcast 018: Mechanical Ventilation.... We go back to some of the basics here, discussing some of the reasons and goals of mechanical ventilation. I came across Ollies' YouTube site Respiratory Review and was very impressed with his series on mechanical ventilation helping to explain some of the terminology and reasoning behind how we ventilate patients. He breaks down the issues in a logical, well ordered format....so go and listen to them. Our plan is to have a series of chats about mechanical ventilation based around his YouTube videos, so watch this space! |
Sat, 10 January 2015
Reducing ventilator associated pneumonia in adult patients through high standards of oral care: A historical control studyLee Cutler, Paula Sluman. Intensive and Critical care Nursing. 2014Consultant Nurse Lee Cutler discusses the study he was involved in with his colleague Paula Sluman. Ventilator associated pneumonia is a big problem in the critical care environment so it is very important that we take all the measures we can do reduce its incidence. This seems like a simple approach which makes a difference. |
Sat, 3 January 2015
Shiela Pantrini has been developing the educational route for the Advanced Clinical Practitioners along side Garry Swann at the Heart of England NHS Trust. She tells us how this occurred and the principles that drove it. We also go on to discuss the plans for the future and what would make a good potential practitioner. Two of the courses which contribute to the Masters programme were mentioned and the links for them are here: Warwick University- Clinical Examination Skills for Health Care Professionals Warwick University- Clinical Investigations and Diagnostics for Health Care Professionals |
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