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In paediatrics we used to do an ENT exam on every child with fever.
Then in 2020 everything changed.
It caused us to rethink our practice + ask...do we do too much?
My pick of these top 5 papers in PEM aim to change the way we think about the interventions we do #RCEMasc: 🧵👇
Then in 2020 everything changed.
It caused us to rethink our practice + ask...do we do too much?
My pick of these top 5 papers in PEM aim to change the way we think about the interventions we do #RCEMasc: 🧵👇
Paper #1: Should we treat all well-appearing febrile newborns?
Most of us are (reasonably) scared of febrile neonates.
Pantell et al developed an AAP guideline to help us treat only sick babies.
dontforgetthebubbles.com/well-appearing…
Could this mean we no longer have to treat them all?
Most of us are (reasonably) scared of febrile neonates.
Pantell et al developed an AAP guideline to help us treat only sick babies.
dontforgetthebubbles.com/well-appearing…
Could this mean we no longer have to treat them all?
Which group did the guideline consider?
• Term babies 8-60 days old with fever
• Exclusions: complex conditions, recent imms
What factors did the working group include?
• Blood results, urine culture, CSF culture
This is a guideline based on the Working Group's findings.
• Term babies 8-60 days old with fever
• Exclusions: complex conditions, recent imms
What factors did the working group include?
• Blood results, urine culture, CSF culture
This is a guideline based on the Working Group's findings.
After studying ED teams, I am thrilled to share insights about how they work and some simple hacks to make them even better.
Spoiler alert: psychological safety is what it’s all about - thanks @amyCEdmondson @RoisinODonovan4
#RCEMasc @RCEMevents @SocraticEM
A thread…
Spoiler alert: psychological safety is what it’s all about - thanks @amyCEdmondson @RoisinODonovan4
#RCEMasc @RCEMevents @SocraticEM
A thread…
Emergency medicine is basically just navigating uncertainty together.
Patient after patient.
Shift after shift.
We are quite familiar with good team behaviours that allow us to do so.
We train for things like…
Closing the loop
Recaps
Graded assertiveness
Communication
Patient after patient.
Shift after shift.
We are quite familiar with good team behaviours that allow us to do so.
We train for things like…
Closing the loop
Recaps
Graded assertiveness
Communication
But as a community we have spent less energy on understanding and deliberately supporting the type of organizational and team culture that is a necessary pre-requisite for those good behaviours to happen.
Things like…
Trust
Familiarity
Feeling valued
Things like…
Trust
Familiarity
Feeling valued
