Improving outcomes in out-of-hospital cardiac arrest

Cardiac arrest can happen to anyone, anytime, anywhere.

For Professor Judith Finn, as Director of the Australian Resuscitation Outcomes Consortium (Aus-ROC) she is particularly focused on strategies to improve outcomes for cardiac arrest patients.

Professor Finn will be presenting at this month’s Annual Scientific Meeting (ASM) in Perth.

Register now

Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

Clinical trials

In her session, which will take place on Monday, November 19, Professor Finn will talk about important resuscitation trials and Aus-ROC.

Aus-ROC aims to increase research capacity in the area of out-of-hospital cardiac arrest.

“In my presentation I will discuss some key clinical trials with an emphasis on research that has been ‘controversial’ and/or changed clinical policy/practice,” said Professor Finn, who is the Director of the Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU) at Curtin University.

Professor Finn added that she is “eager” to hear about “exciting” new research in the field of emergency medicine throughout the meeting.

“I work with a number of emergency physicians on research projects, so I am always fascinated by the interrelatedness of prehospital care and emergency medicine,” she said.

Taking a bite out of the ASM

With Australia still reeling from the Whitsundays shark attacks, FACEM Dr Nicholas Taylor’s presentation at November’s Annual Scientific Meeting (ASM) in Perth is sure to be popular.

Dr Taylor, the Senior Specialist and co-DEMT at Canberra Hospital Emergency Department and the Associate Dean Phase 2 at ANU Medical School, will present on SHARC study (Stopping Haemorrhage by Application of Rope tourniquet or inguinal Compression).

Dr Taylor is a keen surfer and had somewhat distressingly noticed that shark attacks are on the increase worldwide.

“The most common injury is severe trauma to the lower limbs. There have been multiple reports in the media of people dying from blood loss from the leg, but also of improvised leg rope tourniquets being used to assist victims.”

Dr Taylor and his colleague, FACEM Dr David Lamond, used an ultrasound to measure how much the blood flow in the artery behind the knee (popliteal artery) could be reduced after either a leg rope tourniquet was applied, or firm pressure was applied by a fist placed on the groin area. This study has shown that a simple and easily taught first aid technique of placing bodyweight pressure on the victim’s inguinal area, to compress the femoral artery, is vastly superior to using an improvised tourniquet for lower limb bleeding.

“I think the ASM is a fantastic conference to see the best of Australasian Emergency Medicine research and practice and a great chance to catch up with colleagues. I am particularly grateful for the opportunity to present our study at the ACEM ASM as Western Australia is a world hot spot for both surfing, and unfortunately, shark attacks.”

This will be Dr Taylor’s fourth ASM. He remembers at his first ASM (Gold Coast 2007) as a registrar being inspired by the quality both of the medicine, but also the people, and being certain that he had found the right home for his career.

When asked what about emergency medicine appealed to him, he noted, “It’s the teamwork, controlled chaos and the genuine opportunity to learn something new every day.”

Register now

Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

‘Tom has always had a special place in my heart’

“It’s a huge honour and particularly important for me because Tom Hamilton was my first director at the Sir Charles Gairdner Hospital in Perth,” Professor Egerton-Warburton recalls. “I was there as an intern, a Hospital Medical Officer, during my first rotation as a doctor in the emergency department.

“I have huge admiration for Tom, personally and from the work he has done for the College over the years, how he basically took pretty much nothing and made it what we have today 35 years later – a leading, dynamic College.

“Tom has always had a special place in my heart.”

The Tom Hamilton Oration will be held on Sunday, 18 November as part of the College Ceremony.

Passionate advocate for patients, the community and for the health system

Professor Egerton-Warburton has a passion for patient and community advocacy. As the Director of Emergency Medicine Training at Monash Medical Centre, she has developed and guided a generation of emergency medicine specialists – many of whom now have leadership and teaching roles nationally. And she is passionate about developing women in leadership roles.

Some of Professor Egerton-Warburton’s career highlights include her position as President of the Australasian Society for Emergency Medicine from 1997 to 2000. In 2016 her leadership was recognised with the awarding of Australian Medical Association’s Women in Medicine Award for an ‘outstanding contribution to emergency medicine with a strong passion for public health’. She was inducted onto the Victorian Women’s Honour Roll in 2018.

Professor Egerton-Warburton has been actively involved with ACEM for over two decades, and in 2013 she was awarded the ACEM Teaching Excellence medal.

“As part of my oration I am in interested in providing the New Fellows who will be at the College Ceremony some of my insights after 30 years in emergency departments about how to maintain the excitement and enjoyment of emergency medicine,” Professor Egerton-Warburton says.

“I want to talk about language, compassion and empathy, and these are the things I directly learnt from Tom.”

Emergency medicine has made its mark

Professor Egerton-Warburton says the specialty of emergency medicine not only plays a critical role in the wider health system, “but it has also matured to such a state we’ve stepped outside of the original focus which was about training specialists to playing a greater role in the broader community and within government”.

Professor Egerton-Warburton is looking forward to attending the ASM as it is “so important to keep those connections with your colleagues from interstate and other jurisdictions”.

“Obviously there is the scientific element of the meeting, it’s so important for the College to showcase its research and advocacy, but also the networking element is key,” she says.

Register now

Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

Revolutionising CPR

For FACEM Dr Paul Bailey, it is the sense of team work that emergency medicine promotes which drives his passion for the specialty.

“We’re a broad group of individuals and generally excellent team players,” says Dr Bailey, the Director of Emergency Medicine at St John of God Murdoch Hospital, one of the leading private health campuses in Western Australia. He is also Clinical Services Director for St John Ambulance WA.

It is this passion that will see him take to the stage at November’s Annual Scientific Meeting (ASM) in Perth where he talk about High Performance, High Impact CPR, focusing on “how we are revolutionising out of hospital cardiac arrest outcomes in Western Australia, and a call to arms for ACEM Fellows”.

With an interest in cardiac arrest, Dr Bailey hopes that attendees to his presentation leave with the understanding that the key to good outcomes is getting the basics right at expert level, every time.

Dr Bailey was recently featured in the media talking about his passion for improvement in the approach to CPR.

“Having last attended the ASM in Brisbane, I am eager to attend and present at this year’s ASM, and being a Perth local makes it even more special,” Dr Bailey says.

Register now

Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

Perseverance the key

Emergency medicine requires resilience and the ability to accept uncertainties.

That’s the message of Associate Professor Eillyne Seow, Vice President and founding figure of the Singapore College of Emergency Physicians, who will be a keynote speaker at the 35th Annual Scientific Meeting (ASM) in Perth later this year.

“The willingness to consider possibilities requires a tolerance of uncertainty,” Associate Professor Seow says, quoting Rachel Naomi Remen, M.D., a Clinical Professor of Family and Community Medicine at UCSF School of Medicine and the Founder and Director of the Institute for the Study of Health and Illness in California. She is one of the pioneers of Relationship Centered Care and Integrative Medicine.

Associate Professor Seow adds: “Emergency medicine is fun, has many puzzles for us to solve. It is also challenging with stressors from many quarters but we are a resilient group. Tolerance and resilience is certainly in our [emergency practitioners’] DNA.”
 
Register now

Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.
Check out the program and further details on the ASM website.

Emergency medicine landscape

Starting her training in emergency medicine in 1987, Associate Professor Seow has a strong clinical and research interest in geriatrics, diagnostic error and patient safety.

When asked about the emergency medicine in Singapore and Australia and to highlight any similarities or differences, Associate Professor Seow says “emergency medicine care cannot be exported”. “We share similar patient demographics [multiracial, multicultural]. However the resources we have and the way we deploy them are different,” she says.

Associate Professor Seow says meetings like the ASM are a good opportunity to “get together to bounce ideas against each other, share possible solutions”.

“I was delighted to receive the invitation [to be a keynote speaker]. It has been a while since I have met up with my friends in the Australian emergency medicine world. I am looking forward to catching up with them,” Associate Professor Seow says.

“The Perth healthcare community have over the last few years generously hosted Singaporean emergency physicians, I would like to take this opportunity to thank them,” she adds.

ASM opening an event not to be missed

Organisers of the 35th Annual Scientific Meeting (ASM) are promising something special when FACEM Dr Michelle Johnston takes to the stage to welcome delegates on day one of the conference.

In a break with tradition it will be a politician-free zone, and instead Dr Johnston will bring her unique creativity and passion for emergency medicine when she opens the conference.

‘Doing something a little bit differently’

Dr Johnston has dedicated her career to finding that sweet spot between creativity and critical care medicine.

“I guess people ask me to do things when they want something done a little bit differently,” Dr Johnston says with a smile.

“There was the thought that perhaps we could somehow have a more creative opening ceremony, a ceremony that would be targeted not only just towards the theme of ‘On the Edge’ but an event to simultaneously make people think and to celebrate who we are right now and what ‘On the Edge’ can mean to different people.”

So, what does that all mean? What can people expect? Poetry? Video? Sound? Lighting?

“I have gone through a number of iterations, thinking how we can best celebrate ‘On the Edge’ and I have taken it very much as Perth being on the edge of the planet. I’ve often had this sense of us half tipping off the edge of the planet – perhaps no one would even notice,” Dr Johnston says.

“But on the other hand, being on the edge also means being on the forefront of a wave, and emergency medicine is on the edge, the emergency department is at the front of a hospital, we are often a group that embraces new technologies, edgy-type things, and I want to present that in a way that will be uplifting, to get us all excited about what is going to come over the week while also showcasing what Perth has to offer.

“So I have done something kind of crazy!

“I’m hoping it will be an audio-visual feast.

“There will be a story that perhaps people have not quite heard before, or in the way they’ve heard it told. Our story, and how we came to be where we are today.

“We will also have a magnificent Welcome to Country with Noongar Elder Barry McGuire, which I am extremely excited about. It will be a real highlight.”

Conferences, collaboration still relevant

Dr Johnston said despite the rise of online discussions and social media, events like the ASM were relevant and important as ever before.

“We need these meetings even more,” she said. ‘I think social media and the internet has in one way connected us but in another way has broken some bonds.

“Nothing takes the place of one on one meetings, of the spontaneity that comes with meeting people, mingling both academic and socially, and having the wonder of the unexpected that can only come when you are with a group of people with similar ideas and purpose.

“The Organising Committee for the ASM has been really interested in mixing things up and pushing boundaries, and that will be reflected in the program and the activities surrounding the conference.”

Artificial Intelligence to be the game changer for patient outcomes

The use and benefits of new technologies by the healthcare sector has recently been in the news, with British Prime Minister Theresa May announcing plans to use artificial intelligence (AI) and data in the diagnosis of chronic diseases.

“The United Kingdom will use data, artificial intelligence and innovation to transform the prevention, early diagnosis and treatment of diseases like cancer, diabetes, heart disease and dementia by 2030,” Mrs May said in a speech in late May. The announcement created headlines in the UK and around the world.

The excitement of the announcement is shared by Dr Martin Than, Emergency Medicine Specialist at the Canterbury District Health Board, New Zealand, who will explore AI and what it means for emergency medicine when he presents as a keynote speaker the 35th Annual Scientific Meeting (ASM) in Perth later this year.

Register now

Early Bird Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.

Check out the program and further details on the ASM website.

On the Edge of AI in emergency medicine

Dr Than is the Director of Research at Christchurch Hospital’s Emergency Department and has a specific interest in evidence-based healthcare and the safe rapid translation of research findings into clinical practice.

With his deep interest in new technologies and AI he will discuss what technology, machine learning and artificial intelligence will impact emergency medicine.

“Medicine will start to change dramatically in the next five years,” Dr Than says. “And I think we all accept that change is happening but I don’t think people quite understand just the extent and speed of change.”

Caution and skepticism regarding new technology is natural and appropriate and in part, that reaction is following the ‘hype cycle’, according to Dr Than. The hype cycle is a tool that provides a graphic representation of the maturity and adoption of technologies and applications. Basically, technology goes through various stages on the rocky road to mass adoption.

For Dr Than, the benefits of AI in emergency medicine are starting to crystallize and become more widely understood.

“Soon we will have the data, the machine enhanced techniques to use the data and analyse it, and have the processing power to do it in real time at the patient bed side,” he said. “So those three things together fundamentally change what can happen in patient care. For any patients in front of you at any one time, you should be able to make quite precise and individualised predictive diagnoses.

“Research as we know it will continue but much research will actually become real time patient care. Each new patient that you treat will become one more patient in your database that leads to the treatment of the next patient immediately afterwards.”

Dr Than says despite the advances in technology, data and use of computers, there would always be a role for emergency physicians. In fact, it is the hope that doctors and nurses will be freed up to spend more time communicating with patients.

“I see this (new technology) as being a bit like an angel on your shoulder,” Dr Than says. “You don’t have to listen to it, but it will be prompting you and giving you advice when you ask for it.

“I believe that it’s definitely going to happen, it’s going to come quicker than we expect.”

Dr Than is aware that, like in the UK, sceptics and opposition to AI exists, but says the issue has moved on from “publishing some interesting observational findings in a journal”.

“This is actually about taking data and applying it to the next patient you are going to see,” Dr Than says. “So that to me is doing something very meaningful and something that drives me to continue this work.”

Reflecting on emergency medicine

For Associate Professor Anna Holdgate, a lot has changed in emergency medicine over the last 30 years.

A Sydney-based emergency physician with a distinguished record in Australasian emergency medicine as a researcher, teacher and mentor, it will be these changes that she will reflect on as a keynote speaker the 35th Annual Scientific Meeting (ASM) in Perth later this year.

Register now
Early Bird Registration is open for the ASM, themed ‘On the Edge’. Join us 18-22 November in Perth where we explore the multiple different facets of life in emergency medicine.
Check out the program and further details on the ASM website.

Constant change

“I will reflect on what is new and what is not, what has changed and what has not, and what has changed back to where it was when I started my career,” Associate Professor Holdgate says.
“I will be looking at changes in clinical practice, changes in culture and behaviour in emergency medicine, and the changes in educational techniques and strategies.
“And evidence to support those changes, or whether there is in fact any evidence to support some of those changes. It is sometimes fashion as much as evidence that shapes what we do.”
Associate Professor Holdgate, who is a Senior Staff Specialist at Liverpool and Sutherland Hospitals, added changes she had witnessed and experienced in emergency medicine have not necessarily always been for the better.
“Some [changes] are [for the better] and some aren’t,” she said. “And some probably really don’t make much difference.
“It is very important when there is change to think if it’s of proven benefit and a useful thing to do, or whether it is just change for the sake of change but doesn’t actually make much difference.
“One of the important messages I want people to think about is that just because something has changed doesn’t necessarily make it better, and we need to keep critical thinking continuing even as things change.”

And what are some of the specific changes she will comment on?
Associate Professor Holdgate teasingly says that you will have to be at the ASM to find out.

Bringing everyone together
“Sharing information is one of the key dynamics behind emergency medicine,” Associate Professor Holdgate says when asked why events like the ASM are important.
“Of all the specialities it is probably the one that requires team work at the highest level and that the experience of people from a whole lot of different places both geographically and demographically makes a huge difference to your own practice.”
Associate Professor Holdgate, who was awarded the ACEM Teaching Excellence award in 2013 and a recipient of the John Gilroy Potts award for research in 2014, says she loved the “variety of practice” in emergency medicine.
“It’s an opportunity to see people from all walks of life and also an opportunity to interact with junior doctors and help shape their careers into the future, their clinical thinking, and hopefully develop their critical thinking skills to have a long-lasting influence on their future clinical practice,” she said.