Don’t forget to post your selfies using the hashtag #DFTBHolidayHunt
Andy talks to us about frequency of critical procedures in the paediatric emergency department. How many years does Andy need to practice to get the required number of intubations to maintain competency?
Answer: 106 years (from Andy Never Enough)
In 2016, Andy reviewed Nguyen et al’s paper looking at paediatric critical procedures in the ED. The article was a retrospective chart review of every paediatric attendance that required a resuscitation cubicle in three Victoria hospitals in 2013. Of almost 55,000 attendances, only 37 required any form of critical procedure – approximately 7 per 10,000 presentation.
83% of doctors working at the campuses in the study did not perform a single critical paediatric procedure. At the time Andy was working part time in the hospital and may have seen no more than 20 children a week. He reckoned it could take him 17 months to perform a single critical procedure.
Andy quotes Ross Hofmeyr who suggests clinicians need to perform 75 intubations a year to maintain their competency and calculated it would take him 106 years to get just get to 75 intubations (Ed: what a statistic!)
Preparing for major trauma is a vital pre-patient step, and improvisation can be key. How does Shane say you can improvise a bite block for a Le Fort II/III fracture?
Answer: Use a few tongue depressors taped together! (from Shane Broderick’s Professionals Prepare Properly)
Shane talks us through his approach to preparing for trauma. Quoting his Cian McDermott he tells us that “professionals prepare properly”. He lays out a series of superb tips, with number 5 being “better to be looking at it than looking for it” (aka check and recheck equipment). And when you can’t find it, can you improvise? Shane says, “No McKesson bite blocks for your Le fort II/III? No problem! Use a few tongue depressors taped together (Thanks to Jason van der Velde).”
Kids love talking about poo, as do paediatricians! But if you have a sibling with Hirschsprung’s Disease, how much more likely then the general population are you to have it too?
Answer: Siblings of children with Hirschprung’s Disease are 200 times more likely than the general population to have Hirschprung’s; 4% vs. 0.02% (from the post Hirschprung’s Disease by Peter Tormey)
General David Morrison AO (Retd), an outspoken opponent of gender bias and discrimination, gave a talk on workplace bullying and harassment. Andy uses General Morrison’s talk to discuss bullying in the workplace: discrimination, unjustified criticism, verbal threats, undue pressure and having jokes made at someone’s expense. Which heroic duo does Andy say characterise ‘defenders’ in the bullying arena?
Answer: Hermione and Ron (from the post Playground behaviour – in adults)
This is such an important post. Andy concludes with “It is okay to speak up and speak out. If you witness bullying, in any off its forms, it is your moral duty to pluck up the courage of Neville Longbottom and stand up for what is right.”
At DFTB 2019 Russ and Cian demonstrated how useful POCUS can be. What favourite snack can help you to do a supra-pubic aspiration?
Answer: Toast! (from the post POCUS: Russ Horowitz and Cian McDemott at DFTB19)
And finally, our Christmas question. In 2016, the Journal of Happiness published an article entitled, “What makes a merry Christmas?” But, what does make a merry Christmas?
Answer: we are happier when our Christmas plans involve family or faith and less happy when spending money and receiving gifts is the overwhelming aim.
And that’s our cue to wish you a wonderful festive season and safe and healthy 2021.
from the DFTB team x