Maybe you recognise the drill ……. you are tired, your frontline NHS job is tough, there is a list of jobs as long as your arm at home, you still need to book transport to attend this conference, and you’re not sure if work will provide any study funding. But you decide to go for it. You’re pretty sure there’ll be someone to sit with – but too late now. Within five minutes of arriving you are infected – the space has a buzz, the crowd has a buzz and there is great coffee and little mini muffins (an army marches on its stomach), and it only gets better from there.
PEMfest18 was a multi-disciplinary PEM conference focused not on what we ‘should’ do, but rather on what we ‘do’ do. Organised by Damian Roland and the Paediatric Emergency Medicine Leicester (PEMLA) group it was a shot of adrenaline for the soul that had a much longer half-life. Held in Birmingham on the 19th April, I have tried to capture some of my learning and salient points below, but for a fuller snapshot, peek at the #PEMfest18 twitter feed.
Edward Snelson: Everything about Wheeze in Children and Young People in Under 5 Minutes.
Totally managed what it said on the programme, but what’s not included was the relaxed, engaging and uber-informative walk through the developmental immunology and wheeze pathophysiology that provided this attendee with a way of ‘thinking’ about wheeze and its management rather than a tight-fitting (and perhaps uncomfortable) algorithmic onesie. A taster snapshot is below but if you want an accurate replay you can read more about it here (unfortunately minus the delivery and buzz):
Dan Lumsden: Funny Movements in Kids.
A recurring worry for me are parents with a video of their kid doing some weird thing with their arms, legs, head, face, etc …. and I don’t know whether to worry or not to worry. Dan Lumsden addressed practical issues when evaluating hyperkinetic movement disorders in his session that was delivered with palpable passion, warmth and good humour. He is also busy pulling together (amidst the day job at Evelina Children’s Hospital) an educational resource, MovEd, and is actively looking for some help to join him. ‘Do get in touch’ was an open invitation but while we’re awaiting the launch of MovEd, he shared a recent ADC article (Rauci et al, 2018) that is seriously worth a look if you want a contextual starting point for the parent video-kid-funny movement consultation coming to an ED near you.
Damian Roland: Scoring an Own Goal.
This session took a deep dive into POPS (Paediatric Observation Priority Score) and generated a lot of very interesting debate. Are we letting numbers drive practice? How do we best use scoring systems in our practice and what is the role of cognitive bias? The consensus? Balancing the rapid identification of ‘sick’ and ‘well’ is a challenge worth mastering as spotting the well child early frees up focus to spot the sick one quick. Numbers can’t override intuition, but they can prompt some self-examination before an infant or child heads out the door. This recent article, from the Damian and Edward Snelson, hits on a lot of the points.
Tessa Davis, Katie Barnes and Ian Lewins: Our Approach to Education.
What is it like to finally meet the people whose work you have been looking at, and using, for ages? Super fun. Tessa provided some background to the success story that is DFTB, and managed to use her obvious super power of divination to provide additional context to the earlier wheeze debate. It was also unanimous that Bubble Wrap (a fairly recent addition to DFTB arsenal) is the ‘go-to’ link to digest and assimilate the topical and relevant from the plethora of PEM-related evidence.
How do you critique your own presentation? You don’t – but I will say I managed not to throw-up or have a heart attack. I was really proud to join such an illustrious team and share how a little social enterprise, can connect the super powers of the NHS and Universities; making advanced practice paediatric education agile, clinically relevant, more accessible and fun. The flipped classroom was our number one tool for delivering a cool 49 extra pair of paediatric advanced practice hands to the Northwest; a job made so much easier because of the output from DFTB, PEM Infographics, and GP Paeds Tips. Take home messages: be brave – flip your classroom; start small and its easy (because you can’t yell at seeds.) A helpful guide from Plymouth University as well as a PMC article.
Ian shared the incubation and delivery of Derby’s Children’s ED PEM teaching that has recently been made accessible, engagable and very FOAM(y). He also challenged us to consider how PEM CPD can happen anywhere; CPD While You Pee and Blog on the Bog took multi-tasking to another level as did Ian’s hilarious delivery – you remember things so much better when you are smiling! The work of Ian and the rest of the Derby team seems to be gaining momentum daily and defo needs to be looked at: Awesome, Amazing and Applicable pretty much sums it up!
Take a look at this sample from the remarkable Emma Buxton, part of the PEM Infographics team that fits into the day’s wheezy sub-theme.
A PEM Marketplace: think good practice speed dating – that got participants up, moving and interacting after a delicious lunch. I was manning our show and share table, but #PEMfest18 captures some of the great ideas on show.
Gareth Lewis et al: A Critically Careful Case.
A sparky and vocal multi-disciplinary crew from the Leicester ED showed us all how it’s done by providing a real-life glimpse into how M & M rounds could be transformed into a safe, supportive and energising opportunity learning and staff well-being/support. It put an engaging spin on critically unpicking a difficult ED case. BTW: never trust a baby.
Rachel Rowlands: At Life’s End.
A bit of the heartache was taken out of this tough and demanding topic by the ingenious use of cat photographs to provide the backdrop for a discussion of CDOPS (Child Death Overview Panel). She shared some priceless tips for making the difficult a tad bit gentler: preventing parking tickets for bereaved families; domestic violence packs, providing feedback to all members of the team regarding findings and outcomes to help make sense and provide closure. Probably the most difficult slot of the day which was handled with grace and clarity.
Verdict and Prognosis: Adrenaline for the soul that was passed from participant to participant. Fun, worthwhile, and informative is an understatement; and so worth the trip out to Birmingham. The good news is that PEMfest19 is incubating (perhaps conjoined with DFTB19 if we are lucky) and Damian et al. obviously started as they mean to go on. Watch this space as it is sure to be a winner. In short, I can’t wait to be infected again!