And in that order too. Can’t work with team or sort environment if not in control of self.

If you cannot control self then hand over task to someone else (if possible).

#DFTB19 #proceduralparadox

ENVIRONMENT

People
Space
Equipment
Position

#DFTB19 #proceduralparadox

There is a procedural paradox between clinicians and patients
That paradox is OK, and arguably a really good thing
Everhyone has a plan until it goes wrong. use yourself, team and environment to get back on track

#DFTB19 #proceduralparadox

Is the paradox real though? Maybe it’s a great thing. My meeting with a psychologist provided a few surprises.

Who would you want to be there to treat you or your family? An enthusiast might be what you want and need.

#DFTB19 #proceduralparadox

ENVIRONMENT

People
Space
Equipment
Position

#DFTB19 #proceduralparadox

SELF
Many ways - but there is always time to pause. Consider focused breathing technique to regain technique.

#DFTB19 #proceduralparadox

TEAM

Cognitively offload as much as you can to the team around you. Trust your juniors and your nurses.

#DFTB19 #proceduralparadox

If you feel like you’re losing control then think about how to get control of 3 things
Yourself
The Team
The Environment

#DFTB19 #proceduralparadox

HT @cliffreid

Everyone has a procedure plan until it starts to go wrong.

As Mike Tyson said - everyone has a plan until you’re punched in the face. It’s easy to lose control.

#DFTB19 #proceduralparadox

every procedure.

Either the patient needs it
OR
You want to do it.

These HAVE to align

#DFTB19 #proceduralparadox

Let’s think about how differently we feel about procedures.

Our perspectives are arguably very different.

HT to @psirides
for the origin of this slide.

#DFTB19 #proceduralparadox

Arguably a lot of PEM involves inflicting distressing procedures on our patients. We need to be as good as we can be at this.

#DFTB19 #proceduralparadox

But maybe you’re like me and you actually look forward to procedures in PEM and EM. Even when they are painful and distressing!

Does that not sound a bit odd, a bit of a paradox?

#DFTB19 #proceduralparadox

You might think that you become like Spock. Unemotional and analytical. Plan for the event ahead and share your mental model in a dispassionate and neutral manner.

….but are you really?

#DFTB19 #proceduralparadox

Delighted to be at #DFTB19 talking on procedures from the operator perspective.

Let’s think about what it feels like to be a proceduralist in PEM and EM

#DFTB19 #proceduralparadox