I can’t imagine what it was like to go through what Fred Ettish went through. I remember being stunned at the overwhelming failure of his Karate in one of the early UFC fights in the mid-nineties, and gave no thought to the man inside the gi. I may even have been one of the viewers who felt some Schadenfreude at the apparent humiliation of traditional karate by Western boxing.
Now I see this man in a different light. Someone who has lost almost almost everything, yet refused to give in. I have no idea how I would react to such adversity, and never want to be tested in such a way. For an inspiring demonstration of spirit, watch this video that brought a tear to my eye. At around two minutes in you will see this is not about martial arts. This is about courage and strength and there is something to learn here for all of us.
This is the daughter of my friend. Avery is only seven months old and has survived a critical illness and is thankfully now fully recovered. Her Dad has nothing but praise for the medical and nursing staff who cared for her. But one thing could have been better. Avery endured multiple attempts at vascular access without ultrasound guidance.
If you were her parent, and you were an emergency physician with galaxy-class expertise in emergency ultrasound, how would you react? Complaints? Incident forms? Outrage?
How about education? For free. Accompanied by lavish praise for the experts who treated Avery and made her better.
Avery’s Dad is ultrasound podcaster and gentleman Dr Matt Dawson. He is offering FREE ultrasound training to anyone who wants to improve their vascular access skills.
Are there nurses, physicians, or technicians in your ED or ICU that could improve their care with this training? Please consider sending them for this training. To register for the course, and to read Avery’s full story, go to notapincushion.com.
And if you’re already comfortable with ultrasound-guided vascular access, then visit the site anyway, as there is some education here for all of us: how to turn a gut-wrenchingly distressing experience into something positive that will benefit countless others. I am thoroughly inspired.
Best wishes to an amazing family.
It reminded me a bit of my wedding in 2005, when my pre-hospital colleagues surprised us with a guard of honour, holding up laryngoscopes, Magill’s forceps, tracheal tubes, and other airway paraphernalia.
I am stunned by the beauty and brilliance of this video by Spanish filmmaker Cristóbal Vila – Inspirations: A Short Film Celebrating the Mathematical Art of M.C. Escher.
M.C. Escher (1898-1972) was the Dutch artist who explored a wide range of mathematical ideas with his woodcuts, lithographs, and mezzotints.
The cool bloggers at openculture.com write: Although Escher had no formal training in mathematics beyond secondary school, many mathematicians counted themselves as admirers of his work.
I’ve been too busy to blog literature updates for a couple of weeks since I and my colleagues have been flat out running a two week training course in prehospital and retrieval medicine.
Our Helicopter Emergency Medical Service physicians and paramedics care for a wide range of adult and paediatric trauma and critical care patients in some challenging environments. We therefore need to provide a fairly comprehensive induction course for new recruits.
The new guys did us proud. They just need to stay this awesome.
Something I’ve been teaching for years – but never actually done – has been described in a case report from Oman.
A 2 year old child suffered a respiratory arrest due to an inhaled foreign body, which led to a bradyasystolic cardiac arrest. She was intubated by the resuscitation team who could not achieve any ventilation through the tube. The tube was removed and reinserted by an ‘expert’ (there is no mention of capnometry, for what it’s worth) and the same problem persisted.
The life-saving manouevre was to insert the tracheal tube further down into the right main bronchus and then withdraw to the trachea. This forced the obstructing object distally so that one-lung ventilation was then possible, resulting in return of spontaneous circulation and oxygen saturations in the mid-80’s. The object – a broken piece of plastic – was removed bronchoscopically and happily the child made an uneventful recovery.
Is this technique in your list of life-saving tricks? Hopefully, it is now.
A child is alive because a doctor was able to ‘think outside the guidelines’ in an incredibly high pressure situation. Rigid adherence to ACLS procedures here would have been futile. The guidelines save lives, but a few more can be saved when care can be individualised to the clinical situation by a thinking clinician.
Well done Dr Mishra and colleagues.
Sudden near-fatal tracheal aspiration of an undiagnosed nasal foreign body in a small child Emerg Med Australas. 2011 Dec;23(6):776-8
[And here’s something else to consider if you have no airway equipment with you and your basic choking algorithm isn’t working]