Michael McCarron
1.3K posts

Michael McCarron
@PEMDrMike
He/ him | PEM Specialist | Paediatric Retrieval Specialist @NETSNSW | Assoc editor @ArchivesEandP | Sail ⛵️ & explore the world 🌎 in spare time
Sydney, New South Wales Katılım Kasım 2017
268 Takip Edilen347 Takipçiler
Michael McCarron retweetledi
Michael McCarron retweetledi

Observation is an investigation
My #DFTB23 Keynote talk.
Spoiler: The decision to observe needs to be an active one, not just a process to avoid making a decision.
youtube.com/watch?v=wtIwZ_…

YouTube

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Thinking about a move to the country but not sure if its right for your family? Or are you recruiting staff to your country ED? Come and hear from the experts why "growing up rural is awesome"! #acemrrr24

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Michael McCarron retweetledi


@DrSimonCraig @Qantas @Qantas customer service is atricious... especially if you're unlucky enough to get their South African or Fijian call centres.
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Dear @Qantas
I would like to seek a refund.
I booked a return flight from overseas.
One leg of the return flight was "cancelled" on the Qantas app.
I called customer service and rebooked on a new service (with a booking fee of $300 USD)
....
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Michael McCarron retweetledi

Responding to a tweet I’ll offer this
VIDEOLARYNGOSCOPY PROBLEMS….and rebuttals
‘Unavailable’
-yes if you haven’t got it you can’t use it (resource constrained settings)
-but in a high income setting unavailability of VL is an OPERATIONAL CHOICE
‘Failure’
-In the recent DEVICE study DL failed more often than VL
‘DL succeeds when VL fails’
-there are large case series of VL rescuing failed DL but none of the opposite
-it uncommon at best (and dare I say it) when it occurs often due to poor VL technique
‘VL reduces DL skills’
-if this is true (and I’m not sure it is) I’m not sure it bothers me much, it is a very clinician focussed rather than patient-centred view (cf the LMA reduces FM skills, DL reduces blind nasal skills)
-and VL of course is the best way to teach DL skills
‘Capnography more important’
-capnography is vital in determining correct/incorrect tube positioning but has nothing to do with the act of intubation
‘The burden of proof lies with those who want change’
-ok, that proof is widely published, it just needs to be implemented
-if VL existed and DL was invented there is about zero chance anyone would adopt it
DL is ‘tried and true’
-tell it to the families of patients who have died unnecessarily of oesophageal intubation
(One more in NZ media last week, another in UK about to go to inquest)
To counter the quote at the top of the slide (which once again is clinician-centred and hints at “heroic healthcare”)
‘Intubation is a potentially dangerous service we provide for our patients, which we should perform in the most effective, reliable and safe way we can. The evidence for each of those three goals lies with VL’
(happy to add refs if requested)

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Michael McCarron retweetledi

How to use corticosteroids for croup in children
@danihalltweets @DFTBubbles
ep.bmj.com/content/early/…

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Michael McCarron retweetledi

How long should you observe a child following a near drowning event to ensure there is no delayed lung injury?
#PAS2024
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@OmAndScop @EMRSscotland @BairdyAl You get to wear a drysuit - I'm jealous 😂. HUET is definitely not on my list of "things I like to do at work". Well done passing it!
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@DrRJWebb @stjohnambulance @SJAYouthEng It might actually happen... my paediatrician colleague & friend helped save a gorilla's life abc.net.au/news/2022-10-3…
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Fantastic!! Teaching first aid to children equips a generation to save lives, because you can never quite be sure when a rhino might come at you (or your friend). @stjohnambulance @SJAYouthEng
Joanna Di-Bella@JoannaDiBella
A great reminder that all learning has value today- one little girl demonstrated her skills in first aid by putting a class mate who had been run down by a rhinoceros (not really obs) in the recovery position!! She impressed me!! @stjohnambulance she learned this with you!
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@DFTBubbles As a gay man and PEM I feel we are stuck in a cycle of repeatedly measuring what we already know is the problem. It's time now for a QI/ implementation study that actually delivers positive change for LGBT+ patients & families.
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UK Neonatal transport activity 2012–2021
⬆️Transfers
⬆️Use of HFNO
⬇️ uplift of care and for lack of neonatal capacity for <27 weekers
Narrative review of UK Neonatal Transport Group dataset
@Alldoj, @SarahDavidsonL, @DrDonSharkey
fn.bmj.com/content/early/…

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Recurrent themes from paediatric mortality and morbidity reviews
Top themes:
💓 Persistent tachycardia
💉 Lactate >4
Network perspective 🇬🇧 2021–2023
adc.bmj.com/content/early/…

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Michael McCarron retweetledi

Our darling nurse Ashley died on Christmas eve in Qld - the cost of getting her home is to NSW is enormous - pls help us if you can @NETSNSW . gofund.me/4e72758b
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Im a big fan @LiangRhea - thank you so much for trekking to Sydney and contributing to our conference #jkb2023 #operatewithrespect

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