Coronaanpassade kurser 2021; v 20 och v 21

2021 års ordinarie kurs går v 20, denna är fullbokad
2020 års kurs blev flyttad till 2021, v 21. De som var anmälda till kursen 2020 har alla fått plats på denna (ni behöver inte anmäla er igen)

Bägge kurserna 2021 är "coronaanpassade". Vi hoppas förstås alla på att vi skall vara i genom detta till våren. Trots detta har vi planerat kurserna 2021 så att vi kan genomföra dom även med eventuella restriktioner på hur många som får samlas i en lokal.
Kurserna kommer i omfattning och innehåll vara väsentligen oändrade men alla moment under veckan kommer genomföras i små grupper. Kurserna kommer också kompletteras med några hemuppgifter att genomföra innan kursveckan
Väl mött v 20 och v 21.

Ordinarie kurs 2021 v 20 är full men det finns fortfarande några platser lediga v 21 2021


This video appeared on Twitter recently. Ignoring for a moment that it really is just to good to be true (and probably is not).
One good reaction was "I was laughing till I realised Ive seen a lot of anesthesia inductions go about like this". That reflection is so spot on: Many of our most critical procedures go like this. In Swedish I call it "hoppsan-medicin" which translates to something like "Ooops-care". So we see similarities that are not good. But that is just the immediate analysis..
Going back to our pilot and while laughing at him, you have got to hand it to him that he is idetifying and correcting a critical problem quicker than most would, at the same time as he is jibbering on.. (a junior pilot would probably crash the plane 5 out of 10 times with that error) 
What does the experienced pilots behaviour tell us? For one thing, he is probably an extremely experienced pilot. Having done this tens of thousands of times before, he uses something bordering on "Gaze-heuristics" (extreme pattern recognition, catching a ball etc). With experience, they work fine, in aviation and CC alike. Problem is first and most obvious, following a checklist will minimize the likelihood of trying to take off with flaps up. But a not so obvious one is a pilot like this is just not mentally really there (obvious in the video) and the Big problem for the passangers is when he experiences a(nother) major problem or anything that overwhelms his interior autopilot and demands his mental/cortical awareness. Deviating to a more structured cortical approach, our pilot very much starts in the "mental backseat"..
How does this relates to our #Scandinaviananaesthetist, the one who has done 15000 ETIs & thousands of emergency RSIs etc etc... .
Our experienced colleague, doing just another roadside or ED TBI RSI.. Sometimes you see the same thing with him/her and sometimes you can identify a big risk that he is just not mentally there. (Sorry to disillusion those of you who still find it exciting, after 15000 you just dont get that all worked up any more..) And things go fine, even when not entirely according to plan, "Gaze-heuristics" and internal autopliots in good effect. Up until it is not fine, wich allmost never happens.. Wich makes us believe (us back in the plane or in the ED bed), that everything is just fine.. Marginal safety improvements is just not a great mediamagnet..
Another problem with not being there mentally, is that quality suffers. Our pilot in the video is probably not that hung up on doing "threepoint kissers" any more, "any landing you can walk away from son.." and so on..
Bottom line (finally) is: Imagine if we could motivate this old dog in the cockpit to get into the "training and structure" programme (the one that his less experienced colleagues rely on to get the job done.) How good and safe would not this guy fly planes?
Using really experienced anesthetists in CC-How good could it not be, getting these people off the "Gaze-heuristics", out of the "mental backseat", into the "training and structure" Wow..
You old-dogs, please,please,please: Start taking part in regular training and at least consider using a structured approach to critical procedures. With your experience sharpened by regular and structured training you can do both wonders and magic. Dont compare yourself to lesser experienced, compare yourselves to the highest imaginary standard You could possibly acchieve
And while we are at it - You Junior doctors (who still rely on a checklist to avoid crashing when you forget to lower the flaps - and you Will, sooner or later, with or without a checklist) PLEASE dont think that a checklist will keep you out of difiiculties or solve all of your problems, and PLEASE dont think that extensive training on a rubberduck is a substitute for clinical experience.
What the checklist and rubberduck training Will do is allow us all, old-dogs and novices alike, to deliver the best possible care at our level of experience, on every take-off.

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Dutton har bra beskrivit det tidigare, både här och här.. DCR består av hemostatisk resusitering, permissiv hypotension (eller i Duttons fall Aktiv hypotensiv resuscitering) och förhindrande av koagulopati, hypotermi och acidos. Den här artikeln i danska läkartidiningen av Stensballe et al beskriver transfusionsdelen av DCR på ett bra vis

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