Dr. Damian Roland (@damian_roland) - #FOAMed supporter

What I learnt this week: The importance of #connectingwith #WILTW

In #WILTW on September 12, 2014 at 6:02 pm

This is the seventeenth #WILTW

This week Alys Cole-King went on a 24 hour tweetathon in aid of world suicide prevention day. She used the hashtag #connectedwith aiming to “raise awareness that strong relationships, connectedness and a sense of belonging are powerful protective factors against suicide.

She also wrote a great blog on the importance of friends and family and how easy it is to sacrifice this in trying to be supportive to the patients and colleagues you work with. It is a theme that has run since her NHS Change Day pledge. It is very well timed as on the other side of the planet Mike Cadogan has written on very similar themes as part of a personal reflection on the challenges he has faced in delivering the #FOAMed movement. “Family comes first” his first of 5 lesson learnt.



Being connected with people is a very easy thing to think you are doing when in fact you are not. It has been a painful process but I am now all too aware of times when I haven’t actually been truly engaged with people close to me.  At times this may have led to active antagonism with no insight at all on my behalf that this was happening. I do my best to always be utterly honest with the problems or issues I may be bringing to a discussion. Unfortunately too often there is little time to sit down with people, catch up and actually listen to the issues at stake. We work in health care environments in which time spent in the cafeteria may be seen as being work shy as opposed to being engaged. Its clearly not an easy think to balance but true connection is something I really hope to work on.

What did you learn this week? #WILTW

What I learnt this week: Everything is awesome #WILTW

In #WILTW on September 5, 2014 at 4:13 pm

This is the sixteenth #WILTW

The following tweet raises a number of interesting questions:

Are we really that miserable? My immediate response was surely not! I think, by and large, my day-to-day interactions and social media output concurs with that. I admit a tendency to look a little more stressed than I actually am (although this has advantages in not being given a deluge of additional tasks…) but think/hope my outlook is generally positive.

But if I look a little deeper then there is something to reflect on. Going back through blog posts I can honestly say that my view of the world is not “wow – isn’t everything great!”. There is a slight negative aspect to a number of them and an underlying theme that change is a very long and laboured process. I look at my recent timeline and, although there are a fair sprinkling of supportive #nhschangeday and #FOAMed tweets, there are also not an inconsiderable number on difficult situations and challenging world events. On further reflection I must be honest that actually my interaction with social media (twitter in particular) is not always a “smiley-happy” experience. All too often I can be rankled by editorials or upset by the black-and-white nature of peoples thinking. I must also admit, and this is slightly painful, occasionally it is a little frustrating to see others comments and material go quasi-viral when you have had the same idea (or even previously released the same content).

Am I more miserable than I actually think…! It is a sobering thought.

I think this is good wake up call to the importance of mindset. Earlier this week, my wife and I, without our kids(!) watched the Lego Movie. I personally highly recommend this film. It runs out of ideas towards the end but basically nearly 90% of the jokes are adult orientated (or I am just a big kid perhaps). The signature tune is “Everything is awesome”

Once you have heard this tune you are destined to hum it for the rest of the week; so beware!

It’s likely there will remain times that content flowing in-and-out of social media is frustrating and incites a feeling of dejection and depression. But there are many other times when collaboration and support are clearly demonstrated to be intrinsic to the motivations of many FOAMites and Medical tweeps. And while Mike Cadogan’s frank review of his learning over the last 5 years is not a litany of joy  – the nature of the comments on this post and the learning from it leads me to believe we will all be the better, and more positive, as a result.

Everything is awesome.

What have you learnt this week #WILTW

The ice bucket challenge: The best solution to SVT

In FOAMed, Medical Education on August 31, 2014 at 8:21 pm

Not one to waste an educational opportunity I used my ‘ice-bucket’ challenge video to talk about another use of ice-buckets…


Children in Supra-ventricular Tachycardia (SVT) are not uncommon presentations to Emergency Departments. It’s worth remembering that infants won’t present complaining of palpitations and may just be brought in by parents with poor feeding, irritability or just not being ‘right’. There is a really nice blog post about SVT  from Paediatric EM Morsels but I want to focus on one form of treatment – ice-water. I have yet not to have a child present who I have been unable to revert by this technique (It will happen I am sure…).

The key mistakes people make are:

1) Not holding properly. Young infants must be completely swaddled and have their face held in the water. This looks dreadful – so a lot of pre-warning to the parents is necessary.

2) They don’t complete immerse the face. It is not a slight ‘dab’ – the whole face must be immersed

3) They panic at 3 seconds.

In my experience you need a good 5s (sometimes slightly longer). This feels like a very long time (and is worse than the swaddled hold!) so you must brief parents (and other staff!) extensively about it.  Another approach is to basically hold longer than comfortable, and then hold a bit a more, if you don’t feel like counting in your head.

My ice-bucket challenge was to demonstrate what 5s feels like. Believe me if you can revert this way it is A LOT better than adenosine….

(Would have been better if I had thought through in advance what I was going to say but the light was running out fast…!)

[I have donated to the MND association]


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