Emergency departments are at the forefront of dealing with the harmful effects of alcohol consumption. ED alcohol-related presentation data is not routinely collected in patient data sets. I will describe the outcomes of the ACEM Alcohol Harm (AHED) project. For the first on a national scale the project quantified the level and effect of alcohol harm presenting to emergency departments (EDs) in Australia and New Zealand. Over 100 EDs and more than 2000 ED clinicians have been involved. AHED provided an evidence base to advocate for measures to reduce alcohol harm I will demonstrate by how using evidence and anecdote clinicians are power witnesses and can influence culture and policy change.

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Category:general -- posted at: 2:25pm AEST

Over 85% of the world’s population live in Low and Middle Income countries. Health statistics in these countries are characterised by numerous deaths from treatable time-sensitive illnesses and injuries resulting from inadequacies in health systems; particularly Emergency Care.
However, across the world, Emergency Care continues to grow, and every country has a story to tell. There are similarities in our stories: the overwhelming sense of responsibility, the exhaustion and feeling of being undervalued. But there are also glaring differences in quality. Africa can be better and it should be.
2017 marks 10 years since the first Emergency Medicine Physician graduated in Africa. From one single Residency program in 2007, there are now 11 more in 9 of Africa’s 54 countries.
2009 saw the formation of The African Federation for Emergency Medicine (AFEM) supporting Emergency Care development across Africa. AFEM’s projects include:
The biennial African Conference on Emergency Medicine (AfCEM), the only scientific conference on African emergency care.
The Annual Consensus Conference that addresses various aspects and challenges of Emergency Care in Africa.
A quarterly international, peer-reviewed journal, publishing original research on topics relevant to Africa, freely available online and offering free publication support to African researchers through Author Assist.
Supadel, a peer-to-peer sponsorship program funds attendance of practitioners to AFEM-affiliated conferences on African soil, allowing them to network and learn valuable lessons in Emergency Care to improve systems in their countries.

Building and maintaining robust Emergency Care systems addressing community needs and improving the health of populations requires us to connect to each other and the world. For us to contribute to the world and for the world to support and contribute to programs and projects in Africa.
The African story is about everyday people connecting with each other to change themselves, improve their systems and transform lives.

For more details about the upcoming African Conference on Emergency Medicine On 7-9 November 2018, In Kigali-Rwanda, click here

To hear more about Supadel and sponsoring delegates to African Meetings, go here, and to see what we're doing in Sydney, read about SMACCReach here.

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Category:general -- posted at: 10:25pm AEST

"Mortality measured at a particular time point (landmark mortality) is often regarded as the gold standard outcome for randomised controlled trials in Intensive Care Medicine. An important limitation of many Intensive Care Medicine trials is that they hypothesize large and potentially implausible reductions in absolute mortality. This is a major problem in trial design for two reasons. Firstly, it makes false negative trial results more likely. Secondly, the less plausible a postulated mortality reduction is the more likely that a statistically significant mortality difference will represent a false positive. This is because a p-value is defined as the probability of finding a result equal to or more extreme than that actually observed, under the assumption that the null hypothesis is true. This means that the greater the pre-trial chance or prior probability that the null hypothesis is correct, the lower the chance that a p-value below a particular significance threshold will represent a true positive.

The biggest single problem with the current evidence base is that most hypotheses being tested have low prior probability. We need a new research paradigm to address this problem, particularly in relation to the fundamentals of Intensive Care Medicine. Intensive Care therapy is fundamentally about providing supportive care. Such care includes airway support, oxygen therapy, ventilation therapy, haemodynamic support, fluid therapy, temperature control, and nutritional therapy among others. Setting the goals for these therapies is what intensive care doctors do every day. At present, for most of these treatments, the level of evidence on which we are making our decisions is extremely limited. Moreover, the illusion of physiological gain may be leading us astray; making us believe we know the right thing to do when we really do not. We should be creating systems in our intensive care units that allow us to learn iteratively from every patient so that we can systematically reduce mortality over time by understanding how to optimise supportive care. Bayesian adaptive platform trials using response adaptive randomisation can improve the outcomes of patients with mathematical precision but require us, as doctors, to stop believing we know the answers when we really do not."

Direct download: Paul_Young_-.mp3
Category:general -- posted at: 7:00am AEST

Endocarditis has been on the back burner for a while now. It is a disease that is evolving as new risk groups emerge and microbiology change. This talk will provide you with the framework to identify the disease and avoid the pitfalls in preventing you to nail down this diagnosis. After this talk you will neither be bored nor afraid of abnormal blood cultures and you will realized you don't need to fulfill SIRS criteria to be sexy.

Direct download: David_Carr.mp3
Category:general -- posted at: 7:00am AEST