This year the Australasian College of Emergency Medicine (ACEM) winter symposium was held in the beautiful Barossa valley in South Australia. This 4 day conference is designed to bring emergency physicians together from across Australia and New Zealand to network, learn and share best practice. It’s always held in a non-metro location and is organised by local emergency physicians with the help of ACEM. The winter symposia are different, maybe friendlier and perhaps a bit less stressful than some of the major scientific conferences but that’s no criticism. Arguably it compliments and enhances the conference experience in Australia.
About me and why am I writing for St.Emlyn’s
My name is Katherine and I am an ACEM advanced trainee. I am an avid traveller and will take any excuse to escape my home city, particularly if there’s a professional development opportunity involved. The ACEM Winter Symposium was no exception, with the ability to couple a brilliant conference program with a relaxing getaway in one of Australia’s most beautiful regional areas. The medical education landscape has rapidly evolved even since I was in medical school, and I have found that attending conferences and courses has given me much more tangible knowledge as well as an opportunity to network with like-minded colleagues than I could have expected. In an environment that is becoming ever more competitive for jobs in Australia, being able to engage with the wider community on a clinical and educational base is of increasing importance. As a result, I consider myself a keen consumer of #FOAMed, so the chance to contribute to St.Emlyn’s was one seized with great enthusiasm.
Simulation, performance for exams (with Vic Brazil), Mass casualty simulations with Andrew Pearce, an ECG workshop with Louise Cullen and a thoracotomy workshop with the Royal Adelaide trauma surgeons. Mostly small group work with lots of interaction and engagement. Workshops are increasingly the most valuable part of conferences as you can really get hands on and involved in the teaching, there’s more interaction with colleagues and tutors and thus better learning for everyone.I didn’t attend these but followed some of the learning online and heard more about them at the conference itself.
Vic Brazil ran a really interesting workshop on performance. It encompassed how we can improve our performance in exams by the way that we behave and project ourselves. Exams our stressful for all and the new formats of the FACEM exams, and the increasing use of OSCEs as assessment tools mean that this is now a real consideration for trainees (and trainers)1.
Performance art – team leading in low fi sim with @SocraticEM and @IanMeducator at #acemws17 pic.twitter.com/8AevcFI5cU
— Michael Edmonds (@drmedmonds) July 26, 2017
Andrew Pearce ran an excellent prehospital workshop on disaster planning, which in light of recent events in Europe and Melbourne is really topical. The key learning point is that major incidents can occur and will occur, and that we need to be well prepared, but pragmatic in our approach to such events.
It's (simulated) chaos in the Barossa this morning at the #acemws17 Mass Casulty workshop pic.twitter.com/TFsV21xzXl
— ACEM Events (@acemevents) July 26, 2017
The Sim workshop (which Simon attended) focused on the use of an online Simulation Scenario builder. It’s in evolution at the moment but could offer ‘off the peg’ simulation scenarios that can be shared under #FOAMed principles. We’ve not seen this before, but it looks like a really good idea (a really good time saving idea).
Check this resource to build and share simulation guides with process and outcomes. #acemws17 #Simulation #foamedhttps://t.co/6nQuw8035i
— Simon Carley (@EMManchester) July 26, 2017
The first day of the symposium started off on a high, with a plenary by St.Emlyn’s own Simon Carley on complex decision making, and renown EM researcher Louise Cullen on translational research and the challenges in implementing a clinical overhaul of chest pain assessment.
.@EMManchester – "if Roger Federer has a coach, shouldn't ED physicians have peer review? Get someone to physically watch you" #acemws17
— Suneth Jayasekara (@DrSuneth) July 27, 2017
The morning’s concurrent sessions included a stream on emergency psychiatry, an area not usually highlighted in EM conferences, which included the pitfalls of pre-hospital psychiatric transfers, appropriate sedative measures, medical clearance and methamphetamine psychosis / delirium. This session was a real insight into the complexities of managing patients intoxicated with Meth and other substances. As EM physicians we know it’s complex, but this talk really exposed just how difficult and timee consuming it can be to really differentiate and support patients with acute psychiatric problems.
Other streams included a lung USS workshop, paediatrics (including a discussion on paeds sedation and a round-up of best paeds papers) and a session for new fellows, with some excellent insight into mentoring, resilience and risk taking in your career. The day closed with concurrent neonatal resuscitation and nerve block workshops, as well as a stream on healthcare innovation and international emergency care, the latter of which posed the question, “are we doing enough in international EM?”.
Great talk from Antony Chenhall on thinking about how to support developing contexts develop EM #acemws17 pic.twitter.com/kB7iifaH2E
— Natalie Thurtle (@Turtle1doc) July 27, 2017
Day two started with a crash course in critical care by a consortium of #FOAMed alumni. Fluid resuscitation in septic shock and the use of POCUS in the undifferentiated hypovolaemic patient sparked a flurry of keen conversation between the emergency physicians and intensivists alike. An introduction to ECMO in the ED by Chris Nickson was also well received, as this is a practice not yet established in many Australian hospitals, let alone emergency departments.
Resus room management for E-CPR with role cards – took 40 protocol versions to develop @precordialthump #acemws17 https://t.co/icsjQghbaC
— Michael Edmonds (@drmedmonds) July 28, 2017
The morning’s concurrent sessions included the free papers session and an advanced airways workshop, as well as a radiology stream (covering trauma imaging and MRI) and a critical bleeding stream, with a summary of the PATCH trial, the use of ROTEM and a no-nonsense guide to haemorrhage control. The diverse topics covered in the afternoon sessions saw many guests swapping frequently between streams, a testament to the quality of the speakers. When guests weren’t enjoying live snakes in action in the toxicology stream (there were snakes!), they were discussing clot retrieval in the stroke session or being schooled on ECGs by Louise Cullen and optimising education through social media by Simon in the trainee stream.
#acemws17 snakes snakes and snakes. Like never before pic.twitter.com/1eU0OilXMP
— Tariq Nehvi (@tnehvi) July 28, 2017
Atkinson: still worth considering perimortem c-section >15mins maternal downtime as could still make diffrence to maternal outcome #acemws17
— Natalie Thurtle (@Turtle1doc) July 28, 2017
Obstetrics also had its own session, an excellent obstetrician lead summary on all things terrifying in emergency obstetrics (including eclampsia and resuscitative hysterotomy), while dermatology and burns streams provided updates on all things intriguingly integumentary.
Having trouble with pelvic binder placement? Call it the "trochanteric binder" instead, no mistake where to put it! #acemws17 #foamed
— Dr Kat (@KGridz) July 28, 2017
The final day of the symposium started with a summary of all things exciting yet slightly unnerving in the current state of emergency medicine, with a summary of mass casualty efforts during the Manchester Bombing, the use of REBOA and a trauma surgeon’s perspective of damage control surgery. The conference ended on a high note with a plenary lead by Cullen and Carly, on research priorities and what the future of emergency medicine is going to look like. It is no surprise that guests seemed to linger after the final session, keen to extract as much as possible from the speakers and their own colleagues, before flying home or indulging in more of the region’s beautiful vineyards and country hospitality.
@EMManchester: never underestimate the power of using a narrative / patient story in teaching, it's what people remember #foamed #acemws17
— Dr Kat (@KGridz) July 28, 2017
.@louiseacullen ED research priorities #acemws17 pic.twitter.com/5cbBwv1CDa
— Natalie Thurtle (@Turtle1doc) July 29, 2017
@louiseacullen: Even if research, education etc is not 'your thing', the best you can do is be supportive of your colleagues #acemws17
— Dr Kat (@KGridz) July 29, 2017
There's a discrepancy between the risk a patient will accept and the risk we will accept: doctors are so much more risk averse #acemws17
— Dr Kat (@KGridz) July 29, 2017
The first night of the symposium included a welcome session, a casual canape and wine style affair serving as an excellent ice-breaker for those new to the symposium and the state. As a trainee, it was a nice opportunity to talk to other training directors and my own consultants as well as interstate trainees about their experience in the training program.
Night two of the conference involved a cellar door experience, where attendees were taken to a variety of local wineries for a tasting experience (as is custom in South Australia), followed by a choice of a degustation style dinner. Guests were invited to choose between a higher-end affair at Hentley Farm (a renown restaurant in the Adelaide region) or a ‘Beer vs Wine’ Degustation at Barossa Brewing Co. The later was a more casual event but certainly proved to be a fun exercise for the palate, with selected wine and beer from the Barossa region pitted against each other while matched to food of the extremes of sweetness, salt and spice.
#acemws17 gala dinner! pic.twitter.com/PUjf5hynia
— Suneth Jayasekara (@DrSuneth) July 28, 2017
The final night of the symposium was the Gala Ball at Chateau Tanunda, Australia’s largest and oldest Chateau established in 1890. Guests attended in masquerade theme, with award-wining wine from the Chaeteau winery and food served canape and tapas style atop lavishly long tables, optimising the chance to socialise. The dessert and cheese bar was also popular, as was the dance floor, where much to the delight of the trainees, the directors of training took on a more human form in the art of ‘daggy dancing’.
The ACEM Winter Symposium was just as intellectually stimulating as it was a wonderful opportunity to see a beautiful part of South Australia. It proved to be one of the more relaxing conferences on this year’s EM circuit, as the stunning scenery, crisp country air and lack of city noise makes it a completely immersive experience. I definitely left this conference feeling full – of knowledge, of restored enthusiasm for my career path, and definitely of the culinary delights of the Barossa!
Next year the conference moves to New Zealand and Rotorua.
Dr Tom Soulsby brings #acemws17 to a close. Join us in 2019 in Rotorua, New Zealand for the next ACEM Winter Symposium! pic.twitter.com/Lu4rUjX8uX
— ACEM Events (@acemevents) July 29, 2017
Endnote from Simon Carley
It was an honour and privilige to join the Australasian College of Emergency Medicine (ACEM) conference in South Australia this year. This was the winter symposium which compliments the Summer Scientific meeting of ACEM. I learned that the Winter Symposiums are designed to be different, they are always held outside of metropolitan venues and are aimed at the broad reach of emergency medicine. This year this meant a trip to the Barossa winelands North East of Adelaide. It’s a stunning place with wonderful views, wines and food, in other words a great place to catch up with colleagues from across Australasia. Notably this conference is smaller than the Summer meeting, roughly 200 delegates and is has a higher proportion of consultants as opposed to trainees.
So apart from the wonderful company, the fabulous organisation (the ACEM events team led by Rebecca are simply amazing), the gorgeous food and wines that are simply amazing, what about the learning….., as let’s face it that’s what conferences are about, bringing people together to share and learn the craft of EM.
I completely agree with Louise Cullen’s final thoughts.
Huge thanks to the wonderful organising committee of #acemws17! What a wonderful conference. So pleased to be a part with @EMManchester
— Louise Cullen (@louiseacullen) July 29, 2017
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