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Paeds Tips You Won’t Find In Books – @_NMay at SMACC Gold

The packed-out paeds concurrent at SMACC Gold as captured by Cliff Reid

Talking at SMACC Gold seemed like such a good idea in advance – and it was a wonderful (if faintly terrifying!) experience.

When I came up with this title (yes – I was in the privileged position of picking the title of my own talk), I had envisioned something totally SMACC – a completely tweetable talk full of nuggets of other people’s wisdom about seeing kids in the ED. And I had exactly that two weeks before the conference; more than forty amazing gems collected from paediatric specialists I admire.


And the slides were exactly as I’d imagined – practically no text, simply images which communicated the points I was making and would serve a dual purpose of reinforcing the wisdom and reminding me what I was meant to be saying.


The problem was – it was dreadfully dry.


You see, good talks and educational lectures need to have a story. Nowhere is this more apparent than at SMACC where the power of narrative is given equal weighting alongside clinical innovation. And rehearsing what I was going to say felt so uncomfortable – there was no thread, no story. I had originally started my pre-talk planning as I always do with a storyboard trying to link the ideas but it hadn’t really worked and I didn’t really know what to do or how to fix it. Panic began to set in…

Luckily I spent the week before SMACC in Fiji alongside two wonderful and passionate educators, Iain Beardsell and Nick Jenkins. Watching and learning from them (and in particular reflecting on Iain’s rehearsal for his talk at SMACC) was exactly what I needed. I re-thought my talk as more of a paediatrics pep talk, focusing instead on the ethos of paediatric EM and the ways we can think differently about treating and understanding children. If we get this right, I think we can improve the experiences of our patients and their families, improving experiences of healthcare and investing in their future attendances. And when we see the terrible things that are thankfully a rarity in PEM we can take comfort and solace knowing that we did everything we could when it mattered the most.

With a renewed focus I hacked out about 50% of the original content and totally restructured the talk – and here it is. A labour of love for PEM.

The Slides:

The video from the end of my talk:

I would absolutely love to know what you think.

The original paeds tips you can find on twitter under the #paedstips hashtag.




Addendum 2/7/2014: Huge thanks due to Gerard Fennessy whose calm council as chair of the concurrent was instrumental in settling my last-minute nerves. Cheers!

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Cite this article as: Natalie May, "Paeds Tips You Won’t Find In Books – @_NMay at SMACC Gold," in St.Emlyn's, July 1, 2014,

Posted by Natalie May

Dr. Natalie May, MBChB, MPHe, MSc, PGCert Medical Education, FRCEM, FACEM is section lead for paediatrics and medical education. She is an Editorial Board Member of the St Emlyn’s blog and podcast. She is a specialist in Emergency Medicine (Australia) and a Specialist in Emergency Medicine with Paediatric Emergency Medicine (UK). She works as Staff Specialist in Prehospital and Retrieval Medicine with the Ambulance Service of New South Wales (aka Sydney HEMS). She also works as aStaff Specialist, Emergency Medicine, St George Hospital (South Eastern Sydney Local Health District). Her research interests include medical education, particularly feedback; gender inequity in healthcare; paediatric emergency medicine. You can find her on twitter as @_NMay

  1. Paeds tips
    I put together this dry list for my trainees the week after the talk

    5 April 2014 at 22:03

    by Dr. Natalie May at smaccGOLD

    1. Train/Prepare well for critical illness so the emotions don’t weigh in
    2. Kids generally don’t feign illness
    3. Address pain, fever, fatigue, fear – makes your job easier in every respect
    4. Engage the parents, the nurses (RN and MO cannot be interchanged for assistance) and the patient
    5. Never lie to / mislead a kid (affects later consults)
    6. Let the kid speak first (it builds rapport and understanding)
    7. Toddlers want parents, teenagers want space
    8. Treat the parent, not just the kid. Let them vent. See how they are managing. Empathise with their efforts and anxieties
    9. Two attempts for IV then IO if sick
    10. Get help early if sick
    11. Manage and prevent pain (including neonates) – intranasal opiates, sucrose, nerve blocks, topical anaesthetics
    12. Always check sugar esp in perplexing presentations
    13. Beware of persistent, unexplained tachycardia
    14. Check for testicular torsion in abdo pain (if rural can try manually detort)
    15. Umbilical hernia rarely obstruct < 4 y.o
    16. Rectal prolapse + sick = ?colonic intussuception
    17. Undress all kids for rash and NAI
    18. Double check your drug/fluid doses
    19. Remember child protection laws
    20. Good discharge advice is your safety net


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