75. Hot Debriefing | Processing events while you're still in the arena

Finding time to debrief challenging cases can feel nearly impossible amidst the tumult and task saturation of medical practice. The reality, however, is that it’s a necessity, not a nicety.  In this episode, emergency physician Stuart Rose and rescue specialist Ashley Liebig discuss two different approaches to immediate debriefs: INFO and the hot offload.  

Guest Bios: 

Stuart Rose is an emergency physician practicing in Calgary, Canada and lead author of the seminal debriefing paper, Charge nurse facilitated clinical debriefing in the emergency department. 

Ashley Liebig is a HEMS Flight Nurse and Helicopter Rescue Specialist with Austin Travis County STAR Flight. Prior to her flight and rescue career, Ashley served in the US Army as a combat medic with the 101st Airborne Division. She is known around the world as a teacher of managing the stress response

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For full show notes of this episode and all sorts of other goodies, visit our podcast website

We Discuss

• A particularly stressful resuscitation that was taxing, emotionally and physically, and an approach to the “hot offload” [03:30];
• Debriefing core concept #1:  The ED charge nurse is optimally suited to organize the debriefing and to lead the conversation [07:25];
• A structured approach to debriefing using the mnemonic INFO [12:40];
• Sample debrief scripting [13:30];
• Handling conflict or criticism that may arise during a debrief [18:35];
• The importance of establishing psychological safety [21:00];
• Principles of a hot offload [28:15];
• Hot offload steps [32:25];
• Ashley’s Credo:  work hard, be respectful, be kind [36:40];
• And more.