EMCrit Podcast

The needle vs. knife debate rages on, but it looks like the knife may be winning

Driving Pressure with Dr. Roy Brower

Pulmonary Hypertension and Acute on Chronic RV Failure

It seems simple, but not treating this situation with respect can lead to disaster.

A slight diversion to discuss how to argue better

Today, I am joined by my friend, Mike Lauria, to interview Gary Klein, PhD. Dr. Klein is a masterful cognitive psychologist. He is known for many groundbreaking works, including: the Recognition-Primed Decision (RPD) model to describe how people actually make decisions in natural settings; a Data/Frame model of sensemaking; a Management by Discovery model of planning to handle wicked problems; and a Triple-Path model of insight. He has also developed several research and application methods: The Critical Decision method and Knowledge Audit for doing cognitive task analysis; the PreMortem method of risk assessment; the ShadowBox method for training cognitive skills. He was instrumental in founding the field of Naturalistic Decision Making. The Books Sources of Power This is the one that got Mike and I started as Klein Fanboys Streetlights and Shadows The absolute best compilation of Dr. Klein's decision-making concepts that are directly applicable to medicine Seeing What Others Don't Next up on my reading list Recognition Primed Decisionmaking Wikipedia Link for RPD Sites and Links Dr. Klein's Company Shadowbox Training Articles Mentioned in the Show Kahneman D, Klein G. Conditions for intuitive expertise: a failure to disagree. Am Psychol. 2009 Sep;64(6):515-26. Can We Trust Best Practices? Six Cognitive Challenges of Evidence-Based Approaches. Journal of Cognitive Engineering and Decision Making Additional Related Stuff Effect of availability bias and reflective reasoning on diagnostic accuracy among internal medicine residents. Effects of reflective practice on the accuracy of medical diagnoses.  Going fast might not induce more error, it's about experience and if you have the patterns to recognize: Disrupting diagnostic reasoning: do interruptions, instructions, and experience affect the diagnostic accuracy and response time of residents and emergency physicians? Slowing down doesn't help.  Slow is just slow. Smooth is FAST, and smooth is about economy of cognitive resources and movements The relationship between response time and diagnostic accuracy. The etiology of diagnostic errors: a controlled trial of system 1 versus system 2 reasoning. The Checklist Manifesto: How to Get Things Right Descartes' Error: Emotion, Reason, and the Human Brain Now on to the Podcast:

Rapid Sequencing of Awake Intubation

What to actually do (besides nothing) for severe hyponatremia

NC: yea or nay

A lecture by an emergency physician explores stress, team dynamics, and the 'Fog of War' concept in emergency medicine. The significance of mental preparation in emergency situations and the impact of mental rehearsal on team performance. How acute emotions affect memory in medical contexts and stress management during high-pressure events. The influence of threat and challenge appraisal on performance under stress. Tools for assessing appraisal in emergency medicine residents and stress inoculation training. The importance of mental preparations, team readiness, simulation, and analysis in trauma resuscitations.