March 21, 2014

Social Media And Critical Care (SMACC)

This year I was fortunate enough to attend the Social Media And Critical Care (SMACC) conference from Mar 19th – 21st, 2014 at the Gold Coast Australia, also known as SMACCGOLD.  SMACC is a modern, academic meeting, mixed with on-line technologies to deliver innovation in education in the fields of emergency medicine and critical care. This conference addresses important clinical issues in a format that is energetic, cutting edge, and yet reputable. So what did I learn?  Well, more than I can put into one post, but some of the highlights are listed below.

Who were some of the people I got to meet and interact with at the conference?


Well just to name a few….

What can Free Open Access Meducation (FOAM) do for you?

Screen Shot 2014-03-21 at 12.31.05 AM

Emergency Medicine is a persistently changing field in which there is significant practice pattern variation amongst physicians.  Changes in  practice typically have a very slow uptake in medicine, in general, but are an essential  part of  clinical practice and what’s best for our patients.  FOAM will allow you to overcome the chasm that commonly occurs in medicine by having a more real time knowledge translation of best clinical practices through interaction and collaboration.

What did I learn from the Social Media And Critical Care (SMACC) Conference?

Top 10 List

There was so much great information, that there is no way I can list all of it in one post.  Instead, I will mention my top 10 lessons learned…

  1.  Airway ManagementAirway management is all about mindset and rescuing an airway is too late, we should be proactive with airway management.
  2. Vasopressors can be started in peripheral IVs until central venous catheter is placed. [1]
  3. Have you heard of The proCESS Study? Well it turns out we are now better at looking for sepsis, work hard to resuscitate septic patients with early IVF and antibiotics, and maybe monitoring (i.e. CVP and MAP) may not matter
  4. Patients receiving end-of-life care often come to ED and we can be a critical decision-making point where goals of care are established and we can take great satisfaction not only in our great saves but in the satisfaction of letting people die well. In the end “Cure sometimes, treat often, and comfort always.” -Hippocrates-
  5. Damage Control ResuscitationIn Damage Control Resuscitation (DCR) in trauma patients the earliest key to survival is hemorrhage control and DOES NOT apply to trauma patients who are not hemorrhaging. The 4 pillars of DCR are early bleeding control, permissive hypotension, limiting IVF (dilution), and targeting coagulopathy.
  6. We need practice doing cricothyrotomies, we need to know the anatomy involved in doing cricothyrotomies, and if you do a cricothyrotomy do it bougie-assisted.
  7. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potentially lifesaving maneuver in the setting of hemorrhagic shock.
  8. Emergency Department Extracorporeal Membrane Oxygenation (ECMO) and Extracorporeal cardiopulmonary resuscitation (ECPR) are realities that are coming to EDs and initiated by emergency physicians in patients with cardiac arrest [cite source=”pubmed”]22306260[/cite].
  9. Ear-to-Sternal Notch PositionWhen preparing to intubate a patient, remember the “ear to sternal notch” position is the ideal position.
  10. In patients with extra-axial intracranial hematomas an emergency burr hole evacuation may have to occur from the emergency medicine physician if neurosurgery is not available [2]

*Checkout some other reflections from smaccGOLD:

What else went on during the conference?

SMACC Sono Wars

SMACC Sono Wars: Northern Hemisphere (Ultrasound Podcast) vs Southern Hemisphere (The Sono Cave)

SMACC Sim Wars

SMACC Sim Wars: By the way Boba Fett (Scott Weingart) and Alien (Cliff Reid)

Where and when will the conference take place next year (2015)?

SMACC Chicago

May 20 – 22nd, 2015 Chicago, IL

I believe Joe Lex (@JoeLex5) put it best when he said:

  • If you want to know how we practiced medicine 5 years ago, read a textbook.
  • If you want to know how we practiced medicine 2 years ago, read a journal.
  • If you want to know how we practice medicine now, go to a conference.
  • If you want to know how we will practice medicine in the future, listen in the hallways and use FOAM.


  1. Ricard JD et al. Central or Peripheral Catheters for Initial Venous Access of ICU Patients: A Randomized Controlled Trial. Critical Care Med 2013. PMID: 23782969
  2. Wilson MH et al. Emergency Burr Holes: ” Ho to Do It.” Scand J Trauma Resuscitation Emerg Med 2012. PMID: 22469190
Cite this article as: Salim Rezaie, "Social Media And Critical Care (SMACC)", REBEL EM blog, March 21, 2014. Available at:
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Salim Rezaie

Emergency Physician at Greater San Antonio Emergency Physicians (GSEP)
Creator & Founder of REBEL EM
  • Erich Hanel
    Posted at 09:59h, 21 March Reply

    Nice summary! Twitter was busy with SMACC stuff, lots of great bite sized learning last week.

    • Salim Rezaie
      Posted at 13:50h, 21 March Reply

      Hello Erich,
      TY For reading and commenting on the blog. It was an amazing conference. The shear amount of information that came out on twitter was astronomical. Very much recommend this conference, and hope I did it justice with my summary of highlights.


  • Asit Misra
    Posted at 13:51h, 21 March Reply

    Thanks for sharing this. I can now understand what I have missed. Looking forward to attend it in Chicago.

    • Salim Rezaie
      Posted at 13:54h, 21 March Reply

      Hello Asit,
      No worries mate…as they say down under. It is a must attend conference…the energy, the collaboration, the enthusiasm is just infectious.


  • Alan Batt
    Posted at 16:50h, 21 March Reply

    Great summary Salim, and thanks for all your tweets – concise and timely! Chicago is a must, hope to meet you there!

    • Salim Rezaie
      Posted at 18:48h, 21 March Reply

      Hello Alan,
      I appreciate it very much. I agree Chicago is a must. Hope we get to run into each other then. TY for reading and hopefully did the conference some justice.


  • Andrew Coggins
    Posted at 22:56h, 21 March Reply

    Great Summary – I’m looking forward to Chicago too – SMACC 1 and 2 have been like no other conference I’ve been too… Impressive site too – will be back soon!


    • Salim Rezaie
      Posted at 23:01h, 21 March Reply

      Hello Andrew,
      Thanks for taking the time to read the post and check out the site. A work in progress…just like anything else. I unfortunately missed the first one, but will not be missing the 3rd one in Chicago.


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    Posted at 03:39h, 22 March Reply

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  • DuneDocs
    Posted at 07:39h, 22 March Reply

    Way to go Sal!

    Concise and relevant. Hated to miss it.

    Busy stomping out Brucellosis and stoke team development!

    See u in chi town hopefully.


    • Salim Rezaie
      Posted at 07:44h, 22 March Reply

      Hey Jason,
      Thanks for reading. Its crazy to see how far EM is coming in its critical care mission. The post doesn’t even do the conference justice. I just mentioned some of the highlights. Thanks for reading and keep in touch.


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  • anne smith (@annestir)
    Posted at 12:23h, 25 March Reply

    Hey Salim
    Thanks for this summary, I was intensely jealous the whole week with all the awesome smacc tweets coming through. Also I was really looking forward to an Australia trip next year but now it looks like I’ll be returning to the US. Have always wanted to visit Chicago, so there you go!
    Keep well

    • Salim Rezaie
      Posted at 12:27h, 25 March Reply

      Hello Anne,
      It was an amazing conference. Words cannot even begin to do it justice. You are doing an amazing job down in South Africa. Keep up all the great work. Plan on seeing you in Chicago. 😉 Thanks for reading and hope you are doing well.


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  • rob mac sweeney
    Posted at 11:46h, 26 March Reply

    Great post Salim, it was fantastic meeting you at SMACCgold. Good luck with your job and blog. I look forward to seeing you in Chicago.

    • Salim Rezaie
      Posted at 12:25h, 26 March Reply

      Thank you Rob. It was great to meet you as well. Keep up the good work. Good luck to you as well and yes plan on seeing me in Chicago.


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