Christopher Hicks @HumanFact0rz Twitter profile

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Christopher Hicks

@HumanFact0rz

6 years

The Dark Nate Rises.

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Christopher Hicks

@HumanFact0rz

6 years

For those who are using the tragedy at #YongeandFinch to peddle their anti-immigrant, anti-muslim sentiment on social media: that is never what Canada will be about. Put your hate aside, and set your thoughts to where they should be now: with the victims and their families.

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Christopher Hicks

@HumanFact0rz

4 years

We're open. A brand new trauma bay at @UnityHealthTO , with new workflows, new equipment and logistic solutions, new tools to promote teamwork and safety. Purposely designed, extensively tested, revised with end-user feedback. A trauma care environment like no other.

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Christopher Hicks

@HumanFact0rz

2 years

We are in the midst of a catastrophic health systems failure in Canada. Consider this: the emergency medical care I can offer today is demonstrably inferior to that of just 10 years ago. The avoidable harm to patients and moral injury to providers is truly unforgivable.

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Christopher Hicks

@HumanFact0rz

3 years

This is The Way.

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Christopher Hicks

@HumanFact0rz

5 years

Hydralazine: When you want to drop blood pressure by you don't care how much over who the F knows how long.

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Christopher Hicks

@HumanFact0rz

4 years

As seen on the XR table at the Whistler Health Centre. Really interesting idea, CC: @DrCarolynSnider

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Christopher Hicks

@HumanFact0rz

6 years

A wee thread on why the words “drug seeker” should never appear on any patient’s ED chart, ever. And yes EM people, we are probably the worst at throwing this spurious label around where it doesn’t belong 1/n

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Christopher Hicks

@HumanFact0rz

2 years

Picture a commercial airliner taking off with a 33% reduction in flight crew, with 70% of the seats occupied by passengers unable to de-plane when they were supposed to, saddled with outdated IT systems and under major construction. That’s how emergency medicine feels in 2021.

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Christopher Hicks

@HumanFact0rz

5 years

Dear CPOE: If I’m ordering a non-contrast CT scan: 1. You don’t need to ask me if the patient is diabetic 2. You don’t need to remind me there’s no creatinine on record 3. You don’t need to ask me both of those things THREE TIMES for the same series of CTs Also I hate you.

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Christopher Hicks

@HumanFact0rz

2 years

I don’t know why I feel need to respond to this garbage. But if I may be the reasoned voice of arbitration for a moment: The present collapse of our health care system was predestined and preordained, well before COVID. Everyone on the inside could see it coming. Everyone. 1/

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Christopher Hicks

@HumanFact0rz

4 years

How it started: How it’s going:

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Christopher Hicks

@HumanFact0rz

4 years

Working with a great EM resident today, and had a great shift — right up until the end, when a consulting services with a bad attitude damn near derailed the whole thing. My suggestions for avoiding conflict over the phone were: (1/3)

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Christopher Hicks

@HumanFact0rz

4 years

Our #COVID19 Protected Airway process as of 03/22/20. We've broken it down into three steps: 1. Pre-brief as a team before entering 2. Call-and-response checklist during intubation, led by Safety/Logistics Officer 3. Pre-departure transport checklist Share, revise, discuss.

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Christopher Hicks

@HumanFact0rz

5 years

I start every consult, to every service, with my name, my designation, and a “How are you?” This, followed by a NASA-style bottom line on the reason for calling. Brevity and civility are not antonyms.

Rhea Liang

@LiangRhea

5 years

Advice to young docs when calling the on call surgeon. We expect to be called. You can skip 'how is your day?' or 'is this a good time?' or 'I'm really sorry to bother you but...' If I answer the phone- just talk. And *especially* don't say 'sorry did I wake you?' at 3pm.😳

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Christopher Hicks

@HumanFact0rz

2 years

@cjmdenny @petrosoniak The long answer is we sim-engineered solutions using design thinking principles. The short one is we put stainless steel work surfaces on top of procedure carts filled with entirely delicious procedure bundles, with custom built under-cabinet parking.

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Christopher Hicks

@HumanFact0rz

6 years

When the Enterprise was in trouble and Jean-Luc Picard was out of ideas, he’d seek input from his team. “Suggestions?”, he’s say, openly. One of my first and most enduring examples of effective team leadership. TNG nerds, who’s with me? #BeJeanLuc

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Christopher Hicks

@HumanFact0rz

2 years

I’m an emergency physician of (mumbles) years now. COVID vax’d x 3, Regrets x 0 Everyone who has thoughtfully considered the science has judged vaccination to be superior to just rolling the dice. And you know what? They’re correct. #GetVaccinatedPlease

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Christopher Hicks

@HumanFact0rz

4 years

“The patient has a partially healed proximal phalanx fracture in a distinctive Mandalorian mask-pattern”

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Christopher Hicks

@HumanFact0rz

4 years

Our #COVID19 Protected Code Blue Top Five key messages. Focus on team safety and standard process. Feedback PLZ, #COVIDfoam .

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Christopher Hicks

@HumanFact0rz

2 years

Is COVID contributing to staffing shortages? It sure is. But so is workplace violence, burnout, chronic underfunding, cripplingly useless IT, mismanagement at all levels, and the refusal of governments to even look at the problem in a thoughtful way, let alone try to fix it. 2/

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Christopher Hicks

@HumanFact0rz

3 years

6. Recognize there’s more than one way to be happy 7. Not impose your value systems on others

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Christopher Hicks

@HumanFact0rz

4 years

“What we have here is a textbook COPD exa—“

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Christopher Hicks

@HumanFact0rz

5 years

Coining a new medical phrase today: Benign somnolence An obtunded patient with a GCS of < 7 who nevertheless looks just fine, thank you very much Applies to ODs of benzodiazepines, GHB, admin meetings

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Christopher Hicks

@HumanFact0rz

6 years

I’m totally doing this before my next thoracotomy.

Wuzz Tv

@Wuzz_Tv

6 years

The baby didn't even realize. 😍🤗

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Christopher Hicks

@HumanFact0rz

3 years

If you’re keen to have your colleagues lose faith in your clinical judgment, be sure to ask the following question, mid-massive hemorrhage protocol, with an actively bleeding patient whose SBP is < 70: “Hey, what’s the hemoglobin?”

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Christopher Hicks

@HumanFact0rz

4 years

Should I try to influence behavioral change by way of posting a sign? A unified decision algorithm:

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Christopher Hicks

@HumanFact0rz

5 years

Resus Tower Project, Stage 2: Mobile trauma procedure carts 🔥🔥🔥

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Christopher Hicks

@HumanFact0rz

4 years

I’m old enough to remmeber when we published studies BEFORE we decided to change practice based on the findings.

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Christopher Hicks

@HumanFact0rz

6 years

Faculty mentors: Stop advising your mentees to “learn to say no” to stuff. This strikes me as disingenuous, as most mentors have earned the privilege and protection to do so by saying yes to heaps of bullshit over the years.

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Christopher Hicks

@HumanFact0rz

6 years

The Grotto: All thirteen articles from the #EMClinics 2017 Trauma Edition, available via open-access download until Dec 30 #FOAMed #MedEd

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Christopher Hicks

@HumanFact0rz

1 year

STOP: -IV antibiotics for just about anything that isn’t severe sepsis -Any antibiotics for diverticulitis -Chest tubes for spontaneous pneumothorax -NG tubes for anything #UOFTEM23

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Christopher Hicks

@HumanFact0rz

4 years

3. Personalize — “Why don’t you meet me at the patient’s bedside and we can talk about this face to face?” This prioritizes shared decision making, elicits a commitment form the person on the other end of the phone, and — let’s face it — it’s harder to be a dick in person (3/3)

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Christopher Hicks

@HumanFact0rz

6 years

I learned from a senior colleague of mine that one should always attend hospital and committee meetings wearing scrubs. Adds an air of clinical legitimacy when dealing with admin-types, and allows you to bail at a moment’s notice, no questions asked. @SF_Red

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Christopher Hicks

@HumanFact0rz

7 years

If a recipe exists for safety and wellness it's this: Fix systems, support people; Not fix people and barely support the system.

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Christopher Hicks

@HumanFact0rz

2 years

To simply focus on the COVID is to ignore the last crisis, and the next one, and all that will follow, all of which have the capacity to topple our system. Why? Because independent of the crisis du jour, the system itself lacks resiliency. 3/

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Christopher Hicks

@HumanFact0rz

4 years

To everyone out there going to work, doing the thing, looking after patients, making a difference this holiday season: Here’s to your heart, effort, commitment, skill, focus, ability. Keep that shit up.

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Christopher Hicks

@HumanFact0rz

7 years

Successful shoulder reduction using Cunningham technique 5 mins after patient arrives = Benton Slam

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Christopher Hicks

@HumanFact0rz

2 years

So throw shade and the occasional ad hominem if you wish, I know that sort of attention helps keep some folks relevant in social media land. When you’re ready to have a more fulsome discussion about the problems we collectively face, come on back. /6

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Christopher Hicks

@HumanFact0rz

4 years

"Ask any doctor or nurse what they struggle with most at work, and it will never be the patients: it is the systemic encumbrances that saps them of their energy, their drive, and their ability to innovate." More 👉 @AdvPerformHD @NORR_AEP

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Christopher Hicks

@HumanFact0rz

2 years

Nobody cares when you think life begins. Your religious views are irrelevant. The only thing -- the ONLY thing -- that matters is a woman's right to hold dominion over their own body. Any suggestion to the contrary is rhetorical nonsense, to be dismissed outright. #RowVWade

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Christopher Hicks

@HumanFact0rz

4 years

Crash testing the new trauma bay: Self, team, environment, system #Design

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Christopher Hicks

@HumanFact0rz

5 years

Shelly Dev: I like working with medical students because they’re the closest thing to civilians in our profession. They remind us of the the goodness, curiosity and vulnerability that so many of us lose after years in practice #EMW2019

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Christopher Hicks

@HumanFact0rz

9 years

I never noticed this unassuming little sign cloistered away above the clocks in our #trauma bay; pretty decent advice http://t.co/Tf49ij4WeN

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Christopher Hicks

@HumanFact0rz

4 years

This is The Way.

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Christopher Hicks

@HumanFact0rz

2 years

And this is why @petrosoniak ’s thread and thesis is so very relevant: You can’t solve a problem if you can’t be bothered to look at it. The sort of change our health system so desperately need will never come if we continue to live crisis to crisis. 5/

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Christopher Hicks

@HumanFact0rz

4 years

Last time I looked, doctors, nurses ... < checks notes > ... already work plenty of weekends.

Ford prepared to ask surgeons to work weekend to clear backlog | Globalnews.ca

Ontario Premier Doug Ford's comments came 10 days after modelling research painted a stark picture of surgery wait times across the province.

globalnews.ca

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Christopher Hicks

@HumanFact0rz

2 years

So yes: By all means manage the present ongoing public health emergency, with every medical, social and political tool available. But don’t pretend for a minute that our system will somehow autoresuscitate when talk of spike proteins is in our rear view mirror. It won’t. 4/

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Christopher Hicks

@HumanFact0rz

3 years

You know you're an emergency physician when you refuse to walk up a flight of stairs at home unless you can generate a second task en route to make the trip more efficient.

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Christopher Hicks

@HumanFact0rz

5 years

1. It was a virus 2. It was a virus 3. It was a virus 4. It was a virus 5. It was a virus 6. It was a virus

Clay Jones

@SBMPediatrics

5 years

Reasons your patient isn’t getting better after prescribing an antibiotic: 1. Wrong antibiotic 2. Wrong dose 3. Wrong route 4. Abscess 5. Lack of patience 6. Not a bacterial infection What did I miss?

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Christopher Hicks

@HumanFact0rz

4 years

1. Empathize — The person on the other end of the phone was probably having a shite day too; Don’t tolerate verbal abuse but “I get that this is frustrating for you” helps 2. Strategize — “I recognize you disagree; Let’s build a solution that works best for our patient” (2/3)

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Christopher Hicks

@HumanFact0rz

4 years

1a. Nursing 1b. Paramedic

Paul Sufka, MD

@psufka

4 years

Order of usefulness when they ask for a doctor on an airplane: -Emergency medicine -Primary care -Pulmonary/cardiology (tie) -Endocrine/rheumatology/ID/GI -General/thoracic surgery -ENT -Psychiatry -Dermatology -Neurosurgery -Ophthalmology -Radiology

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Christopher Hicks

@HumanFact0rz

6 years

Labeling someone a “drug seeker” serves nobody but the physician. It implies that you’ve you’ve caught someone trying to get over on you, and that you’re just too damn clever to let that happen. That’s not a patient-centred response. It serves only to fluff the MD’s ego 3/n

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Christopher Hicks

@HumanFact0rz

7 years

If you see a respiratory therapist walking around the emergency department, follow them: usually leads to interesting stuff.

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Christopher Hicks

@HumanFact0rz

4 years

Protected Code Blue strategy based on available personnel in PPE In PPE Action 0 No ALS/BLS 1 HiOx mask on patient, compression-only CPR 2 As above, work to obtain IV access 3. As above, add airway operator >= 4: Add leader

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Christopher Hicks

@HumanFact0rz

6 years

#TipsForNewDocs #TipsForAllDocs

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Christopher Hicks

@HumanFact0rz

4 years

Our updated protected airway checklist #COVID19 #COVIDFOAM

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Christopher Hicks

@HumanFact0rz

5 years

“I recognize this person had a life, and dreams, and a family, and I recognize the people in this room who tried to help, even though they knew none of that” —James Maskalyk @jamesmaskalyk #SMACC @smaccteam

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Christopher Hicks

@HumanFact0rz

6 years

I am of the opinion that all tuberosities, trochanters, condyles and epicondyles should all just be called tuberosities now. There are probably four orthopedic surgeons who would care, and I suspect with time they’d get over it.

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Christopher Hicks

@HumanFact0rz

7 years

Med students: this is bad advice.

𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊

@PulmCrit

7 years

med students- the next time someone tries to teach you the difference between an S3 vs S4 gallop, ask them if they've heard of Stexit

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Christopher Hicks

@HumanFact0rz

6 years

And. Here. We. Go. #resusTO

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Christopher Hicks

@HumanFact0rz

7 years

If a female professional is being asked to chose between career and family, it is the system that is broken, not Motherhood.

Brett Snodgrass

@BrettSnodgrass1

7 years

@DrJamieFryer @EmmyBetz @EMNews @meganranney @feminemtweets Someone has to take a reduced activity in their career when two doctors have a child. A woman neurologist told me that in 2005.

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Christopher Hicks

@HumanFact0rz

6 years

When asked to tick “emergency room physician” or “specialist” on a form, I choose the following. Every. Single. Time.

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Christopher Hicks

@HumanFact0rz

6 years

I hate the phrase “language barrier”. That someone speaks a different language than you is not a barrier. Further: 1. Family members are not reliable translators 2. Insist on an accurate history by way of a medical translation service 3. Google translate will do in a pinch

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Christopher Hicks

@HumanFact0rz

4 years

Protected Code Blue: Sim it to win it #COVIDFoam

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Christopher Hicks

@HumanFact0rz

6 years

Instead, consider identifying that the patient’s desire for opioids is problematic, and express your concern that they may have a serious issue with dependence that puts them at risk for overdose and death. Build a relationship, rather than serve an indictment 6/n

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Christopher Hicks

@HumanFact0rz

4 years

Interstingly enough, with this strategy I have way fewer arguments than I did 5 years ago, and get way more of what I want, and what I feel the patient needs. I used to blow up, now I’m cool like the Fonz.

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Christopher Hicks

@HumanFact0rz

7 years

Look ye mighty on my greatness, and despair #ResusTowers

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Christopher Hicks

@HumanFact0rz

6 years

Why do we treat opioid dependence any differently? If a patient is “seeking narcotics” from you, you have just identified a huge risk factor for morbidity and mortality that many clinicians go on to ignore, in favor of the “Gotcha!” approach 5/n

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Christopher Hicks

@HumanFact0rz

4 years

Never watch a complicated movie like Interstellar with your kids. Holy smokes we had to pause every five minutes so they could explain it to me.

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Christopher Hicks

@HumanFact0rz

6 years

End thread. Back to work 9/9

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Christopher Hicks

@HumanFact0rz

6 years

Offer help, counseling, addiction resources. Consider harm reduction strategies. Let them know you’re concerned. Don’t expect a high five every time you do so, but put in the work before you decide to write someone off for trying to scam some percs from you 7/n

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Christopher Hicks

@HumanFact0rz

2 years

Hicks and Petro watching as the central line kit is opened on the patient’s stomach for want of functional horizontal ED workspace.

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Christopher Hicks

@HumanFact0rz

4 years

@ManchesterEmer1 If by CT you mean small bore chest tube, it looks just fine.

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Christopher Hicks

@HumanFact0rz

9 years

Summary slide on resilience training, mental practice, and creating expert teams (+ wise words from Glen Gould)

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Christopher Hicks

@HumanFact0rz

2 years

It’s helpful because it’s accurate. An undignified experience for patients, an unsafe environment for staff — wherein error is only avoided by chance, not by design. The public has a right to know.

Dr. Brian Goldman

@NightShiftMD

2 years

I worked in the ER yesterday and will again today. It's busy. A severe shortage of nurses makes it harder to process patients. But patients are being seen and treated. Can someone explain to me how it's helpful to say the system is "on the verge of collapse"?

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Christopher Hicks

@HumanFact0rz

6 years

Failing to do so is like ignoring ripping chest pain radiating to the back as a possible dissection because you don’t like the person’s shirt. It’s an arbitrary judgement that serves the clinician, not the patient 8/n

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Christopher Hicks

@HumanFact0rz

6 years

I get that this is a promo for a major corporation, but if you don’t sob like an idiot when you watch it you probably need a pulse check.

Sports Illustrated

@SInow

6 years

Justin Gallegos, a runner at Oregon with cerebral palsy, thought he was just finishing another cross country race. Little did he know, Nike was waiting at the finish line to offer him a pro contract (via @kabdullah360 / Elevation 0m)

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Christopher Hicks

@HumanFact0rz

6 years

And to all the repugnant shitgibbons who’ve now chosen to troll me for this, I didn’t come here looking for a fight, and you’re not worth the skin off my knuckles in reply.

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Christopher Hicks

@HumanFact0rz

6 years

We don’t write “alleged stroke” or “alleged ACS”, so in cases of domestic abuse why do we write “alleged assault”? @KariSampsel delivering a powerful message at #CAEP18 .

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Christopher Hicks

@HumanFact0rz

3 years

It’s easy to devote time to work. To career, to advancement. If you want to know success, devote time to people. The ones you love, the ones who inspire you. It’s harder, but it means something much greater.

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Christopher Hicks

@HumanFact0rz

4 years

Augmented by the world’s first Trauma Black Box, in partnership with @TGrantcharovMD and @surgicalsafety

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Christopher Hicks

@HumanFact0rz

2 years

The most depressing thing about mandatory modules is that everyone involved, from developers to hospital admin to doctors, nurses and other staff enduring their uselessness, knows in their bones that the whole exercise is pointless. And yet we do it anyway. Madness.

Christopher Hicks

@HumanFact0rz

2 years

"Bureaucracy is the death of any achievement." -Einstein I guess someone made Albert do mandatory reappointment modules, too. CC: @FralickMike

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Christopher Hicks

@HumanFact0rz

6 years

Trying out a new power phrase for tough situations: 1. (aloud) “This is a challenge” 2. < Breath > 3. Have at it @ResusPadawan @EmICUcanada @precordialthump @Inject_Orange @cliffreid @emcrit @phenomenaldocs @ashleyliebig @EMSwami @DocTomEvens

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Christopher Hicks

@HumanFact0rz

6 years

When you tell them the lung POCUS findings and they still make you order a CXR.

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Christopher Hicks

@HumanFact0rz

7 years

Shift from "I wouldn't do that" to asking "Why did that make sense at the time?" @MartinBromiley #DasSMACC

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Christopher Hicks

@HumanFact0rz

3 years

CC: All hospitals, everywhere

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Christopher Hicks

@HumanFact0rz

4 years

I've been on shift most days this past week and can tell you that, to a person, there is a remarkable sense of togetherness, shared purpose, calm and steady preparation that is beautiful to behold. Reminds me that "We're in this together" isn't a phrase, it's an attitude.

Michael Lauria

@ResusPadawan

4 years

In our MICU now. To all our friends around the globe, hang in there. We are with you and I know you are with us...here is how/why it’s important. @emcrit @HumanFact0rz @EmICUcanada @SocraticEM @stemlyns @precordialthump @cliffreid @codachange @docpgb

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Christopher Hicks

@HumanFact0rz

4 years

There are few pathognomonic findings in medicine, with this clinical image of profound micropenis being a notable exception.

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Christopher Hicks

@HumanFact0rz

3 years

“The funny thing about design is that, when it works well, no one says anything” @petrosoniak

Design for Survival: How to Build a Better Trauma Bay | The Walrus

In the high-pressure world of emergency medicine, a Toronto hospital finds new ways to save lives

thewalrus.ca

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Christopher Hicks

@HumanFact0rz

5 years

Sub-species of traumatic cardiac arrest, as identifed by #POCUS : 1. Cardiac standstill, no effusion --> STOP

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Christopher Hicks

@HumanFact0rz

4 years

Canada here. Out of curiosity and concern, why isn’t @SenWarren already President of the United States of America?

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Christopher Hicks

@HumanFact0rz

3 years

Begs the question: Why doesn't the government listen to nurses when they advocate on their own behalf? Hundreds of ER doctors implore Ontario to boost nurses' pay amid 'dangerous' staffing shortage

Hundreds of ER doctors implore Ontario to boost nurses' pay amid 'dangerous' staffing shortage |...

More than 350 emergency physicians across Ontario have signed an open letter demanding the province give more substantial pay increases to critical-care nurses, who've worked on the front-lines of...

www.cbc.ca

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Christopher Hicks

@HumanFact0rz

4 years

To my boys: Being your Dad is the best, the brightest, the most important, the most humbling, the most irreplaceable thing I’ll ever do with my life. It’s an honour to know you. You are the fire. I love you 3000.

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@HumanFact0rz

3 years

The most common and problematic posture of the resuscitation team leader: Arms crossed, shoulders down. Sim educators: How often do you address non-verbal language in your debriefings? CC: @j_stokesparish

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Christopher Hicks

@HumanFact0rz

6 years

Petro: Flipping trauma resuscitation on its head -- Focus on physiologic priorities, not route algorithms #EMClinics #FOAMed

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@HumanFact0rz

3 years

In an organized resuscitation the primary survey is preceded by a series of steps to optimize self, team and environmental preparation: the Zero Point Survey #EMU2021

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Christopher Hicks

@HumanFact0rz

1 year

“Gone are the non-evidence-based peculiarisms of advanced trauma life support (ATLS): the savage fluid boluses, the primacy of the trauma surgeon, the mechanistic thoughtlessness of an algorithmic approach to everything.” Coming soon:

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Christopher Hicks

@HumanFact0rz

8 months

We order too many CT scans. There, I said it.

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Christopher Hicks

@HumanFact0rz

5 years

Dr. Duic found ways to monetize EM in a way that most of us would find disgraceful, if not criminal. Simple formula, really: Conscript a group of loyal followers, then make them too wealthy to ever say no to you.

The Globe and Mail

@globeandmail

5 years

Scrubbed: Ontario emergency room chief faces questions about failing to hire any female doctors in 16 years

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Christopher Hicks

@HumanFact0rz

2 years

Motion to make public ally available a daily Ontario-wide report of: 1) Emergency department patients admitted to hospital awaiting a room 2) ED length of stay and acuity for those patients 3) ED occupancy as a percent of total beds @davidcarr333 @petrosoniak @alandrummond2

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