Stephen Hearns @StephenHearns1 Twitter profile

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Stephen Hearns

5 years

3 years,the odd late night,multiple revisions & a few tantrums later,its finally here Peak Performance Under Pressure is now available on #Amazon Own the Pressure & The Arc of Performance Thank you to everyone for their support in getting me here

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Stephen Hearns

@StephenHearns1

4 years

Med student son just asked me what the embryological origin of the round ligament was. Very pleased to tell him I had absolutely no idea. Why do lecturers still teach this stuff?

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Stephen Hearns

@StephenHearns1

4 years

When writing a #COVID19 guideline or checklist don’t write it for yourself. Design it for the least experienced member of your team who is fatigued & frazzled at 2am with a critically ill patient in front of them.

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Stephen Hearns

@StephenHearns1

4 years

Medical student son just home from his first 12 hour shift as a health care assistant. Exhausted. Feet sore. His eyes opened to how hard nurses work.

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Stephen Hearns

@StephenHearns1

2 years

My son’s first day on the ward as a medical student. He had been looking forward to it so much… Reflecting on how much time I give to medical students.

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Stephen Hearns

@StephenHearns1

5 years

“How would a patient with a tension pneumothorax appear?” First answer by 9 out of 10 med students & junior doctors: “They would have a deviated trachea” Can we please stop perpetuating this misconception?

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Stephen Hearns

@StephenHearns1

3 years

#rainbowwarrior heading up the Clyde to #cop26Glasgow A tight squeeze under the Erskine Bridge

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Stephen Hearns

@StephenHearns1

6 years

My first patient of the day in the ED has brought a flask of tea and a packed lunch with them. Sums it up really.

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Stephen Hearns

@StephenHearns1

9 months

Dealt with a medical emergency on an @easyJet flight today All well til I was handed an old style manual sphyg. Haven’t used one for >30 yrs Winged it til the airport fire crew turned up with an electronic one Put the stethoscope round my neck to create an air of competence

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Stephen Hearns

@StephenHearns1

3 years

Anyone concerned about their country welcoming refugees from the crisis in Afghanistan should read this. One of our highly skilled air ambulance pilots in Scotland

Once, I only survived thanks to the kindness of others... so now it’s my turn: Refugee turned 999...

Far below, faces turned to the sky in hope as the United Nations helicopter filled the sky with a deafening noise, renewing faith.

www.sundaypost.com

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Stephen Hearns

@StephenHearns1

6 years

New era starts tomorrow for @EMRSscotland Our team willl be available 2 respond to major trauma by helicopter & fast response vehicle until 11pm every night.A landmark development for life saving pre-hospital critical care in Scotland funded by @ScotTraumaNwk

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Stephen Hearns

@StephenHearns1

3 years

Roof of Glasgow’s Major Trauma Centre ⁦ @EMRSscotland ⁩ ⁦ @scotambhelimed5 ⁩

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Stephen Hearns

@StephenHearns1

6 years

Neymar Syndrome.A syndrome of fictitious injury associated with a delusional optimism for secondary gain.Risk factors include low moral fibre & seriously questionable hair cuts.Temporary relief with aerosol delivered placebo. Scottish variant: “ya big jessie”

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Stephen Hearns

@StephenHearns1

6 years

Dr,paramedic,nurse,student interested in prehospital care and helicopter retrieval medicine? The Helicopter Medical Careers Conference will provide the inspiration & information to plan your career University of Glasgow March 23 Event registration opens 8am Monday 12th Nov

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Stephen Hearns

@StephenHearns1

2 years

In a prehospital team the small, tedious jobs make the big jobs safe & efficient. Kit checks, daily drills, writing cognitive aids, follow ups, database entry… The best PH clinicians understand this & don’t just wait for the big stuff without mucking in with the wee stuff

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Stephen Hearns

@StephenHearns1

1 year

Proud dad. My son Thomas with his research poster at #retrieval2023

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Stephen Hearns

@StephenHearns1

3 years

Barra airport. Beach runway. Love the baggage reclaim hall.

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Stephen Hearns

@StephenHearns1

5 years

A wee update on the book Title finalised - Peak Performance Under Pressure Feedback in from 3 reviewers - psychologist, HEMS doc & pilot Copy editor edits being reviewed just now Artwork & cover design in progress Planning for publication late Aug Thanks for your support

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Stephen Hearns

@StephenHearns1

4 years

So generous of ⁦ @NandosUK ⁩ Huge delivery of fantastic scran to ⁦ @Clyde_em ⁩ emergency department. Thank you.

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Stephen Hearns

@StephenHearns1

2 years

Common to see “vasovagal” in prehospital report forms used for patients with undifferentiated Transient Loss of Consciousness Not all TLoCs are vasovagal. There are many other causes. Vasaovagal labellinbg leads to anchoring & confirmation bias during subsequent ED assessment.

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Stephen Hearns

@StephenHearns1

2 years

I always wonder if our ED receptionists secretly pass a card to our patients saying: “Once the consultant comes in to speak to you give a set of symptoms 180 degrees different to the ones you told the ST/ FY2/ ENP. The trainee doctors love it when patients do this”

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Stephen Hearns

@StephenHearns1

3 years

The Mamores in ridge to ridge sunshine. Scotland at its very best.

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Stephen Hearns

@StephenHearns1

3 years

Just bought one of these wee Peli lights. I realise it’s a slippery slope to a utility belt with a 5 cell maglite, celox in a pouch and my stethoscope on a bungee cord.

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Stephen Hearns

@StephenHearns1

4 years

Found this during my lockdown attic clearance. Bit cheeky applying for a London HEMS job while still an SHO back in 1998. Nothing ventured!

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Stephen Hearns

@StephenHearns1

3 years

Urgency momentum Flying or response driving to an incident at maximum safe speed creates a sense of urgency & time pressure after we arrive on scene Results in assessments, decisions & communications being made with an urgency which is often not unnecessary & can lead to error

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Stephen Hearns

@StephenHearns1

3 years

Responding to emergency situations we require cognitive aids to help us take the right action at the right time Many SOPs, guidelines & checklists are however poorly designed for use by teams under pressure 10 tips to improve readbility of of documents in high performance teams

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Stephen Hearns

@StephenHearns1

4 years

Relaxing transmission prevention measures over Christmas is a mistake Can someone explain why this won’t create a huge surge in transmission? As an EM doc,people will take full advantage of a temporary relaxation-leaving my ED,ambulance & police colleagues to pick up the pieces

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Stephen Hearns

@StephenHearns1

4 years

My ED seeing c.60% of our “normal” no. of pts. Dept feels safe. Trainees getting breaks, leaving on time & receiving teaching & support. Sick pts receiving the care they need,with minimal waits We’re a state of flow, with the right level of pressure.This is our optimal capacity.

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Stephen Hearns

@StephenHearns1

3 years

Preparing a talk for a group of lawyers about pressures in the emergency department and why these can contribute to diagnostic errors Would be grateful for people’s thoughts on what pressures lead to error in emergency medicine.

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Stephen Hearns

@StephenHearns1

3 years

Common cognitive biases associated with diagnostic error - an infographic

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Stephen Hearns

@StephenHearns1

3 years

Carried out an extensive aerial search of the west of Scotland this afternoon. Plenty of snow but no sign of sleighs or reindeers yet.

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Stephen Hearns

@StephenHearns1

6 years

Involved in a number of legal cases at the moment where the clinicians’ assessment of capacity is under scrutiny. Increasingly important that we assess & record capacity & consent @RCollEM guidance on capacity is an excellent document.

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Stephen Hearns

@StephenHearns1

4 years

Just found son number 2 watching the video about Mrs Elaine Bromley’s case as part of his 2nd year medicine course. Excellent to see this as part of the undergraduate course at Glasgow University. @MartinBromiley

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Stephen Hearns

@StephenHearns1

4 years

I always try to gauge the state of the ED when I walk up from the car park in the morning. A ratio of police vehicles to ambulances >1 is rarely a good sign for how the opening hour is going to play out.

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Stephen Hearns

@StephenHearns1

4 years

Challenging technical rescue today for Arrochar Mountain Rescue Team & ⁦ @MCA_media ⁩ Prestwick SAR helicopter crew.

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Stephen Hearns

@StephenHearns1

3 years

Reflecting on the effects of fatigue on my communication, cognitive & technical skill abilities after a late night in an overcrowded ED The contrast between aviation & healthcare in mitigating fatigue induced compromised performance is staggering Why do we still ignore this?

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Stephen Hearns

@StephenHearns1

3 years

When I was a medical student a sensation of "impending doom” was a symptom be wary of in patients. Now, when I’m approaching a weekend of ED backshifts it has a whole new meaning.

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Stephen Hearns

@StephenHearns1

3 years

“Sir, I have to let you know that we only deal with emergencies in the emergency department” “Well, if someone had made me aware of that I wouldn’t have wasted my time coming”

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Stephen Hearns

@StephenHearns1

2 years

Prescribed myself a wee #Omicron mental immunity booster this morning Scottish bothy fire with the rain pouring down outside and tea on the boil

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Stephen Hearns

@StephenHearns1

3 years

Doctor, paramedic, nurse or student interested in a career in pre-hospital & retrieval medicine? The Helicopter Medical Careers Webinar is now free to watch. Inspiration & information for your future helicopter medical career #HelimedCareers

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Stephen Hearns

@StephenHearns1

7 years

Congratulations to @drrichardlyon on his well deserved MBE. He’s come a long way…

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Stephen Hearns

@StephenHearns1

4 years

Erskine Bridge sunset this evening

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Stephen Hearns

@StephenHearns1

2 years

Respect for all healthcare colleagues in acute hospital & ambulance services having to cover Hogmanay night shift tonight at short notice due to colleagues testing positive. 👊

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Stephen Hearns

@StephenHearns1

2 years

Med student son number 2 is 21 today. He’ll appreciate me posting this one from the archives.

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Stephen Hearns

@StephenHearns1

3 years

3 vets on the Performance Course.Things I’ve learned so far: Horses need 30mm ET tubes Donkeys are difficult to intubate Donkeys bring a companion donkey with them to hospital to keep them calm before operations Horses remain standing during procedural sedation @PJPollockVet

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Stephen Hearns

@StephenHearns1

2 years

Phoned a rural general hospital to give them an update on a patient retrieved the previous night. I asked for Dr X. The switchboard replied “I don’t know who that is. We only know the doctors by their first names” Would be nice to work in a small hospital like that.

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Stephen Hearns

@StephenHearns1

1 year

Trying to choose a new head torch for mountain rescue. Petzl alone have 12 types All I need is a 5 star review which says “Particularly effective when it’s dark” Who pays £630 for a torch?

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Stephen Hearns

@StephenHearns1

5 years

Doctor, paramedic, EMT, nurse or student interested in aeromedical prehospital trauma care & retrieval medicine? Following our sell out 2019 Conference, Helicopter Medical Careers is back. Glasgow University March 28th 2020 #HelimedCareers

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Stephen Hearns

@StephenHearns1

3 years

CALMDOON! A wee infographic with suggestions for regaining personal composure & situational control. From frazzle to high performance flow - Scottish style

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Stephen Hearns

@StephenHearns1

4 years

Every Scottish cyclist should be so equipped

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Stephen Hearns

@StephenHearns1

2 years

Powerful opening to the BJA special edition on rethinking our approach to major incidents. Couldn’t agree more.

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Stephen Hearns

@StephenHearns1

3 years

I’m 51. I’m trusted to be in charge of an emergency department full of patients. I’ve written a book on cognitive performance. At home however I am still not deemed competent to put on a wash involving white clothes without supervision.

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Stephen Hearns

@StephenHearns1

5 years

Reflecting on the dedication of volunteer mountain rescuers This wk 20 professional people used 5 days of annual leave to improve the care they can give to injured patients. They also subjected themselves to an exam which would challenge many health care professionals. Chapeau

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Stephen Hearns

@StephenHearns1

3 years

In ER it was always “CBC and lytes. Stat”. Can’t recall Dr Green ever saying “Stop rolling about the floor and behaving like that or you’re gonnae get the jail” I was recruited under false pretences.

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Stephen Hearns

@StephenHearns1

4 years

In catastrophic limb bleeding correctly applied tourniquets can be life saving.This is however uncommon in civilian practice Twice this week alone I’ve seen pts with minor bleeding with poorly applied T’s.More harm than good 1st aid instructors please teach T use with caution

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Stephen Hearns

@StephenHearns1

3 years

Running a session on communication under pressure yesterday. Paramedic said he was recently working with a student. In a house with a man with chest pain. He mentioned that the man was “a regular caller” The student immediately left, returning with a Stiffneck Select

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Stephen Hearns

@StephenHearns1

2 years

Me to 20 yr old law student son: “Can you empty the tumble dryer” Son: “The clothes are still wet dad” Me: “That’s the washing machine you’ve opened”

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Stephen Hearns

@StephenHearns1

6 months

The base sauna at the Turku HEMS base in Finland today. What every helicopter service in the UK is missing out on. Ideal for a civilised debrief.

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Stephen Hearns

@StephenHearns1

5 years

Pleased to be at the stage of checking final proofs for “Peak Performance Under Pressure” This is how the chapter titles are going to look in the book. All set for publication next month ⁦ @classprofession ⁩

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Stephen Hearns

@StephenHearns1

3 years

Skye sunrise Worth getting out of the sleeping bag at 4am.

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Stephen Hearns

@StephenHearns1

3 years

The new on call beds for ⁦ @EMRSscotland ⁩ have arrived.

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Stephen Hearns

@StephenHearns1

3 years

“No, I’m sitting in my office. I just can’t seem to get my camera to work on Teams”

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Stephen Hearns

@StephenHearns1

5 years

In self imposed solitary confinement in a remote Scottish Highland cottage for what is hopefully the final editing session of the book. The irony of writing about cognitive overload and fatigue isn’t lost on me. Planning for publication in July 🤞 Performance Under Pressure

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Stephen Hearns

@StephenHearns1

3 years

A whole cohort of medical students currently based in the ED who will be thinking that the first line investigation for headache is a D-dimer

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Stephen Hearns

@StephenHearns1

2 years

Administering an IV drug to a patient yesterday. Paramedic kindly grasped what she thought was the blue tourniquet to remove it. She was actually trying to pull off the redundant floppy finger of my gloves. #Ninefingers

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Stephen Hearns

@StephenHearns1

3 years

Walking into the emergency department this morning when I saw this new commemorative bench. Quite moved by the sentiment.

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Stephen Hearns

@StephenHearns1

3 years

That feeling of empathy when at 1am you get round to seeing the pts who have patiently waited for five hours following telephone triage to the ED & who are discharged after a 2 minute examination without the need for XR, bloods or need for a specialist emergency physician opinion

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Stephen Hearns

@StephenHearns1

4 years

Opening a new apple device is still a special experience. Just as Steve Jobs intended.

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Stephen Hearns

@StephenHearns1

4 years

Set out to climb Beinn Narnain today with Mrs H. @Kerrymilligan1 Nearly at the top when alerted to Arrochar MRT call. Fallen rock climber on Sugach Buttress about 30mins from our location Excellent teamwork as always with @DaveWCurrie & the crew of Prestwick SAR helo @MCA_media

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Stephen Hearns

@StephenHearns1

3 years

Joe’s heading out for his tea at Kelvingrove #POTUS #Cop26Glasgow

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Stephen Hearns

@StephenHearns1

2 years

Arrochar Alps today. Sublime.

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Stephen Hearns

@StephenHearns1

3 years

48 hour rescue involving 250 volunteers. What an incredible feat.

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Stephen Hearns

@StephenHearns1

4 years

Thanks to everyone for their kind comments about Peak Performance Having purchased the publishing rights,we’ve been able to relaunch at the much more accessible price of £14.99 Each copy also comes with a 50% off code for the online performance course

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Stephen Hearns

@StephenHearns1

4 years

First day outside after 14 days of Covid isolation. Took things easy with a few wee walks at Loch Lomond. So good to be out and about again.

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Stephen Hearns

@StephenHearns1

2 years

In ⁦ @EMRSscotland ⁩ we’re always grateful to rural hospitals for tea and cakes. A clear front runner today. First question we were asked “Tea or coffee?” 😊👍

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Stephen Hearns

@StephenHearns1

1 year

Training for high pressure. Is there too much emphasis on simulation?? Should we drill task execution more? Frees up cognitive capacity & makes use of our procedural memory All of the Core Cognition performance infographics available open source at

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Stephen Hearns

@StephenHearns1

3 years

A wee 2 minute video on Rally Points. Rally points are essential for effective teamwork in high pressure situations. - Achieving a shared and an accurate mental model - Prioritsing actions - Delegating to cognitively offload #PerformanceUnderPressure

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Stephen Hearns

@StephenHearns1

4 years

Really nice gesture by @CostaCoffee Dumbarton drive thru today. Coming back from @EMRSscotland prehospital tasking. Server very generously gave us our coffees for free. Very much appreciated.

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Stephen Hearns

@StephenHearns1

2 years

Ready to start the day.

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Stephen Hearns

@StephenHearns1

3 years

8 tools to improve team communication in high pressure, high stakes situations.

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Stephen Hearns

@StephenHearns1

5 years

Good luck to the new @EMRSscotland North Team starting today in Aberdeen under the leadership of @Alastair__Ross Scotland now has 3 aeromedical retrieval teams & 2 hospital based prehospital critical care teams on duty 24hrs a day - all consultant delivered. @ScotTraumaNwk

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Stephen Hearns

@StephenHearns1

3 years

Mental rehearsal - an essential tool for personal pressure preparation. Also useful for refection following high pressure situations.

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Stephen Hearns

@StephenHearns1

3 years

CPR should be a core skill taught to all school children. However, basic present wrapping skills should be a close second. I am totally useless.

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Stephen Hearns

@StephenHearns1

2 years

Noses certainly run in our family. Kicking off the festivities with my 3 sons last night. 😊

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Stephen Hearns

@StephenHearns1

4 years

I still instinctively pour peanuts from a bag into my left hand. You would think I would have learned by now. Gap analysis.

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Stephen Hearns

@StephenHearns1

2 years

⁦ @deaconbluemusic ⁩ in Glasgow. Superb And I'll sail her up the west coast Through villages and towns I'll be on my holidays They'll be doing their rounds They'll ask me how I got her I'll say, "I saved my money" They'll say, "Isn't she pretty? That ship called Dignity"

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Stephen Hearns

@StephenHearns1

1 year

Last night. 1000m up a mountain. Km’s from the nearest road. 53 years old. I still wake up at 3am convinced I can hear someone outside coming to get me.

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Stephen Hearns

@StephenHearns1

4 years

The new Performance Under Pressure Online course is now open to students Providing high pressure professionals with the skills to achieve peak performance Have a wee look at the intro video & course details here:

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Stephen Hearns

@StephenHearns1

4 years

All set and very excited. Glasgow University’s first ever teaching session on performance, pressure, communication & cognitive biases. 90 minutes for the final years starting shortly.

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Stephen Hearns

@StephenHearns1

2 years

If you’re interested in a career in prehospital care access to the 2021 Helicopter Medical Careers Conference is free 5 speakers from medical,paramedic & nursing backgrounds discussing their careers in HEMS, retrieval, search & rescue & military medicine

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Stephen Hearns

@StephenHearns1

3 years

The time of year for a wee addition to my prehospital PPE. The midge can cause carnage at prehospital scenes during the Scottish summer.

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Stephen Hearns

@StephenHearns1

4 years

Paramedic, doctor or nurse interested in working on a HEMS helicopter providing pre-hospital care? @scotambhelimed5 paramedic Cheryl Logan will be discussing her role in aeromedical transfer & pre-hospital care @ the Helicopter Medical Careers Conference

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Stephen Hearns

@StephenHearns1

3 years

Staying tonight at the northern end of Skye with number 3 son The Lookout Bothy. An old Coastguard lookout station. Scottish bothy locations don’t come much better than this. 😊

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Stephen Hearns

@StephenHearns1

4 years

I’m wasting alcohol gel from dispensers in the ED as it keeps squirting through the gap on to the floor.

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Stephen Hearns

@StephenHearns1

5 years

Gave a talk on decision making & cognitive biases to NHS GGC optometrists today. Managed to get in my one and only ophthalmology gag. “Last week I found out I was colour blind. I was shocked. The news came right out of the purple”

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Stephen Hearns

@StephenHearns1

3 years

A wee reminder that access to the recording of the 2021 Helicopter Medical Careers Conference is available for free If you’re a paramedic, nurse, doc or student interested in developing your pre-hospital career HMC is for you

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Stephen Hearns

@StephenHearns1

4 years

Presented to a large group of mostly med students & junior docs last night Decision making,cognitive biases, fatigue,mental rehearsal,positive self talk, cognitive aids, drilling,debriefing,comms under pressure New to most. Why are are these not part of every UG med curriculum?

Kieran Thompson

@thompsonkieran

4 years

Just finished attending a great webinar by @StephenHearns1 - loads of insightful stuff and 300 people was a pretty good turnout I think. Nice work Dr Hearns, thank you!

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Stephen Hearns

@StephenHearns1

3 years

Not the best landing conditions for world leaders arriving at Glasgow Airport tonight.

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Stephen Hearns

@StephenHearns1

3 years

So grateful for expert assistance of @Scot_STAR paediatric retrieval team last night at @clyde_em Interesting experience to be on the “other side” of a critical care retrieval as a service user. Very pleased & relieved when they arrived.

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