SMACCed Over.

I’m a little slow out of the gates this year, with pretty much everyone else having their SMACCGold dissections up within minutes of the conference ending.  I thought I would take a considered approach and turn out an epic review, filled with cutting wit and profound insights.  I then realised that this would require a significant effort on my part, so here is my usual page of celebrity stalker photos instead…

But first, SMACCGold.

Having had my anxieties about being out of my depth or not fitting in allayed by the inaugural SMACC conference in Sydney last year, I was both more relaxed and more excited about this year’s offering on the Gold Coast.

I started with the airway workshop the day before the conference proper.  This was all about practical management of all types of airways with legends of the airway game such as Scott Weingart of EMCRIT, Rich Levitan of Airwaycam, Minh Le Cong of PHARM and Nick Chrimes of Vortex, ClinicalCrEd and Simpact fame giving demonstrations and one on one instruction in various aspects of airway management.


Toby going in through the cribiform plate, searching for signs of a brain.


Some concern about just what Scott is going to do with that scalpel


More intimate than I’ve been with anyone before… What happens on SMACC stays on SMACC


Rich Levitan, airway guru and disciple of the nose.

This was a great opportunity to practice techniques and tricks that we had seen or heard about through social media, but never had the opportunity to try out.

And then, on to the main show!  Much has already been written about the magnificent opening show for SMACCGold.  It was indeed thoroughly impressive.  I do hope though, that the organizers don’t feel the need to go “bigger and better” each year.  The focus needs to be (and I’m sure it will be) the content rather than the packaging.

However there was no fear that this conference was all style and no substance.  As with last year the biggest issue was trying to work out which of the concurrent sessions I would see live and which I would catch up on later.

Highlights for me were seeing Karim Brohi speak on trauma resuscitation.  Karim is a leading figure in trauma care and research and also runs a Master of Trauma Science course out of Barts in London that I would one day love to complete. (I was also gutted I didn’t get to meet Karim and grab a photo as he had to jump on a plane immediately following his last session)

Scott Weingart as always was a dynamic and inspiring speaker on critical care topics like emergency cricothyrotomy and cutting edge resuscitation management.

Cliff Reid ( once again brought a fair percentage of the audience to tears with his talk “When to Stop Resuscitation.”  Cliff has a gift for incorporating moving personal stories into his talks that add an enormous impact and make any presentation unforgettable.

Anthony Holley is a very entertaining speaker making his presentation on artificial blood substitutes far more entertaining than such a topic has any right to be.

Rich Levitan gave a number of talks on various airway management issues, including dealing with “alien airways” in children and neonates.  As someone who has to manage these sorts of patients on an infrequent basis I got an enormous amount out of these sessions.

Finally, the absolute pinnacle of the conference for me was the session chaired by Victoria Brazil entitled “What is Possible, What is Reasonable, What is Best?” which was all about end-of-life and palliative care.  This was a magnificent panel discussion on some of the very thorny issues surrounding a very complex and emotive subject.  I think dealing with end-of-life care is something that paramedics need more support with as we are often the first point of contact in these situations.  I intend to do some more blogging on this at some stage.

So what about non-clinical stuff?  I was very impressed to see an excellent turn out of paramedics this year.  We had good numbers from much of Australia and a few cuzzies from over the ditch as well, including Steve and Graeme (Rotovegas Paramedic) from Rotorua.  (Another disappointment was that I didn’t get to catch Craig Ellis who is one of the St John NZ medical advisers)


The Kiwi contingent of ambos: Steve, Graeme and some big mong. Kia ora bros!

I was invited out to have a drink with a big bunch of ambos which was a nice surprise.  It was a little weird that so many of them knew who I was thanks to the blog and twitter.  I guess it’s a good sign that people are actually visiting the site!

This time round I felt not like I was encroaching somewhere I didn’t belong, but rather like I was getting to catch up with a heap of mates I haven’t seen for a long time.  The strange thing is, many of these people I had never met at all, but had got to know via social media.

I also got to do a bit of creepy celebrity stalking…20140320_205354

I bailed Rich Levitan up at the gala dinner (which was very nice incidentally) and he very graciously spent a great deal of time talking EMS, airway and education with me.  Rich is a thoroughly nice guy and passionate about what he does.  His airway lab is top of my list of things to do.  Rich, if you do get down to Melbourne, drop me a line, I’ll be happy to show you around Melbourne and our version of EMS (and the best coffee shops)


Steve Smith

Steve Smith of Dr Smith’s ECG blog gave a fantastic talk on ECG subtleties.  I have learned more from Dr Smith about ECG interpretation than I ever have from text books.  Steve was also very complimentary to his paramedic colleagues such as Thom Bouthillet of EMS12Lead (among others) who share his passion for electrocardiography.


Most humbling of all, Andy Neil of actually tracked me down!  Andy is a ridiculously smart bloke who is currently training in EM, having formerly lectured in anatomy as well as knocking off a cheeky wee Masters in Theology as well.

A somewhat half-hearted crack at SMACC Gold-Rush also didn’t pay any monetary dividends, but I got to make a bunch of new friends: Jesse Spurr (of InjectableOrange) Penny Wilson (NomadicGP), Rocio Santamaria and Mark Wilson (

Overwhelming the people who go to SMACC, whether it is as a presenter or delegate, are extremely approachable.  From collaring Minh Le Cong and Rob Rogers (Theteachingcourse) in the hallway to chat, to standing in line at the coffee shop talking to some random person who happens to be wearing a lanyard as well, it doesn’t matter whether you are a Professor or a Patient Care Attendant, all that matters is the passion for what we do.  The sense of inclusion was even greater this year than last.

One last high for me was actually climbing on stage!  Ok, I was just a prop for Andy Buck (, amongst many others), Nick Chrimes, Tim Gray and Peter Fritz (co-creator of The Vortex)to help them demonstrate both the Vortex and the ETMCourse, but nonetheless it was fun for me!  It was also great to hang out with these guys who are all dedicated to excellence in clinical care and education.


So were there any downsides to SMACCGold?  There was for me perhaps a little less wow than last year.  I think that this is probably due to just how novel SMACC was when it debuted.  This year I had a better idea of what to expect of the format.  This is not a criticism of the organizers at all as the format is superb and works well.  It is still a cut above anything else out there.

Some of the sessions didn’t grab me as much as I hoped as some of the speakers were not as dynamic as others.  Of course it is a tough ask to appear on a billing with Scott Weingart, Cliff Reid and Victoria Brazil, so perhaps this is a touch unfair.

One of the paradoxes of this conference is that with the focus on FOAMed, much of the content is available, or has been thrashed out in social media long before the conference starts.  However in spite of this, the benefit of seeing the people involved in advancing medical education and critical care cannot be overstated.  And no social media interaction can compare with actually sitting down and sharing a coffee or a beer with some of the luminaries in these fields.

I forget which session it was, or who said it, but the one thing I took away from SMACC this year, is that we can all do better.  However good we are or think we are, we can do better.  Incremental benefits add up and make a big difference in the long run, and benefit can be found by not just by doing cutting edge stuff, but by doing the basics well.  As Karim Brohi said: first, you must sweep the floor.


Next year SMACC heads to the U S of A, landing in Chicago in May.  I hope this will provide the opportunity to meet more of my American crit care and education heroes.  Leave has been booked, saving for flights has commenced and plans for the rest of the trip are being made.  I hope to see you all there!

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12 Responses to SMACCed Over.

  1. Rotovegas Paramedic says:

    Nice one Robbie. Good to catch up with you at the gala dinner and evident from my goofy look that I had way to much of that lovely complimentary red and white wine!!

  2. Pingback: Social Media And Critical Care (SMACC) - R.E.B.E.L. EM

  3. rfdsdoc says:

    what do you mean it shouldnt be bigger and better in Chicago?! This is America!

  4. says:

    Nice one Robbie, and good to see more paramedics there – after all, we are one tribe, united in love of patient care and battling critical illness…

  5. Justin Cleland says:

    Good to meet you as well Rob. I left smacc with the same feeling of one tribe as well, I felt paramedics were very welcome. Also Smacc was great for letting you know that behind world renowned blogs and podcast there are some incredibly humble and generous humans…. @Justin_Cleland

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  7. Tingles says:

    Thanks Robbie – now I feel even worse about not attending!!! Oh well, theres always the windy city net year…

  8. Pingback: PHARM Podcast 95 – Richard Levitan on SMACCGOLD and a call to airway excellence | PHARM

  9. Christopher says:

    Looking forward to meeting up with our brothers (and sisters) from another mother(land)! Team EMS 12-Lead will be in Chicago with bells on.

  10. Pingback: It's gonna be smaccTASTIC! #smaccUS - KI Doc

  11. Pingback: SMACC Chicago Programme now available! - Emergency Medicine Ireland

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