OK - so a bit of the background to this. Jonny Wilkinson and I sat down to discuss the state of #FOAMed and our workshop on Social Media at #IFAD2017 - we were then joined, sequentially, by LOADS of different people, purely by accident.

This evolved into a brilliant Podcast between the team, talking about the issues that matter most to each of us. Off-the-cuff and candid.

As you will have seen one of my other blog posts - we also focused on creating a graphic social media campaign utilising programmes which added quotes on top of HD pictures to encourage conversation of the quotes and snippets of the conference. Some quotes have been said to be over simplistic in their message, which is often the charge levelled at twitter when it comes to FOAMed. Nevertheless, I would proffer that the same messages were given at the conference and are not that far removed from their original aims - to provoke discussion, and to some degree, controversy. It is often the case on twitter that we skip past 'boring' or 'seasoned' messages and only engage with the controversial material. Whilst, as someone who focuses on basic science material, this erks me to no end (as often age-old concepts such as adrenoreceptors, kidney function etc get overlooked)- it did provide us with targets to go after to engage the online audience. Perhaps in response to those who would say, "over simplistic messages are dangerous" - I would say looking at ANYTHING in medicine  in isolation or out of context is dangerous. This is something everyone must learn. And the 'real-time peer review' of the quotes has been excellent, particularly the heated arguments.

One of the most interesting infographs focuses on the fact that sepsis is primarily a vasoplegic disease and not a hypovolaemic state. This was stated by Prof. Paul Marik, whose work on sepsis has spanned many years and is known for his controversial and illuminating theories on vitamin C, steroids and fluid restrictive strategies.  Now, it was also discussed at IFAD2017 that, yes, your patients may ALSO be hypovolaemic via poor intake, fever etc but this is a secondary process and as intrinsic to sepsis as dehydration is to any disease that disrupts homeostasis - this includes prolonged fasting in surgery for a broken wrist, or a quincy that prevents swallowing. All in all, it is very likely that your patient will need fluids in sepsis - but the point of the discussion-challenge was to switch the view of sepsis from one that makes you think, reflexively, that the patient is profoundly hypovolaemic by nature rather than assessing the patients for signs of dehydration. My example would be to look at ICU patients day three post-op, who develops sepsis, who has had their fluids managed on the unit. Hopefully, by virtue of being in an ICU, they will NOT be deplete of their daily water intake enough to require what in some areas is an immediate dose of 30ml/kg fluid. It is certainly an interesting shift in thought process and one that requires a lot more discussion online with people more clever than I.

PRESENTATIONS
The presentations at the conference pertained to interesting topics in fluid management - more so than I expected! This actually threw up so many issues with our Social Media team about delivery and presentation skills. We discussed, at length, 'Why People Go To Conferences' and there will be more about that coming out soon. Presentations themselves at conferences are done extremely poorly - a mix of speakers reading their slides off to an audience, clip art, spinning text and slides with over 1000 words on them do NOTHING to help knowledge retention. Love or hate the SMACC conference, I remember their talks years later because they delivered a talk rather than a word-soup. I could not even read half the slides of some of the talks which focused on putting as much of their data as humanly possible on indecipherable graphs, pie-charts and tables. Arguably (well, not arguably) your presentation should be devoid of your data - which should be provided to the conference attendees well before the event or AT the event, in the form of a print-out or digital publication so that you can focus on the delivery of your THOUGHTS. Consultant Paediatric Surgeon, Mr Ross Fisher was at the conference giving a workshop on 'How to Talk Like TED' - delivering some of the worst talks known to medicine (on purpose) to illustrate the problems with bombaring the audience with useless information that detracts from your key message. As he quite rightly asserts - "It is your message that matters, not your slide". Spend the time working on your delivery rather than your slides. Ross was a delight to have on Social Media Faculty - and I hope our collaborations do not end here.