Alex Psirides

Bio

Alex is an Intensive Care specialist working in Wellington, having trained in London, Melbourne and New Zealand. He has been involved in the design and implementation of Rapid Response Systems in several different hospitals. Because of this, he is clinical lead for the New Zealand Health Quality & Safety Commission’s national ‘Deteriorating Patient’ programme. In his spare time, when not walking his dog or his children, he builds websites & designs logos for Wellington ICU’s prodigious research department. He has nearly written a lot more research papers & as such needs to spend less time on Twitter. He also once ventilated a chimpanzee but it didn’t end well (for the chimp).


DNR Should Be The Default: PRO debate

Life is a sexually transmitted disease with 100% mortality; CPR does not change this.
The application of ‘CPR-for-all’ is the ultimate evidence drift. A treatment that is completely appropriate for dropping dead whilst running a marathon has almost no place in acute healthcare facilities where chronic irreversible complex co-morbidities abound. 90% of doctors would not choose CPR for themselves, yet 100% are trained in how to administer it to patients. Defaulting to ‘CPR-for-all’ removes a patients’ ability to provide informed consent for assault whilst they die from another disease. Remember – 2 weeks in ICU can spare you 5 minutes of difficult conversation.

Why Your Hospital Is Broken

Your hospital is probably broken. Here's why. And how we may be able to fix it.

As patients becomes more complex, the tribal systems we use to look after them remain stuck in the 18th Century when the treatment for everything was amputation and, if you survived, leeches. The large modern hospital is becoming a battleground of competing SODs* and SONs** practising their art in a multi-organ (failure) world. Many staff lack acute medical skills; those with such expertise are siloed far away from the ward in emergency departments, operating theatres and ICUs. Despite disease not knowing or caring what time it is, all hospitals remain solar powered with minimal nocturnal on-site expertise. As nursing & medical staff move more towards rotating rosters where no-one knows more than a single-sentence-summary of their patient’s complex physiological, pathological & pharmacological needs, an ever-present vigilant family member may become the only hope of surviving any acute admission.

The two most dangerous words in healthcare may well be ‘_my_ patient’.
Come listen to a middle-aged intensivist rant about how things were so much better ‘back in the day’*** and bask in the utopian dream of a healthcare system that provides better, safer, patient-centred care.

*Single Organ Doctor
**Single Organ Nurse
***they weren’t


As patients becomes more complex, the tribal systems we use to look after them remain stuck in the 18th Century when the treatment for everything was amputation and, if you survived, leeches. The large modern hospital is becoming a battleground of competing SODs* and SONs** practising their art in a multi-organ (failure) world. Many staff lack acute medical skills; those with such expertise are siloed far away from the ward in emergency departments, operating theatres and ICUs. Despite disease not knowing or caring what time it is, all hospitals remain solar powered with minimal nocturnal on-site expertise. As nursing & medical staff move more towards rotating rosters where no-one knows more than a single-sentence-summary of their patient’s complex physiological, pathological & pharmacological needs, an ever-present vigilant family member may become the only hope of surviving any acute admission.

The two most dangerous words in healthcare may well be ‘_my_ patient’.
Come listen to a middle-aged intensivist rant about how things were so much better ‘back in the day’*** and bask in the utopian dream of a healthcare system that provides better, safer, patient-centred care.

*Single Organ Doctor
**Single Organ Nurse
***they weren’t



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