EMCrit Podcast 49 – The Mind of a Resus Doc: Logistics over Strategy

amateurs discuss strategy; experts discuss logistics

This Part I of the Mind of a Resus Doc Series, in which we delve into the philosophies that make a good resuscitationist.

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  1. Merlin says

    This topic really hit home. As a paramedic I’m big on logistics, and mainly trained in strategies. And the minute you started talking about it, I knew exactly what you mean. I’ve had many of the same thoughts while working in the ER and assisting with procedures. Now as a med student, I’m seeing this difference even more. I gotta say, one group that has mastered logistics (at least where I’m training) is the neurosurgeons in the OR. I shadowed them for awhile and all the residents and attendings seemed to know the logistical application of everything that was going on in that OR. I was impressed, and knew then that I want that kind of knowledge in my field. Your technique of visualization that you talked about, I’ve been teaching that to EMT students for years! Glad to hear someone else talk about it, and using it. So important and useful.

    Anyway, great stuff. Keep it coming.

  2. Henry says

    Excellent podcast!

    One comment. I would argue that simulation can facilitate good logistics. In addition to its usual benefit of providing immediate reflective learning in the company of other resuscitationists, it can act as a rehearsal (not mental, but physical) to work through processes, find equipment, etc.

    There is a growing enthusiasm for simulation in-situ. You place the manikin in a resuscitation bed, present a critical patient, and have a multi-disciplinary team provide care using the equipment in your department rather than in a simulation laboratory or a few toys brought to an auditorium. They will have to make processes work in their department. These processes, understanding the equipment and how to make critical actions occur rapidly can be explored in a debriefing session which can improve the knowledge of the resuscitationist.

    They can still run through the logistics of resuscitation individually in their mind at other times, but I believe simulation can provide a good supplement to this learning process and can result in the development of more resuscitationists who are more highly skilled within the department.

  3. Minh Le Cong says

    HI Scott
    could not agree more with you! ONly 3 days ago I helped out our retrieval registrar who was bringing in a lady with septic shock and renal failure from an outlying hospital 2 hrs flight away. I met the aircraft when it landed and when the doors opened the registrar looked a total wreck and promptly told me the woman was about to die!

    Anyway he had had to deal with two VT arrests inflight and was totally unprepared for running a code at 30000ft in the back of an aircraft with only him and a flight nurse. He did not remember where the gear was kept or how much resus drugs we carried despite my orientation training! He said we was used to running a code in a ED resus bay with 4 other people helping and a cupboard full of drugs.

    So goes to show , as you say experts talk logistics and we discussed what he might have done better in retrospect ,like taking more resus drugs with him in a patient with acute renal failure.

    QUite a coincidence how your post highlighted this issue around this case!

    keep the faith, mate

  4. Mike says


    Agree that logistics is key! I imagine you are going to get into this but logistics also includes planning the future moves of the patient and what will be required to make those moves occur.


  5. says

    This podcast is being referenced at the Bedside Critical Care Conference in Australia today. Goes to show that the relevance of these podcasts lives on and the audience will continue to grow. Great work as usual Scott…

  6. Patrick Burkhardt says

    Hi Scott-
    I´m an anesthesiologist/intensivist from Berlin and a new fan of your fantastic site.
    I´m also a sailor with some 30000 nm in my personal wake, and most of my “resus philosophy” comes from the concept of “seamanship”. When I have new crew on the boat, I teach them how to prepare for foul weather with a similar approach as you describe here. One thing that comes to my mind when I see the image of the resus bay that comes with the title of your show: When you prepare for a storm, clean up the cabin and make sure no loose gear flies around when the boat starts to shake – and when you prepare for a resus, make sure you have at least three large trash cans by the bed. Physical chaos (books and food piling up on the cabin floor or large piles of wrappings, syringes and vials on your resus equipment) creates mental chaos, also known as panic. Avoid at all costs!
    Thank you for your great work.

  7. J Kim says

    Absolutely amazing podcast that hit the homerun mark. I am with you. Please post more actual logistical procedure stuff that no one taught us. Things like how to set up and troubleshoot pleur-vac for chest tubes and how to set up pressure bags and how to operate infusion pumps, etc.


  1. […] I would do.  Of course, the where, what and who might vary from town to town.  A great example of logistics over strategy (see Emcrit).  So here is my plan, in Broome, with my kit and people.  I understand each of you would have a […]

  2. […] Cognitive readiness requires that you consider emergency scenarios and decide on a plan. This starts with a textbook (by textbook I of course mean the internet) and reading what others think you should do in a given emergency scenario. The hard part of cognitive readiness is keeping up with the endlessly changing, endlessly disagreeing opinions, and deciding how to shape them into a plan that you like and that works for you in your environment. Logistics are key. […]

  3. […] after courses like the excellent EMAC, I have become a fan of sim training to embed skills – logistics over strategy as Weingart would say (echoed by French & Le Cong), or ‘making things happen‘ as […]

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