Coda Change

The SMACC Opening Ceremony is an integral part of the conference welcoming delegates to an educational experience unlike any other. Inspiration for SMACC Sydney included the inverted triangle: the alchemical symbol for water which is steeped in history and meaning to represent the City of Sydney and a celebration of diversity and resilience. Retrofuturism influences the design and theming of SMACC Sydney by playing on different aspects of 80's and 90's popular culture. Using music as a storytelling medium the show presents a mesmerising and unique soundscape combining elements of classical, electronic and popular music deftly created by Composer and Music Director Jake Meadows. This year's opening ceremony echoes the program through four stems and performances each illustrating the unique and essential role we play as critical care professionals: Learning and Culture, People and Planet, Bedside Critical Care and Science and Innovation. The show opens with a spoken word performance by Nardi Simpson, an Indigenous performer telling an electrifying story of the land and the importance of Country to Indigenous culture. This is then followed by a vocal ensemble performing Queen's Bohemian Rhapsody, a cheeky throwback to an iconic piece of music and an homage to the importance of humour and levity in our line of work. A change of scene brings a dramatic dance performance performed by ICU Registrar Khairil Musa and his dance partner Sarah King reflecting on the tragic final moments leading to a cardiac arrest. The finale blends classic 80's pop with the iconic sound of the synthesiser with a toe tapping performance of Van Halen's Jump led by vocalist Maya Weiss as an uplifting tribute to creativity and innovation. Performed in the Sydney International Convention Centre Theatre to over 3000 delegates we present to you our best and most memorable opening ceremony yet.

Social media has allowed for important spread of medical knowledge to the public but has also seen the inexorable rise of fake news. Mistrust in the medical profession may be exasperated by misinformation in public domains. Prominent cases such as the Jahi McMath case have led to ethical discussions regarding death. How are we going as neurocritical care professionals?

Technology is good for learning‚ information and even wisdom at our fingertips, tech like simulation and virtual reality is cool. And technology really hit its straps with social and collaborative learning. But technology is bad‚ distracting, and multi-tasking impairs learning, our health can suffer, and good technology can be badly applied (eg PowerPoint as a "crime against connection" in presentations). Some technology is expensive without learning impact, and social media and the internet have dark sides. Vic offers us some thoughts on navigating the good, bad and ugly and suggests some personal strategies for making the most of technology for learning. And there is no Powerpoint.

It's hard to die without passing through MET-calling criteria; if you try to do so on a hospital ward, chances are you'll have an Intensivist next to you. By designing systems to detect patient deterioration, we've inadvertently invented acute palliative care. How did we move from resuscitators to out-of-hours death doulas so rapidly? Is death the future of Intensive Care Medicine?

A neonates journey, just what feedback would your neonatal patient give you after 3 months of intensive care? Listen to the innocent observation and experience of daily life in NICU and perhaps approach a future patient with little voice slightly differently.

How can you live a full creative life in the midst of a busy medical career? Fiona gives a very inspiring talk at the Get Creative Workshop, discussing the fascinating pathway her life has taken, allowing her to fulfill her creative potential whilst still developing her medical career as a paediatric emergency physician.

Delivery of safe healthcare currently faces unprecedented challenges in the UK and globally. This arises, at least partly, from a rising involvement of the criminal law in the investigation of medical errors apparently conflicting with the need to respect a "duty of candour". As a result, doctors face enormous pressures in fear of being blamed for medical errors. David Sellu is a consultant surgeon who was convicted for gross negligence manslaughter in late 2013 after the death of a patient in a private hospital. I (@DrJennyVaughan) was the medical lead for a group of David Sellu's friends as we launched a campaign to overturn his conviction. There has never been a successful 'out of time' appeal in this area of the law so we were dealing with almost impossible odds from the start. The positive result was extraordinary, both for David and our whole profession (www.medicalmanslaughter.co.uk). Since these events, I have supported other doctors facing criminal conviction, such as the paediatrician Dr Hadiza Bawa-Garba, through my work with the Doctors Association UK (DAUK, @TheDA_UK). Thousands of doctors crowd-funded a campaign and successfully overturned a court decision to erase her from the UK medical register. Her case proved to be a lightning rod in the UK for a profession at breaking point. Many healthcare staff are working on critically under-staffed wards and in under-resourced departments, with an increasingly unmanageable workload. DAUK have since launched a "Learn Not Blame" campaign to improve safety for patients and healthcare professionals. We believe that the involvement of the criminal justice system in these cases often does not allow an appreciation of the interplay of individuals within complex health systems. We also remain particularly concerned that a recent analysis of conviction trends shows an excessive conviction rate of black and minority ethnic (BME) healthcare staff.

OHCA, Out of Hospital Cardiac Arrest is surrounded in controversies from bystander CPR and the use of Adrenaline, to airway management and mechanical CPR. Who better to hear the latest updates from other than Gavin Perkins, author of Paramedic 2 and lead on ILCOR guidelines