Andrew Petrosoniak
@petrosoniak.bsky.social
EM & trauma physician | I use simulation to design better healthcare systems and spaces | Founder, Advanced Performance | otherwise @eagles & @raptors
What's the role(s) for LLMs in medicine?
This paper investigated GPT-4 assisting MD performance in open-ended management reasoning tasks
It found "Physicians using the LLM scored significantly higher compared to those using conventional resources"
www.nature.com/articles/s41...
This paper investigated GPT-4 assisting MD performance in open-ended management reasoning tasks
It found "Physicians using the LLM scored significantly higher compared to those using conventional resources"
www.nature.com/articles/s41...
GPT-4 assistance for improvement of physician performance on patient care tasks: a randomized controlled trial - Nature Medicine
In a prospective study involving 92 physicians from multiple institutions, access to large language model assistance on top of conventional resources increased a score expressing the quality of their ...
www.nature.com
February 19, 2025 at 6:27 PM
What's the role(s) for LLMs in medicine?
This paper investigated GPT-4 assisting MD performance in open-ended management reasoning tasks
It found "Physicians using the LLM scored significantly higher compared to those using conventional resources"
www.nature.com/articles/s41...
This paper investigated GPT-4 assisting MD performance in open-ended management reasoning tasks
It found "Physicians using the LLM scored significantly higher compared to those using conventional resources"
www.nature.com/articles/s41...
I think we may have gotten to a time in healthcare unfortunately where stating “this is a patient safety threat” no longer carries weight it did to drive change given the breadth of everyday threats that exist in the system. 🤦♂️😳🤷♂️
February 10, 2025 at 11:51 PM
I think we may have gotten to a time in healthcare unfortunately where stating “this is a patient safety threat” no longer carries weight it did to drive change given the breadth of everyday threats that exist in the system. 🤦♂️😳🤷♂️
Bringing coaches to the bedside - high performance really can't happen without a coach. Whether you're at the bedside or the boardroom, coaches and feedback are critical to success.
Thank you for the invitation @Ordinary2Xtra
podcasts.apple.com/us/podcast/d...
open.spotify.com/episode/00jV...
Thank you for the invitation @Ordinary2Xtra
podcasts.apple.com/us/podcast/d...
open.spotify.com/episode/00jV...
Dr. Andrew Petrosoniak: Bringing Coaches to the Bedside
Podcast Episode · Ordinary to Extraordinary - The Podcast · 02/03/2025 · 1h 22m
podcasts.apple.com
February 4, 2025 at 4:03 PM
Bringing coaches to the bedside - high performance really can't happen without a coach. Whether you're at the bedside or the boardroom, coaches and feedback are critical to success.
Thank you for the invitation @Ordinary2Xtra
podcasts.apple.com/us/podcast/d...
open.spotify.com/episode/00jV...
Thank you for the invitation @Ordinary2Xtra
podcasts.apple.com/us/podcast/d...
open.spotify.com/episode/00jV...
This is one of the best and most comprehensive sport-related concussion reviews I've come across.
Must read for those who treat/manage athletes with concussions
@nejm.org
www.nejm.org/doi/full/10....
Must read for those who treat/manage athletes with concussions
@nejm.org
www.nejm.org/doi/full/10....
Sport-Related Concussion | NEJM
Sport-related concussion is a mild traumatic brain injury that resolves within weeks,
but symptoms may persist beyond 1 month. Light physical activity and graduated aerobic
exercise facilitate reco...
www.nejm.org
January 30, 2025 at 10:37 PM
This is one of the best and most comprehensive sport-related concussion reviews I've come across.
Must read for those who treat/manage athletes with concussions
@nejm.org
www.nejm.org/doi/full/10....
Must read for those who treat/manage athletes with concussions
@nejm.org
www.nejm.org/doi/full/10....
Hospital staff injured in stabbing at QEII
Heartbreaking news out of Halifax. Hoping my fellow ED colleagues are ok.
The violence in EDs knows no limits.
Every day it happens. And will continue.
Serious interventions are needed.
www.ctvnews.ca/atlantic/nov...
Heartbreaking news out of Halifax. Hoping my fellow ED colleagues are ok.
The violence in EDs knows no limits.
Every day it happens. And will continue.
Serious interventions are needed.
www.ctvnews.ca/atlantic/nov...
Three employees injured, patient in custody after stabbing at Halifax ER
Three employees are injured and a patient is in custody following a stabbing in the emergency department at the Halifax Infirmary site of the Queen Elizabeth II Health Sciences Centre.
www.ctvnews.ca
January 30, 2025 at 2:12 PM
Hospital staff injured in stabbing at QEII
Heartbreaking news out of Halifax. Hoping my fellow ED colleagues are ok.
The violence in EDs knows no limits.
Every day it happens. And will continue.
Serious interventions are needed.
www.ctvnews.ca/atlantic/nov...
Heartbreaking news out of Halifax. Hoping my fellow ED colleagues are ok.
The violence in EDs knows no limits.
Every day it happens. And will continue.
Serious interventions are needed.
www.ctvnews.ca/atlantic/nov...
Amazing work by our ED & sim team at Unity Health Toronto to demonstrate how we're improving cardiac arrest care.
Using this video we can effectively deploy training at scale.
This will save lives.
Work led by @FarahW1991 & @garrick_mok
www.youtube.com/watch?v=i6tq...
Using this video we can effectively deploy training at scale.
This will save lives.
Work led by @FarahW1991 & @garrick_mok
www.youtube.com/watch?v=i6tq...
CPR Coach
YouTube video by St. Michael's Hospital
www.youtube.com
January 8, 2025 at 8:00 PM
Amazing work by our ED & sim team at Unity Health Toronto to demonstrate how we're improving cardiac arrest care.
Using this video we can effectively deploy training at scale.
This will save lives.
Work led by @FarahW1991 & @garrick_mok
www.youtube.com/watch?v=i6tq...
Using this video we can effectively deploy training at scale.
This will save lives.
Work led by @FarahW1991 & @garrick_mok
www.youtube.com/watch?v=i6tq...
This might be my favorite article of 2024. Thank you
@bradspellberg.bsky.social for this!
The policy to override policies...basically designed to deal with when a policy makes absolutely no sense and is not in patient's best interest.
jamanetwork.com/journals/jam...
@bradspellberg.bsky.social for this!
The policy to override policies...basically designed to deal with when a policy makes absolutely no sense and is not in patient's best interest.
jamanetwork.com/journals/jam...
January 6, 2025 at 2:51 PM
This might be my favorite article of 2024. Thank you
@bradspellberg.bsky.social for this!
The policy to override policies...basically designed to deal with when a policy makes absolutely no sense and is not in patient's best interest.
jamanetwork.com/journals/jam...
@bradspellberg.bsky.social for this!
The policy to override policies...basically designed to deal with when a policy makes absolutely no sense and is not in patient's best interest.
jamanetwork.com/journals/jam...
Opportunity cost might be the most under appreciated tactics we can use to improve our decision making. You can literally hack your own brain by explicitly framing what else you can do with an alternative choice.
This is experiment is one of my favourites
1/ 🧵
This is experiment is one of my favourites
1/ 🧵
December 11, 2024 at 8:29 PM
Opportunity cost might be the most under appreciated tactics we can use to improve our decision making. You can literally hack your own brain by explicitly framing what else you can do with an alternative choice.
This is experiment is one of my favourites
1/ 🧵
This is experiment is one of my favourites
1/ 🧵
Should we integrate surprise/unexpected events in training? A study of pilots provides some interesting insights.
I now use radical transparency with simulation - providing participants with the entire case in advance but there's likely nuance to this.
pubmed.ncbi.nlm.nih.gov/29913086/
I now use radical transparency with simulation - providing participants with the entire case in advance but there's likely nuance to this.
pubmed.ncbi.nlm.nih.gov/29913086/
Training Pilots for Unexpected Events: A Simulator Study on the Advantage of Unpredictable and Variable Scenarios - PubMed
The outcomes suggest that the inclusion of U/V simulator training scenarios is important when training pilots for unexpected situations.
pubmed.ncbi.nlm.nih.gov
December 9, 2024 at 1:24 PM
Should we integrate surprise/unexpected events in training? A study of pilots provides some interesting insights.
I now use radical transparency with simulation - providing participants with the entire case in advance but there's likely nuance to this.
pubmed.ncbi.nlm.nih.gov/29913086/
I now use radical transparency with simulation - providing participants with the entire case in advance but there's likely nuance to this.
pubmed.ncbi.nlm.nih.gov/29913086/
This week we launched Epic (EMR) at Unity Health Toronto. Today we crash tested it during a cardiac arrest simulation.
Most importantly, we ran this simulation as the FIRST test of a cardiac arrest patient - before this occurs in real life.
Most importantly, we ran this simulation as the FIRST test of a cardiac arrest patient - before this occurs in real life.
December 5, 2024 at 7:44 PM
This week we launched Epic (EMR) at Unity Health Toronto. Today we crash tested it during a cardiac arrest simulation.
Most importantly, we ran this simulation as the FIRST test of a cardiac arrest patient - before this occurs in real life.
Most importantly, we ran this simulation as the FIRST test of a cardiac arrest patient - before this occurs in real life.
Reposted by Andrew Petrosoniak
New infographic about ways to use generative AI in medical education. Some ideas we came up with:
💡generating teaching cases
🦮guiding morning report cases
📄preparing for journal club
📚summarizing large amounts of data
🔄feedback on notes/documentation
🔓 journals.lww.com/academicmedi...
💡generating teaching cases
🦮guiding morning report cases
📄preparing for journal club
📚summarizing large amounts of data
🔄feedback on notes/documentation
🔓 journals.lww.com/academicmedi...
December 3, 2024 at 12:09 AM
New infographic about ways to use generative AI in medical education. Some ideas we came up with:
💡generating teaching cases
🦮guiding morning report cases
📄preparing for journal club
📚summarizing large amounts of data
🔄feedback on notes/documentation
🔓 journals.lww.com/academicmedi...
💡generating teaching cases
🦮guiding morning report cases
📄preparing for journal club
📚summarizing large amounts of data
🔄feedback on notes/documentation
🔓 journals.lww.com/academicmedi...
High turnover of senior doctors and nurses in hospitals is associated with increased mortality for patients admitted for emergencies
TLDR:
Retention of healthcare staff is a patient safety priority & measure administrators by their ability to keep staff
www.bmj.com/content/387/...
TLDR:
Retention of healthcare staff is a patient safety priority & measure administrators by their ability to keep staff
www.bmj.com/content/387/...
November 26, 2024 at 5:23 AM
High turnover of senior doctors and nurses in hospitals is associated with increased mortality for patients admitted for emergencies
TLDR:
Retention of healthcare staff is a patient safety priority & measure administrators by their ability to keep staff
www.bmj.com/content/387/...
TLDR:
Retention of healthcare staff is a patient safety priority & measure administrators by their ability to keep staff
www.bmj.com/content/387/...
Predicting the critical administration threshold in bleeding trauma patients.
We identified factors that predict CAT+ allowing for better understanding of who requires small vs large volume blood resuscitation
sBP <90
HR >100
RR > 20
GCS <8
#medsky
pubmed.ncbi.nlm.nih.gov/39343847/
We identified factors that predict CAT+ allowing for better understanding of who requires small vs large volume blood resuscitation
sBP <90
HR >100
RR > 20
GCS <8
#medsky
pubmed.ncbi.nlm.nih.gov/39343847/
Predicting the critical administration threshold in bleeding trauma patients - PubMed
We identified four clinical variables readily available to physicians upon patient arrival associated with meeting the critical administration threshold: systolic blood pressure ≤ 90 mmHg, Glasgow Com...
pubmed.ncbi.nlm.nih.gov
November 25, 2024 at 1:01 PM
Predicting the critical administration threshold in bleeding trauma patients.
We identified factors that predict CAT+ allowing for better understanding of who requires small vs large volume blood resuscitation
sBP <90
HR >100
RR > 20
GCS <8
#medsky
pubmed.ncbi.nlm.nih.gov/39343847/
We identified factors that predict CAT+ allowing for better understanding of who requires small vs large volume blood resuscitation
sBP <90
HR >100
RR > 20
GCS <8
#medsky
pubmed.ncbi.nlm.nih.gov/39343847/
Critical administration threshold in non traumatic critical bleeding
Important insights into non-trauma bleeding patients.
- most died due to MOF
- >50% had bleeding stop with 5 or less RBCs
- 25% only received RBCs
- mortality ~20%
pubmed.ncbi.nlm.nih.gov/39210684/
Important insights into non-trauma bleeding patients.
- most died due to MOF
- >50% had bleeding stop with 5 or less RBCs
- 25% only received RBCs
- mortality ~20%
pubmed.ncbi.nlm.nih.gov/39210684/
Life-threatening hemorrhage as defined by the critical administration threshold in nontraumatic critical bleeding: A descriptive observational study - PubMed
The critical administration threshold may be employed to identify critical bleeding in non-trauma settings of life-threatening hemorrhage, with a mortality rate of approximately 20%.
pubmed.ncbi.nlm.nih.gov
November 25, 2024 at 12:48 PM
Critical administration threshold in non traumatic critical bleeding
Important insights into non-trauma bleeding patients.
- most died due to MOF
- >50% had bleeding stop with 5 or less RBCs
- 25% only received RBCs
- mortality ~20%
pubmed.ncbi.nlm.nih.gov/39210684/
Important insights into non-trauma bleeding patients.
- most died due to MOF
- >50% had bleeding stop with 5 or less RBCs
- 25% only received RBCs
- mortality ~20%
pubmed.ncbi.nlm.nih.gov/39210684/
One of the best EM speakers in the world @davidcarr333
talking acute limb ischemia @EMCases summit.
As usual a world-class talk. I learn something new every time I hear him speak.
talking acute limb ischemia @EMCases summit.
As usual a world-class talk. I learn something new every time I hear him speak.
November 22, 2024 at 2:28 PM
One of the best EM speakers in the world @davidcarr333
talking acute limb ischemia @EMCases summit.
As usual a world-class talk. I learn something new every time I hear him speak.
talking acute limb ischemia @EMCases summit.
As usual a world-class talk. I learn something new every time I hear him speak.
Making better decisions.
One of my favorite topics. I have the pleasure of speaking
@EMCases Summit today on decision making under pressure.
Here are the Elite 8 Decision Making Tactics that can be used across all high-stakes industries
One of my favorite topics. I have the pleasure of speaking
@EMCases Summit today on decision making under pressure.
Here are the Elite 8 Decision Making Tactics that can be used across all high-stakes industries
November 22, 2024 at 1:48 PM
Making better decisions.
One of my favorite topics. I have the pleasure of speaking
@EMCases Summit today on decision making under pressure.
Here are the Elite 8 Decision Making Tactics that can be used across all high-stakes industries
One of my favorite topics. I have the pleasure of speaking
@EMCases Summit today on decision making under pressure.
Here are the Elite 8 Decision Making Tactics that can be used across all high-stakes industries
We kicked off today's @EMCases Summit with some incredible virtual #simulations developed by @SarahFoohey using her award-winning virtual resus room.
We practiced & discussed MHP activation, resequencing trauma resuscitation & management of the head injured patient.
We practiced & discussed MHP activation, resequencing trauma resuscitation & management of the head injured patient.
November 21, 2024 at 5:11 PM
We kicked off today's @EMCases Summit with some incredible virtual #simulations developed by @SarahFoohey using her award-winning virtual resus room.
We practiced & discussed MHP activation, resequencing trauma resuscitation & management of the head injured patient.
We practiced & discussed MHP activation, resequencing trauma resuscitation & management of the head injured patient.
Sending thoughts and prayers to my US colleagues...
I didn't have on my healthcare bingo card that Dr. Oz and RFK Jr are working together to "fix" and "lead" healthcare...
There really are no 2 better people to promote grifting and anti-vax agendas disguised as science.
Wow.
I didn't have on my healthcare bingo card that Dr. Oz and RFK Jr are working together to "fix" and "lead" healthcare...
There really are no 2 better people to promote grifting and anti-vax agendas disguised as science.
Wow.
November 20, 2024 at 7:20 PM
Sending thoughts and prayers to my US colleagues...
I didn't have on my healthcare bingo card that Dr. Oz and RFK Jr are working together to "fix" and "lead" healthcare...
There really are no 2 better people to promote grifting and anti-vax agendas disguised as science.
Wow.
I didn't have on my healthcare bingo card that Dr. Oz and RFK Jr are working together to "fix" and "lead" healthcare...
There really are no 2 better people to promote grifting and anti-vax agendas disguised as science.
Wow.
Imagine a healthcare system where frontline clinicians…those actually providing care, together with patients are involved in a meaningful way in how healthcare is delivered.
How much different might our system look?
I suspect we’d have less failed “initiatives” & bureaucratic failures 🤷♂️
How much different might our system look?
I suspect we’d have less failed “initiatives” & bureaucratic failures 🤷♂️
November 20, 2024 at 5:28 PM
Imagine a healthcare system where frontline clinicians…those actually providing care, together with patients are involved in a meaningful way in how healthcare is delivered.
How much different might our system look?
I suspect we’d have less failed “initiatives” & bureaucratic failures 🤷♂️
How much different might our system look?
I suspect we’d have less failed “initiatives” & bureaucratic failures 🤷♂️
Recently had the pleasure of discussing all things trauma airway management on #EMCases Podcast.
Together with Dr. George Kovacs, we had the pleasure of sharing our experience and evidence-informed opinions related to trauma + airway.
emergencymedicinecases.com/trauma-airway/
Together with Dr. George Kovacs, we had the pleasure of sharing our experience and evidence-informed opinions related to trauma + airway.
emergencymedicinecases.com/trauma-airway/
Trauma Airway and Airway Trauma | Emergency Medicine Cases
In this EM Cases main episode podcast, we tackle the complexities of trauma airway management, including direct trauma to the airway. We discuss indications and timing of intubation, penetrating neck ...
emergencymedicinecases.com
November 20, 2024 at 1:09 PM
Recently had the pleasure of discussing all things trauma airway management on #EMCases Podcast.
Together with Dr. George Kovacs, we had the pleasure of sharing our experience and evidence-informed opinions related to trauma + airway.
emergencymedicinecases.com/trauma-airway/
Together with Dr. George Kovacs, we had the pleasure of sharing our experience and evidence-informed opinions related to trauma + airway.
emergencymedicinecases.com/trauma-airway/
Interesting study. Pause when using non-invasive BP for deciding on management decisions in hypotensive pts
Summary of findings = NIBP overestimate SBP during hypotension and underestimate SBP during hypertension
Use art lines when BP matters.
#medsky
sjtrem.biomedcentral.com/articles/10....
Summary of findings = NIBP overestimate SBP during hypotension and underestimate SBP during hypertension
Use art lines when BP matters.
#medsky
sjtrem.biomedcentral.com/articles/10....
Non-invasive versus arterial pressure monitoring in the pre-hospital critical care environment: a paired comparison of concurrently recorded measurements - Scandinavian Journal of Trauma, Resuscitatio...
Background Blood pressure monitoring is important in the pre-hospital management of critically ill patients. Non-invasive blood pressure (NIBP) measurements are commonly used but the accuracy of stand...
sjtrem.biomedcentral.com
November 20, 2024 at 5:28 AM
Interesting study. Pause when using non-invasive BP for deciding on management decisions in hypotensive pts
Summary of findings = NIBP overestimate SBP during hypotension and underestimate SBP during hypertension
Use art lines when BP matters.
#medsky
sjtrem.biomedcentral.com/articles/10....
Summary of findings = NIBP overestimate SBP during hypotension and underestimate SBP during hypertension
Use art lines when BP matters.
#medsky
sjtrem.biomedcentral.com/articles/10....
You only have a fixed number of good decisions in a day.
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
November 19, 2024 at 8:20 PM
You only have a fixed number of good decisions in a day.
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
This concept, aka decision fatigue is incredibly important in thinking about allocating our decision making cognitive effort. If you're involved in high-stakes decision making, failing to acknowledge this reality can be catastrophic.
1/
Just got this bobble head as a gift from my sim fellow. I’d say it’s legit pretty good!
Though I tend not to bring the bball to work on shift…
Though I tend not to bring the bball to work on shift…
November 18, 2024 at 8:09 PM
Just got this bobble head as a gift from my sim fellow. I’d say it’s legit pretty good!
Though I tend not to bring the bball to work on shift…
Though I tend not to bring the bball to work on shift…
Happy Monday to all of my colleagues working in acute care medicine!
Our favorite day where we face no bed admits and get to see all that a dysfunctional system has to offer!
May you all manage and get thru to Tuesday!
#healthcare
Our favorite day where we face no bed admits and get to see all that a dysfunctional system has to offer!
May you all manage and get thru to Tuesday!
#healthcare
a cartoon dog is sitting in front of a fire with the words " everything is fine " below him
ALT: a cartoon dog is sitting in front of a fire with the words " everything is fine " below him
media.tenor.com
November 18, 2024 at 6:31 PM
Happy Monday to all of my colleagues working in acute care medicine!
Our favorite day where we face no bed admits and get to see all that a dysfunctional system has to offer!
May you all manage and get thru to Tuesday!
#healthcare
Our favorite day where we face no bed admits and get to see all that a dysfunctional system has to offer!
May you all manage and get thru to Tuesday!
#healthcare
Reframing failure to a normal outcome. Inspired by this story from Sara Blakely, at our dinner table we'll have the same conversation. My daughters & I will each share how we failed, what we learned and how we plan to improve.
Failure is an essential tool for success.
m.youtube.com/watch?v=OZEP...
Failure is an essential tool for success.
m.youtube.com/watch?v=OZEP...
Spanx CEO Sara Blakely offers advice to redefine failure
YouTube video by Business Insider
m.youtube.com
November 14, 2024 at 4:40 PM
Reframing failure to a normal outcome. Inspired by this story from Sara Blakely, at our dinner table we'll have the same conversation. My daughters & I will each share how we failed, what we learned and how we plan to improve.
Failure is an essential tool for success.
m.youtube.com/watch?v=OZEP...
Failure is an essential tool for success.
m.youtube.com/watch?v=OZEP...