SweetBEEM 2014

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The BEEM Dream Team of Drs. Anthony Crocco, Ken Milne and Suneel Upadhye. returned from Stockholm, Sweden this weekend. It was a fantastic trip filled with great experiences and knowledge translation.

The adventure started with our arrival in the airport wearing Swedish hockey jerseys (while in Rome). This was despite the fact that Dr. Katrin Hruska lost the friendly bet on the Men’s Olympic goal medal game. She was a good sport and wore the Canadian Hockey jersey for the first day of the SweetBEEM course.

Dr. Arin Malkomian who co-organized the conference . He was wise enough not to bet against the Canada. However, we brought a jersey for him to wear as well.

We took a tour of Stockholm before the conference started. The highlight was visiting Stockholm city hall. This is where the Nobel prize reception is held. Suneel and I used the opportunity to waltz in the golden hall. It was the closest we will ever get to a Nobel prize.

Our group also took a tour of their major trauma centre (Karolinska Hospital) and paediatric emergency department (Astrid Lindgrens Hospital). The paediatric hospital is named after the author of the children book series, Pippi Long Stocking.

We appreciated Dr. Pia Malmqvist coming in on her day off to give us a tour. The trauma bay was connected to the surgical theatre on one side and CT scanner on the other. This made us stop and take pictures of the great design.

Then the two day SweetBEEM course began with 7hrs a day of high quality, clinically relevant evidence based medicine. The Scandinavian audience impressed us with their answers to our Turning Point questions. These doctors practice evidence based medicine even if they did not know it.

The conference ended with a “friendly” game of BEEM Jeopardy. It was a very close competition with the lead changing through the game. Alex Trabek (Ken) had his sparkly coat and Vana White (Katrin) kept track of the questions. The winner was only named after the final jeopardy question. In the end, Norway placed first but everyone tasted sweet victory with a bottle of Canadian Maple Syrup.

The next day the BEEM Dream Team spoke at the Swedish national emergency conference. Suneel had a well attended talk on diving emergencies. His presentation even had video of diving with hundreds of hammer head sharks. Anthony gave a talk on teaching evidence-based medicine at the bedside and paediatric ECGs.

I was invited to debate the evidence for thrombolysis in acute CVA. The challenge was addressed as a scientist considering the null hypothesis that the tPA produces no effect or makes no difference. The burden of proof was upon Dr. Kjell Asplund who was making the positive claim.

I presented the twelve major randomized control trials. There were four trials stopped due to harm or futility, six showing no difference, and only two showing benefit. This was not enough proof for me to reject the null hypothesis. I remain skeptical of the intervention. None of the arguments were directly addressed by Dr. Asplund. It was up to the audience to decide what to make of the information presented. A video of the presentations will be posted soon.

My favourite picture of the trip was of Katrin on the second day of the SweetBEEM conference. We were both feeling the glow of how well things were going. She is smiling at how it had worked out so well. I am watching the BEEMers in action hoping we will have another opportunity visit Scandinavia.

Five is my favourite number because I can count to it on one hand. Here is my Top Five list of SweetBEEM memories:

Smart Docs: We were so very impressed repeatedly with the quality of evidence based medicine being practiced by the attendees.
Garbage in Garbage Out: Getting a Swedish translation of this EBM saying was great!
Scooters: They have fancy little scooters to ride with a arrest is called for the resuscitation team to get to patients quickly.
Fika: Canada may have its Double/Double (TIm Horton’s Coffee) and the USA may run on Dunkin Donuts coffee but the Scandinavians take their coffee breaks seriously.
Come A Long Way: Emergency medicine may be a new specialty in Sweden but they have made huge progress in a relatively short time. Clearly it is due to organizations like Sweets, leadership from Drs. Hruska and Malkomian and an enthusiastic group of emergency physicians.

Thank you Sweden for a wonderful trip, great conference and many fabulous memories. Here is a short video to express our appreciation called “You’ve got a friend in BEEM:)” SweetBEEM 2-Medium