Mastering Intensive Care 017 with Flavia Machado

Do you say “I don’t know” when you really don’t have an answer? Might seeking that knowledge help your patients? Flavia Machado – Improving communication, saying “I don’t know” and working with limited resources (DasSMACC special episode)



This is just one component of a wonderful conversation I held with Professor Flavia Machado when I interviewed her at the recent DasSMACC conference in Berlin. Flavia is doing a great job at raising the awareness of sepsis globally but her other great job is in running a large Intensive Care department in Sao Paolo, Brazil, where she told me that the resources are quite limited. To deal with this challenge she believes optimal communication is vital.

How does Flavia lead her ICU on the issue of communication? She does this

  1. by having an environment where her team members can ask important questions,
  2. by using the WhatsApp messenger app on smartphones,
  3. by teaching trainees using courses on how to break bad news, how to speak with families, and how to deal with doctors who have different clinical opinions, and
  4. by saying “I don’t know” when finding the knowledge will help the patient.

Flavia Machado is professor and head of the Intensive Care Session of Anesthesiology, Pain and Intensive Care Department at the Federal University of São Paulo in Brazil. Machado is board certified in internal medicine, infectious diseases and critical care.

Dr. Machado is one of the founders of the Instituto Latino americano de Sepsis (ILAS) [Latin American Sepsis Institute (LASI)]. She was the president between 2008-2011, vice president between 2012-2015 and is currently its CEO. ILAS is devoted to awareness raising, quality improvement and coordination of multicenter studies in sepsis field.

Machado is part of the executive board of the Global Sepsis Alliance and the executive committee for the World Sepsis Day. She serves on the 2012 and 2016 board of the Surviving Sepsis Campaign International Guidelines. She integrates the International Sepsis Forum (ISF) council since 2014. She is also a member of both the Executive and Scientific Committee of the Brazilian Research in Intensive Care Network (BRICnet)

In this conversation we also cover topics including:

  • Raising awareness of sepsis through the Global Sepsis Alliance
  • Mentoring and being mentored
  • The need for a multi-professional program in ICUs with a multi-disciplinary ward round
  • Setting goals and using checklists
  • How the limited resources in Brazilian healthcare require strict admission rules
  • The use of simple and short protocols based on the evidence
  • How to best deal with conflict with another doctor
  • Using dinner time to connect with family
  • How running is good for the mind
  • The joys of reading books ​

My genuine hope with the Mastering Intensive Care podcast is to inspire and empower you to bring your best self to the ICU by listening to the perspectives of such thought-provoking guests as Wes Ely. I passionately believe we can all get better, both as carers and as people, so we can do our absolute best for those patients whose lives are truly in our hands.

Feel free to leave a comment on the Facebook “mastering intensive care” page, on the LITFL episode page, on Twitter using #masteringintensivecare, or by sending me an email at andrewATmasteringintensivecare.com.

Further reading and listening

Mastering Internsive Care 700

Mastering Intensive Care

with Andrew Davies

Dr Andrew Davies MBBS FRACP FCIC. Intensivist/researcher at Frankston Hospital, Melbourne. Aiming to bring my best self to work & life. | Mastering Intensive Care | New Normal project |

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