Take your mind back a while folks. Remember the best use for a bougie? post…?
We highlighted the technique of using the bougie to aid intercostal catheter insertion. However, we also promised to grandfather in at least one new Fellow to the Utopian College of Emergency for Medicine if someone could impress us sufficiently with his or her suggested use for a bougie. There were some great suggestions – some serious, but mostly not! – ranging from more airway uses, adjuncts to the neuro exam, milkshake drinking with quotations from ‘There Will Be Blood”, and various household and daily life activities. At the end of it all the LITFL team, in association with UCEM, are proud to announce the inauguration of not one but two new Fellows!
Let us find out what is expected from practitioners worthy of UCEM Fellowship status. First up, is this suggestion from Tim Leeuwenburg F.UCEM, the medical MacGyver at KI Docs:
The specific use of the bougie is to elicit the Leeuwenburg Reflex, which I discovered last week whilst bored giving a five hour anaesthetic. Whilst the surgeons were huddling around in the abdomen, myself and the anaesthetic nurse (both bored to tears, so much so I though was going to have to put the BIS monitor on myself, not patient), played around with various bits of anaesthetic equipment.
We discovered the Leeuwenburg reflex whilst using the bougie to remove some navel fluff.
Specifically, the Leeuwenburg reflex is the feeling of tingling along the dorsum of the penis when the bellybutton is stimulated by a ‘swirl’ within it, using a bougie (or I suppose a biro would do)
I do not know what this means, but it was kind of fun….
I have indicated to my anaesthetic nurse that further research may be needed, specifically to look for the ‘reverse-Leeuwenburg reflex’ (ie: stroking the dorsum of penis and seeing if it elicits a tingling sensation in the navel) but she has demurred.
And our other champion of Utopian ideals was Jake Barlow F.UCEM:
Bit late, but I think it would be the only way to place an IDC in Scott “20 inches” Weingart.
Congratulations Tim and Jake, you are now entitled to use the post-nominals F.UCEM and your virtual diplomas are in the virtual mail!
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.