Finding time to debrief challenging cases can feel nearly impossible amidst the tumult and task saturation of medical practice. The reality, however, is that it’s a necessity, not a nicety.  In this episode, emergency physician Stuart Rose and rescue specialist Ashley Liebig discuss two different approaches to immediate debriefs: INFO and the hot offload.  

Guest Bios: 

Stuart Rose is an emergency physician practicing in Calgary, Canada and lead author of the seminal debriefing paper, Charge nurse facilitated clinical debriefing in the emergency department. 

Ashley Liebig is a HEMS Flight Nurse and Helicopter Rescue Specialist with Austin Travis County STAR Flight. Prior to her flight and rescue career, Ashley served in the US Army as a combat medic with the 101st Airborne Division. She is known around the world as a teacher of managing the stress response

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We Discuss

• A particularly stressful resuscitation that was taxing, emotionally and physically, and an approach to the “hot offload” [03:30];
• Debriefing core concept #1:  The ED charge nurse is optimally suited to organize the debriefing and to lead the conversation [07:25];
• A structured approach to debriefing using the mnemonic INFO [12:40];
• Sample debrief scripting [13:30];
• Handling conflict or criticism that may arise during a debrief [18:35];
• The importance of establishing psychological safety [21:00];
• Principles of a hot offload [28:15];
• Hot offload steps [32:25];
• Ashley’s Credo:  work hard, be respectful, be kind [36:40];
• And more.