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Mastering Intensive Care

Sep 27, 2017

Do you say “I don’t know” when you really don’t have an answer? Might seeking that knowledge help your patients?

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 is the Professor of Intensive Care at the Federal University of São Paulo in São Paulo where she is Head of the Intensive Care Section of the Anesthesiology, Pain and Intensive Care Department. Flavia has trained in Internal Medicine, Infectious Diseases and Critical Care, making the field of sepsis something she has become a world leader in. She is one of the Founders of and now the CEO of the Latin America Sepsis Institute (LASI), having been its President. LASI is devoted to quality improvement in Brazilian hospitals as well as to coordination of multicenter studies in the field of sepsis. She is part of the executive board of the Global Sepsis Alliance and the executive committee for the World Sepsis Day. Flavia has served on the board of the Surviving Sepsis Campaign International Guidelines. She is also a member of both the Executive and Scientific Committee of the Brazilian Research in Intensive Care Network-BRICNET. Finally, Flavia is the editor-in-chief of “Revista Brasileira de Terapia Intensiva”, the official journal of the Brazilian Critical Care Association and the Portuguese Critical Care Association.

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

With this podcast please help me in my quest to improve patient care, in ICUs all round the world, by inspiring all of us to bring our best selves to work to more masterfully interact with our patients, their families, ourselves and our fellow healthcare professionals so that we can achieve the most satisfactory outcomes for all. It would be much appreciated if you could help to spread the word by simply emailing your colleagues or posting on social media.

If you have a comment or a question, let’s engage. Whilst my primary goal is to improve patient outcomes by helping us all get better thanks to the inspiring messages of my guests, I also have the goal of building community through Mastering Intensive Care, so people can share their thoughts and their own skills. So leave a comment (on the LITFL episode page or on twitter using #masteringintensivecare), send me an email at or engage in the facebook page Mastering Intensive Care.