2017 has been an intriguing year. For the blog and podcast specifically, there have been many accomplishments. Goals have been obtained faster than planned and we still are striving for even more success. Today, we are talking about something that is not in medicine much but we see it elsewhere such as the military and firefighting: the after action review (AAR). However, a traditional AAR can sometimes be difficult to perform at it takes a long time. In critical events there is an abbreviated version known as the "hot offload" which is being promoted by some such as Ashley Liebig. However, it is worth noting there are some key differences.
To summarize the "hot offload" is more for specifically critical events with negative outcomes. The goal is to very quickly offload information and get the facts out on what happened. You talk about all the sensations: what you saw, heard, tasted, felt, and smelled in the event. This helps to reaffirm memories and explore potentially false thought processes. Feelings of guilt can also be discussed within the confines of those who were there. The "woulda, coulda, shoulda" approach is not there. More, this is a reality check and making sure people are appropriate to return to work. Sometimes this means someone needs to leave even if they are initially unwilling.
The traditional after action review (AAR) is to focus on three components: results, learning, and changes. The first part is to see if what was desired and what was achieved. Essentially, what worked and what did not. In a situation requiring a brief review, this may not be all the details but to focus on the key components. Next, is to learn as far as why certain decisions were made, if it was effective, and would things change given what happened and the end result. Finally, change is the part to see what needs to be modified to better achieve the necessary goals. Again, this can be done quickly or in a very thorough review. The key though is to make sure this happens. Let us use the example of the past year and modify it for this role. In the last year we have attended conferences, given talks to multiple groups, and had our first sponsorship. We have significantly grown in the number of listeners and readers over this year. Many great guests have come on to discuss topics and this too has been rewarding. However, we have had to move our recording studio several times and need better equipment and setup to be more efficient. It is very easy to currently spend several hours to make a single podcast. When we first started we chose programs and technology that was the least expensive or free. This made some processes much harder though and we want to improve on this now seeing the success of our blog and podcast. We have already changed some aspects such as buying a new microphone and will soon purchase a new program to edit our audio. If we are really lucky, we will probably buy a new laptop for all the travel to better record on a system built in this decade. Furthermore, we are reaching out to more organizations to become speakers and other groups have done the same for us. That was a brief example, but that may be all you need. The key is to focus on positives and work to make a positive change. In the stressful and bad events, focus on the "hot offload" since this accomplishes the major needs and then the full AAR later but with your events that just need to have a good talk use a brief AAR. As a quick side note, we are expanding on ultrasound and will be teaching at more places. If you are looking for someone to teach ultrasound to your program, organization, or group let us know by sending us an email at [email protected] or send us a message. We want to thank everyone for their support over the last year. This has been a wonderful experience and we continue to look forward to serving everyone. Let us know what you think by giving us feedback here in the comments section or contacting us on Twitter or Facebook. Remember to look us up on Libsyn and on iTunes. If you have any questions you can also comment below, email at [email protected], or send a message from the page. We hope to talk to everyone again soon. Until then, continue to provide total care everywhere. 
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