SlideShare a Scribd company logo
1 of 88
Download to read offline
Experience Learning
Integrated Emergency Care Programme
Sim-crit, Critical care transfer, Extrication, -ator series
Positively
disruptive
MOVE!
What
do we do?
50:50
ENERGY
TRANSFER
EYEBALL
ANATOMY
PHYSIOLOGY
PRIMARY
SURVEY
Surgical Airway
Thoracostomy
Hysterotomy
Amputation
REBOA
ECPR
Transfusion
Other sim kit
Corpuls
MEQU
Credo
Voice of God FLOW
POCUS-sim
Pre-alert
Live actor
Cas-sim
Monitor
Blood products
Blood gases
Props Response to inputs
Handover
Wearable
Environment
Do a resuscitative hysterotomy live on stage?
Run the sim from scene to hospital?
Is it possible to…..
Why
do we do it?
‘DIFFICULT’ Orthopaedic Surgeon
‘BURNT OUT’ Emergency Physician
‘AUTISTIC’ Anaesthetist
Dr Geoff Roberts Memorial Award
How
do we do it?
Flattened hierarchy after
arrival
Ground zero: Orange suits, first names, mixed capability, new kit, mentor
Candidate Autonomy
Instructor Input
Lecture
Skill
Station
Master
Class ISL
Immersive
Simulation
Nightclub
V Dark - lights
Smoky
Loud
Illegal rave
Dancers
Equipment
First aiders/ Friends
Louder
Difficult actors
More smoke
Extra risk
More medicine
More smoke!
Lost objectives
Sensory overload
Impossible
Unrealistic
Safety?
GREAT FUN!
That was awesome!
-Cliff Reid
Failed simulation
Sensory fail
Lost objectives
No solution
Unrealistic expectations
Totally overwhelming
First scenario - day 1
Screaming live actor
Major bleeding from thigh
Expose
Tourniquet
END
Team Leader
PPE
Environmental shock
Small bed sit - access!
Knife on the bed
Coordinating the team
Kit management
Live actor, combative, screaming & bleeding
Accessing the bleeding limb
Stopping the bleed - options?
Safety
Team
Patient
Final scenario day 3
ROSC post thoracotomy
Bleeding artery
VF
Aortic occlusion
Trauma Induced Coagulopathy
Cardiogenic Shock
Ongoing care plan
Busy & loud ED resus - stimulation
Resource limitations
Other specialities - communication
Rapidly evolving case
Saturation
Complex conflicting physiology
Decision paralysis
Team
Patient
Safety
Knowledge
Skills
Behaviour
Leadership
Followership
Emotional Intelligence
Situational Awareness
Communication
Metacognition
Emotional Intelligence
Mutual Support
Restorative Practice
Behaviour
21.13hrs: 27Y F,
central chest stabbing,
becoming unconscious
14.00hrs: Plane crash:
Car-Fest, Oulton Park,
Little Budworth,
Cheshire
Where
do we go next?
EXPERIENCE
REFRESHER
@Obidoc @HaldenHB

More Related Content

More from scanFOAM

ECPR at the Roadside - Mamoun Abu-Habsa - TBS24
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24ECPR at the Roadside - Mamoun Abu-Habsa - TBS24
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24scanFOAM
 
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...scanFOAM
 
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...scanFOAM
 
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...Unmanned aerial systems "drones" - increasing SAR response capability - Will ...
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...scanFOAM
 
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24scanFOAM
 
Precision in neonatal transport - Ian Braithwaite - TBS24
Precision in neonatal transport - Ian Braithwaite - TBS24Precision in neonatal transport - Ian Braithwaite - TBS24
Precision in neonatal transport - Ian Braithwaite - TBS24scanFOAM
 
Mantas Okas - where do we come from and where can we go if we feel like?
Mantas Okas - where do we come from and where can we go if we feel like?Mantas Okas - where do we come from and where can we go if we feel like?
Mantas Okas - where do we come from and where can we go if we feel like?scanFOAM
 
The Shock Continuum - Sara Crager - TBS24
The Shock Continuum - Sara Crager - TBS24The Shock Continuum - Sara Crager - TBS24
The Shock Continuum - Sara Crager - TBS24scanFOAM
 
Shock Continuum - Sara Crager - TBS24.pdf
Shock Continuum - Sara Crager - TBS24.pdfShock Continuum - Sara Crager - TBS24.pdf
Shock Continuum - Sara Crager - TBS24.pdfscanFOAM
 
Fully Automated CPR | Jason van der Velde | TBS24
Fully Automated CPR | Jason van der Velde | TBS24Fully Automated CPR | Jason van der Velde | TBS24
Fully Automated CPR | Jason van der Velde | TBS24scanFOAM
 
The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23scanFOAM
 
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23scanFOAM
 
Airway Session | Michael Selz and friends at TBS23
Airway Session | Michael Selz and friends at TBS23Airway Session | Michael Selz and friends at TBS23
Airway Session | Michael Selz and friends at TBS23scanFOAM
 
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23scanFOAM
 
Rescuing the right ventricle | Sara Crager at TBS23
Rescuing the right ventricle | Sara Crager at TBS23Rescuing the right ventricle | Sara Crager at TBS23
Rescuing the right ventricle | Sara Crager at TBS23scanFOAM
 
Precision vent management | Sara Crager at TBS23
Precision vent management | Sara Crager at TBS23Precision vent management | Sara Crager at TBS23
Precision vent management | Sara Crager at TBS23scanFOAM
 
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23scanFOAM
 
First 5 min of cold water immersion - sudden death and prolonged survival - l...
First 5 min of cold water immersion - sudden death and prolonged survival - l...First 5 min of cold water immersion - sudden death and prolonged survival - l...
First 5 min of cold water immersion - sudden death and prolonged survival - l...scanFOAM
 
The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23scanFOAM
 
Microvascular oxygen delivery | Knut Kvernebo at TBS23
Microvascular oxygen delivery | Knut Kvernebo at TBS23Microvascular oxygen delivery | Knut Kvernebo at TBS23
Microvascular oxygen delivery | Knut Kvernebo at TBS23scanFOAM
 

More from scanFOAM (20)

ECPR at the Roadside - Mamoun Abu-Habsa - TBS24
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24ECPR at the Roadside - Mamoun Abu-Habsa - TBS24
ECPR at the Roadside - Mamoun Abu-Habsa - TBS24
 
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...
Mechanical ventilation in PARDS - same as adults? - Demirakca - TBS24tion_in_...
 
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...
Failure is an option - journey of an astronaut candidate - Matthieu Komorowsk...
 
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...Unmanned aerial systems "drones" - increasing SAR response capability - Will ...
Unmanned aerial systems "drones" - increasing SAR response capability - Will ...
 
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24
Groupthink - lessons from the Challenger disaster - Vahé Ender - TBS24
 
Precision in neonatal transport - Ian Braithwaite - TBS24
Precision in neonatal transport - Ian Braithwaite - TBS24Precision in neonatal transport - Ian Braithwaite - TBS24
Precision in neonatal transport - Ian Braithwaite - TBS24
 
Mantas Okas - where do we come from and where can we go if we feel like?
Mantas Okas - where do we come from and where can we go if we feel like?Mantas Okas - where do we come from and where can we go if we feel like?
Mantas Okas - where do we come from and where can we go if we feel like?
 
The Shock Continuum - Sara Crager - TBS24
The Shock Continuum - Sara Crager - TBS24The Shock Continuum - Sara Crager - TBS24
The Shock Continuum - Sara Crager - TBS24
 
Shock Continuum - Sara Crager - TBS24.pdf
Shock Continuum - Sara Crager - TBS24.pdfShock Continuum - Sara Crager - TBS24.pdf
Shock Continuum - Sara Crager - TBS24.pdf
 
Fully Automated CPR | Jason van der Velde | TBS24
Fully Automated CPR | Jason van der Velde | TBS24Fully Automated CPR | Jason van der Velde | TBS24
Fully Automated CPR | Jason van der Velde | TBS24
 
The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23
 
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23
Stop complaining and train - news in ultrasound | Domagog Damjanović at TBS23
 
Airway Session | Michael Selz and friends at TBS23
Airway Session | Michael Selz and friends at TBS23Airway Session | Michael Selz and friends at TBS23
Airway Session | Michael Selz and friends at TBS23
 
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23
Septic shock initial 1 hour EM | Jean-Louis Vincent at TBS23
 
Rescuing the right ventricle | Sara Crager at TBS23
Rescuing the right ventricle | Sara Crager at TBS23Rescuing the right ventricle | Sara Crager at TBS23
Rescuing the right ventricle | Sara Crager at TBS23
 
Precision vent management | Sara Crager at TBS23
Precision vent management | Sara Crager at TBS23Precision vent management | Sara Crager at TBS23
Precision vent management | Sara Crager at TBS23
 
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23
RSI in adult patient - what about ventilation | Alexandre Jeleff at TBS23
 
First 5 min of cold water immersion - sudden death and prolonged survival - l...
First 5 min of cold water immersion - sudden death and prolonged survival - l...First 5 min of cold water immersion - sudden death and prolonged survival - l...
First 5 min of cold water immersion - sudden death and prolonged survival - l...
 
The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23The future of the emergency room | Jean-Louis Vincent at TBS23
The future of the emergency room | Jean-Louis Vincent at TBS23
 
Microvascular oxygen delivery | Knut Kvernebo at TBS23
Microvascular oxygen delivery | Knut Kvernebo at TBS23Microvascular oxygen delivery | Knut Kvernebo at TBS23
Microvascular oxygen delivery | Knut Kvernebo at TBS23
 

Recently uploaded

(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...indiancallgirl4rent
 
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near MeRussian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Memriyagarg453
 
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...russian goa call girl and escorts service
 
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...Sheetaleventcompany
 
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur RajasthanJaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthanindiancallgirl4rent
 
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591adityaroy0215
 
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhChandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhSheetaleventcompany
 
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★indiancallgirl4rent
 
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetErnakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Chandigarh
 
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meetraisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetSambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...indiancallgirl4rent
 
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabad
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In FaridabadCall Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabad
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabadgragmanisha42
 
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetHubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetCall Girls Service
 
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF ...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF  ...❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF  ...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF ...Gfnyt.com
 
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real MeetChandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meetpriyashah722354
 
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.ktanvi103
 
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012adityaroy0215
 
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Sheetaleventcompany
 

Recently uploaded (20)

(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
(Ajay) Call Girls in Dehradun- 8854095900 Escorts Service 50% Off with Cash O...
 
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near MeRussian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
Russian Call Girls in Noida Pallavi 9711199171 High Class Call Girl Near Me
 
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...Call Girls Service In Goa  💋 9316020077💋 Goa Call Girls  By Russian Call Girl...
Call Girls Service In Goa 💋 9316020077💋 Goa Call Girls By Russian Call Girl...
 
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...
Punjab❤️Call girls in Mohali ☎️7435815124☎️ Call Girl service in Mohali☎️ Moh...
 
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur RajasthanJaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
 
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591
VIP Call Girl Sector 88 Gurgaon Delhi Just Call Me 9899900591
 
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in ChandigarhChandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
Chandigarh Escorts, 😋9988299661 😋50% off at Escort Service in Chandigarh
 
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★
Enjoyment ★ 8854095900 Indian Call Girls In Dehradun 🍆🍌 By Dehradun Call Girl ★
 
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetErnakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Ernakulam Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meetraisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
raisen Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetSambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...
(Sonam Bajaj) Call Girl in Jaipur- 09257276172 Escorts Service 50% Off with C...
 
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabad
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In FaridabadCall Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabad
Call Girls Service Faridabad 📲 9999965857 ヅ10k NiGhT Call Girls In Faridabad
 
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real MeetHubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
Hubli Call Girls 👙 6297143586 👙 Genuine WhatsApp Number for Real Meet
 
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF ...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF  ...❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF  ...
❤️♀️@ Jaipur Call Girls ❤️♀️@ Jaispreet Call Girl Services in Jaipur QRYPCF ...
 
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real MeetChandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
Chandigarh Call Girls 👙 7001035870 👙 Genuine WhatsApp Number for Real Meet
 
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now ☎ 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
 
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
VIP Call Girl DLF Phase 2 Gurgaon (Noida) Just Meet Me@ 9711199012
 
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Hyderabad Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
Call Girl Amritsar ❤️♀️@ 8725944379 Amritsar Call Girls Near Me ❤️♀️@ Sexy Ca...
 

Experience learning - lessons from 25 years of ATACC - Mark Forrest and Halden Hutchinson-Bazely - TBS24