THATS HOW I (WAS) ROLL(ED)

iPhoneIcon_BigWe try to avoid putting personal stuff on this blog, but my personal observations from being a trauma patient fits too well with Thomas D’s righteous rant about logrolls a few days ago. He wrote about how the logroll, as a diagnostic tool, is mostly useless for finding relevant injuries. He told us, with the possible exception of penetrating trauma, it misses most of the injuries it is intended to find. Injuries that are found on the trauma CT scan anyway. More>>

Posted in Emergency Medicine, Prehospital Medicine | 2 Comments

LOG ROLL AND A FINGER UP YOUR BUM – THEN YOU’RE DONE

DREATLS mythbusting time – again. ATLS provides a great structure for talking and working trauma, but many of their procedures have been rethought the last couple of years as our understanding of trauma improves. Now it’s time for rethinking the log roll and digital rectal exam. More>>

Posted in Emergency Medicine, Trauma | 5 Comments

SEPSIS PROGRESS

iPhoneIcon_BigThe PROCESS and SEPSISPAM studies were serious blows to protocol EGD therapy in sepsis. With all the other dead ends we pursued (activated protein C, colloids, intensive insulin therapy, cortisone and what not) it is tempting to think that little progress has been made. That is not the case. Many studies demonstrate decreasing mortality from sepsis in the last decade. Now, in JAMA, a massive Australian-New Zealandite (sic?) database study confirms we are doing something right. More>>

Posted in Infectious diseases, Intensive Care | Leave a comment

CERVICAL COLLAR R.I.P.

Dog collarAnd so the rigid cervical collar is laid to rest in the Emergency Medical Service (EMS) of Bergen, Norway. Bergen is the second largest city in Norway, and has an active HEMS department at Bergen University Hospital. Particularly, HEMS doc Helge Asbjørnsen has been a strong advocate against the cervical collar, providing the basis for our “Curse of the Cervical Collar” post. Now, the latest EMS SOP is – for all practical purposes – getting rid of the cervical collar in Bergen’s ambulance service.
More>>

Posted in Emergency Medicine, Prehospital Medicine | 27 Comments

SUSPENDED ANIMATION

The Philadelphia ExperimentSuspended animation, the stuff my childhood sci-fi movies were made of, is coming to a hospital near you – if you live in Pittsburgh. Apparently, this has been tested well enough in pigs to let the docs have a go on real patients. We’re as surprised – and excited – as you are. Let’s have a look at medical frontier meeting sci-fi, and why it might not be so far off after all. More>>

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COCHRANE + LUCAS = NO LOVE

iPhoneIcon_BigCochrane does it’s usual thing. Looks at available evidence, then concludes more evidence is needed, and that the use of mechanical CPR isn’t supported by this Cochrane review. The problem is that they’re missing the point of mechanical compression devices. More>>

Posted in CPR, Uncategorized | 11 Comments

OPEN CHEST COMPRESSIONS IN MEDICAL CARDIAC ARREST

iPhoneIcon_BigDespite all the thousands of man-hours and gazillions of money going into researching stuff like therapeutic hypothermia and adrenaline in cardiac arrest we really haven’t got the breakthrough we deserve. With the exception of pockets of excellence, ROSC rates have been parked in the 5-10% range since the 80s or so. More>>

Posted in CPR, Emergency Medicine, Prehospital Medicine | 9 Comments

SMACC GOLD – DOWN UNDER IS THE ONLY WAY FORWARD

iPhoneIcon_BigFor those of you that have somehow missed it, the Social Media Critical Care (SMACC) conference is happening 19th-21st of March. This is the conference we’d most want to attend this year. Unforturtunately for us, it all happens on the Gold Coast in Australia. Fantastic place, but far, far away. Still, it’s on our list of conferences for 2015 – and hopefully, with a bit of planning, we’ll make it there then. Here’s a short overview of pre-SMACC and SMACC 2014, named SMACC GOLD, and why you should care. More>>

Posted in Medical teaching | 5 Comments

PRESSOR DOSES AND PROGNOSTICS

iPhoneIcon_BigJust a short post. In fact, I am writing these first two sentences just to make the post somewhat longer. Anyway, a paper in Journal of Critical Care makes vasopressor infusion doses less abstract. The authors correlate adrenaline and noradrenaline doses in the ICU with outcomes. More>>

Posted in Intensive Care, Uncategorized | 6 Comments

SCARY STUFF

This video is not really medical and you have probably already seen it by now. Still, it says something about going beyond our comfort zones and the rewards to be had for going there.

Posted in Medical teaching, Uncategorized | 1 Comment