IMAGING CASE OF THE MONTH

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XKCD nails it. Again.

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HOW I TREAT PATIENTS WITH MASSIVE HEMORRHAGE

RBC bagThis is the rather peculiar title of an great summary paper on the transfusion pratice in massive hemorrhage, mainly focusing on trauma. It describes the background, evidence and use of 1:1:1 transfusions as well as pro-hemostatics and the use of TEG/ROTEM in an easy to follow fashion. This is incorporated into the description of the slightly different approaches of two large Level 1 trauma centers with very active blood banks and transfusion docs, in Copenhagen and Houston, TX. A recommended read on current practice. More>>

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AVOID THE OXYGEN REFLEX

Avoid wrong wayWe’ve been waiting for the AVOID study, since we mentioned it a few years ago in another post on the harm of excessive oxygen. AVOID (Air Versus Oxygen in Myocardial Infarction). Now, it’s out. As expected, it shows that unnecessary oxygen supplement worsens outcome. The surprise is just how big a difference it makes! In this study, too much oxygen increased recurrent MI fivefold! More>>

Posted in Cardiology, Emergency Medicine, Intensive Care | 27 Comments

QUOTE OF THE MONTH

Q: How do you approach teaching the honing of skills to picking up high risk disease with a low prevalence?

A: “It is a shit-show. let’s just get it out there. these conditions should be missed or we should accept an enormous amount of overtesting.

Our society should issue a statement that missing pulmonary embolism, dissection (of any vessel), necrotizing fascitis – unless the pt presents with totally classic symptoms, should be considered the standard of care”

– Scott Weingart, emcrit.org.

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GOOOOOD MORNING, EUROPE!

Gooood morningSMACC registration is now open! As with previous years, reservations are going fast. Two thirds of the early bird reservations are already gone, so this will be another fantastic SMACC conference! Have a look at the program and the workshops, not to mention the awesome people being there! It all goes down in Chicago June 23-26, 2015. More>>

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THE STEEL WINDPIPE

Mikhail BulgakovWe’ve read and heard many accounts of emergency surgical airways over the years. They’re always exciting, and there’s always something new to be learned. Most written accounts are very clinical, so we were thrilled about discovering this story. It’s not new, by any means, but might be new to many of you. Written by Mikhail Bulgakov, one of the great Russian authors, around the 1920s. There’s prose to this account. And thrill. More>>

Posted in Airway management, Emergency Medicine, Medical teaching | 4 Comments

‘THE BRAVEST MAN IN THE RAF NEVER TO HAVE FLOWN AN AEROPLANE’

Ages ago, a friend of ours mentioned videos from some dodgy WW2 immersion experiments performed by RAF doctor Edgar Pask. The expermients were part of the development of the modern lifejacket. Apparently Edgar Pask, also a professor of Anesthesia at Newcastle university, had himself anaesthetised and then thrown into a pool wearing various lifejacket designs and a breathing circuit. I finally found those videos. More>>

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SONONORWAY, FEBRUARY 9.-12. 2015

The ultrasound experience is finally coming to Norway, and what a faculty! Featuring Vicky Noble, ass.prof at Harvard and director of Massachusetts General Hospital’s emergency ultrasound program. She has an impressive list of publications on ultrasound, and is also a great clinical teacher.

Great clinical teaching and a love for ultrasound is a common factor for all the faculty, which also includes Matt and Mike of ultrasoundpodcast fame, Joe Wood from the Mayo clinic, Beatrice Hoffman from Harvard and Bret Nelson who co-authored the excellent Manual of Emergency and Critical Care Ultrasound with Vicky Noble. And this is just part of the faculty!

We’re willing to bet there’s NEVER been a more competent, dedicated and internationally renowned teaching team for any ultrasound course in Norway. Ever. And YOU have the chance to have all these amazing clinical teachers at your disposal!

Screenshot 2014-10-11 23.05.01

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I AM THE RESURRECTION

CheersIf you make a study on interventions on dead people, you don’t expect much. Well, the Alfred in Melbourne did such a study – and got a resurrection rate of over 50%! Their intervention group was people in refractory cardiac arrest – which basically means you’re dead. The majority of patients in the CHEER trial had been in cardiac arrest for well over 40 mins. That’s when most of us start thinking about throwing in the towel and call the time. But not in the Alfred. Not on Steve Bernard’s watch. More>>

Posted in Cardiology, ECLS, ECMO, Emergency Medicine, Intensive Care | 1 Comment

CODE BROWN: AHHH…THE OLD SCANCRIT SWITCHEROO…

iPhoneIcon_BigSomeone once said that ‘an esophageal intubation is no sin, but there is great sin in not recognizing such a placement‘.

What’s that about?

intentionally intubate the esophagus and I demand recognition for it. More>>

Posted in Airway management, Code Brown, Emergency Medicine, Uncategorized | 10 Comments