Monthly Archives: December 2011

DOBUTAMINE DOESN’T CURE CARDIAC FAILURE AFTER ALL

Posted on December 30, 2011 by K

Numerous studies have questioned the practice of using dobutamine in cardiac failure. Despite that, most guidelines for supportive treatment of decompensated cardiac failure still include dobutamine. A recently published meta-analysis has another go at it.

Posted in Cardiology, Emergency Medicine, Intensive Care | Leave a comment

PREHOSPITAL ANAESTHETISTS

Posted on December 29, 2011 by K

The question as to if physicians have a place in prehospital emergency medicine is often portrayed as a great controversy. That implies that the results from studies comparing paramedic only systems with paramedic-doctor ones are largely conflicting and no conclusions … Continue reading →

Posted in Prehospital Medicine | Leave a comment

VEINVIEWER

Posted on December 22, 2011 by K

Impressive technology that undoubtedly has it’s uses. But how come it doesn’t seem to facilitate venous catheterisation?

Posted in Tech | Leave a comment

GRAND THEFT IMAGE

Posted on December 20, 2011 by K

For our further reference, teaching and the reader’s benefit we are keeping this great illustration (below) of supraglottic airway invasiveness and anatomy. It was ripped from a review on SAD history, failures, use and misuse that was mentioned here before. Authored … Continue reading →

Posted in Airway management, Anesthesia, Emergency Medicine, Intensive Care | Leave a comment

NO MARGINS IN THE CRITICALLY ILL

Posted on December 20, 2011 by K

Intubating the critically ill in the ICU, in theatres or in the streets is likely to be the most dangerous thing we ever do. Their physiological margins are too narrow to allow for any mucking about. Importantly, these guys won’t … Continue reading →

Posted in Airway management, Anesthesia, Emergency Medicine, Intensive Care | Leave a comment

SAY HELLO TO MY LITTLE FRIEND, THE LIPID-SINK EFFECT

Posted on December 19, 2011 by K

We know intravenous injection of lipid emulsion is an effective antidote of some overdoses of lipid-soluble drugs like the local anaesthetics, beta-antagonists, calcium channel blockers and antidepressants. I never thought of it being used as an antidote in cocaine toxicity.

Posted in Emergency Medicine, Toxicology | 1 Comment

ANAESTHETISTS VS ORTHOPAEDIC SURGEONS

Posted on December 17, 2011 by K

You can spot an orthopaedic surgeon a mile away by their hunched posture and the bad habit of dragging their knuckles along the floor. Other specialities have, confronted by this vision of the man-ape,  assumed it reflects their intelligence. The standing … Continue reading →

Posted in Humour | Leave a comment

JUST GET YOUR SCALPEL

Posted on December 15, 2011 by K

The Fourth National Audit Project of The Royal College of Anaestetist and Difficult Airway Society (NAP4) has supplied us with an unique opportunity to analyse our airway management practices. Some of it touches on things recently talked about on this blog. … Continue reading →

Posted in Airway management | Leave a comment

CHEST X OFTEN USELESS IN TRAUMA CALLS

Posted on December 14, 2011 by K

ATLS says we should get chest x-rays for all trauma patients. That is likely to be just a waste unless we have specific findings suggesting actual chest injury.  This study looks at 1008 blunt trauma patients who were hemodynamically stable and … Continue reading →

Posted in Trauma | 1 Comment

IOIOIOIOIOIOIO!

Posted on December 13, 2011 by K

We aren’t taking intraosseus needle techniques seriously enough. Despite their record of speed, safety and ease of use they are still considered a mere handy back up to use after failed IV cannulation. What will it take for them to … Continue reading →

Posted in Anesthesia, Emergency Medicine, Prehospital Medicine, Tech | Tagged | 2 Comments