Monthly Archives: March 2012

BATTLING BAD SCIENCE

A TED talk by epidemiologist Ben Goldacre, who hasn’t been taking his Ritalin lately. He’s quite entertaining, and during the second half of the talk, he also gets quite serious. Have a look.

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CODE BROWN: TENSION PNEUMOTHORAX

We were in the ICU working on a intubated septic patient and had just managed to stabilize his hemodynamics.  Then one of the  nurses noticed how the tidal volumes on the ventilator were decreasing. Blood pressure and sats dropped gently … Continue reading

Posted in Cases, Code Brown, Emergency Medicine, Intensive Care, Prehospital Medicine | 10 Comments

KETAMINE ADVERSE AIRWAY EVENTS

How common are apnoea and bronchospasms when using ketamine?  In 2008 Annals of Emergency Medicine published a huge meta-analysis of airway and respiratory adverse events in paediatric ketamine sedation. They identified more than 30 studies and ended up with a … Continue reading

Posted in Anesthesia, Emergency Medicine, Paediatrics, Prehospital Medicine | Leave a comment

MIDAZOLAM REDUCES INCIDENCE OF KETAMINE AGITATION BY TWO THIRDS

While looking for references for a talk on ketamine, I found a study on emergence phenomena. One aspect of emergence phenomena is the state of emotional distress, the nightmare or simply the bad trip that sedated patients risk being trapped … Continue reading

Posted in Anesthesia, Emergency Medicine, Prehospital Medicine | Leave a comment

WHAT´S A HIGH LACTATE?

Lactate is a very important marker in critical care. It’s very useful as a measure in trauma patients, septic patients and other critical care patients, high values indicating inadequate oxygen delivery to tissue. This is also naturally occuring in healthy … Continue reading

Posted in Emergency Medicine, Intensive Care, Miscellaneous | 3 Comments

ROBOT SEES ITSELF FOR THE FIRST TIME

This is cool. Strangely sad too.

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THE BAILEY MANOEUVRE FOR DEEP EXTUBATION

The Difficult Airway Society are taking extubations seriously. They recently issued extubation guidelines. One of the advanced methods for extubation they mention is the Bailey Manoeuvre. While not exactly news, it is something I will consider incorporating into my own anaesthetic … Continue reading

Posted in Airway management, Anesthesia | Leave a comment

PARACETAMOL IV OR ORALLY

Just a quickie. A study compares paracetamol plasma concentrations after intravenous and oral administration. Day-care surgery patients were randomised into receiving 1g Paracetamol either orally 30 mins before anaesthesia or intravenously 1 minute before anestesia.

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

THE SIX MILLION DOLLAR MAN

Extra Corporeal Membrane Oxygenation or ECMO is more and more referred to as Extra Corporeal Life Support or ECLS, due to it being used more and more as a V-A system, supporting the circulation as well as the respiration. There … Continue reading

Posted in Anesthesia, ECLS, ECMO, Intensive Care | 3 Comments

EXTREME SPORTS, RISK AND MICROMORTS

Living is dangerous. We’re all dying, but most of us strive to stay alive for as long as possible. Still, many of us want to explore and experience as much as we can in this time. This often puts us … Continue reading

Posted in Statistics, Wilderness Medicine | 2 Comments