Monthly Archives: June 2012

ESTIMATING SYSTOLIC PRESSURE VARIABILITY

A study in Anesthesia Analgesia 2012 describes how to visually estimate Systolic Pressure Variability (SPV) without relying on automated calculations of a monitoring system. How does a visual estimate compare to values calculated by the PICCO? Can we ‘manually’ estimate … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care, Uncategorized | 3 Comments

INTRANASAL REMIFENTANIL

There was a discussion I had the other day where intranasal remifentanil came up. It turned out they meant sufentanil. But it got me curious, and a PubMed search did of course turn out a study where remifentanil has been … Continue reading

Posted in Anesthesia | 2 Comments

CAPNOGRAPHY IN CARDIAC ARREST

A recent study in Resuscitation explores end tidal CO2 measurements in cardiac arrest patients. The authors try to identify what impact various factors have on the numbers you see on your screens. They discuss what implications this could have for … Continue reading

Posted in CPR, Emergency Medicine, Prehospital Medicine, Uncategorized | 2 Comments

TRACHEAL FLAPS AFTER TRACHEOSTOMIES

In Anesthesiology june 2012 there is a case report describing a rare complication after tracheostomy. It describes the creation of an obstructing mucosal flap as sequele after a percutaneous dilatational tracheostomy. As long as the patient was cannulated the flap … Continue reading

Posted in Airway management, Intensive Care | Leave a comment

DOUBLE-UP NON-OPIOID PAIN MANAGEMENT

Most of us tend to underdose our patients with paracetamol (acetaminophen) and NSAIDs, and then just top up the opioids afterwards. Both non-opioid drug classes have a huge safety window, especially for short term treatment. With no present contraindications, I … Continue reading

Posted in Anesthesia | 2 Comments

OBSTETRIC EPIDURAL

From the Danish duo Wullfmorgenthaler. Being Danish, they’re not always SFW. And often just bizarre and weird. But sometimes very funnny. This one helps me get through my obstetric night shifts, with their commotio cerebri regimen pager calls (i.e., about … Continue reading

Posted in Humour | 1 Comment

DR. POPSICLE AND THE RULE OF 1-10-1

We love this guy. Dr Gordon Giesbrecht. Professor at the university of Manitoba. He studies human physiology and our responses to extreme environments. He has done some groundbreaking work in cold-stress physiology and prehospital care in hypothermia. He is one … Continue reading

Posted in Prehospital Medicine, SAR, Wilderness Medicine | 5 Comments

CONTINUOUS INTERCOSTAL NERVE BLOCK

Isolated rib fractures in healthy young patients is most of the time no big deal. In other, more vulnerable, patients they can be lethal or significantly contribute to morbidity. A study in J Trauma dec 2011 suggests continuous intercostal nerve … Continue reading

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

SNPeCPR

Survival rates after cardiac arrest are depressingly low and have only marginally improved, if at all, since the fifties. It is not all gloom though. A study in Resuscitation 83 (2012) is testament to how there is some thinking going … Continue reading

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