Author Archives: K

‘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 … Continue reading

Posted in Prehospital Medicine, SAR | Leave a comment

CODE BROWN: AHHH…THE OLD SCANCRIT SWITCHEROO…

Someone once said that ‘an esophageal intubation is no sin, but there is great sin in not recognizing such a placement‘. What’s that about? I intentionally intubate the esophagus and I demand recognition for it.

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

SC BETTER THAN IC

A study in AJEM compares ultrasound visualisation of the subclavian vein using the supraclavicular and infraclavicular approaches.  With the increasing dominance of procedural ultrasound in central vein cannulation, perhaps there will be a shift towards supraclavicular cannulation at the expense … Continue reading

Posted in Ultrasound, Uncategorized | Leave a comment

E-POINT SEPTAL SEPARATION

A paper in AJEM describes a way to quickly assess left ventricular function that I wasn’t too familiar with. By measuring the distance between the anterior mitral valve and interventricular septum we can roughly assess the heart’s ejection fraction.

Posted in Cardiology, Emergency Medicine, Ultrasound | 4 Comments

MEGAN’S SONG

There is an important article about intubation in EMSWorld. It is about a prehospital intubation gone terribly wrong. It is essential reading for all of us who manage airways outside or inside hospitals. Read it here.

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ETT DEPTH CONFIRMATION BY TRACHEAL PALPATION

A study in Can J Anesth looks at the accuracy of confirming endotracheal tube position by palpating the sternal notch.

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LET´S NOT EVER HAVE THAT DISCUSSION AGAIN

Most of us know this so just a quickie post about ketamine and ICP. Two recent papers. First, this meta-analysis lives here. Second, this systematic review lives here:

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

DEATH TO THE YELLOW CATHETER OF DEATH

It’s not news but I recommend you read Paul E Marik’s review of the Pulmonary Artery Catheter (PAC) from Annals of Intensive Care 2013. Basically he tears the whole thing apart, writes an obituary and suggest we make it a … Continue reading

Posted in Cardiology, Intensive Care | Leave a comment

MANUAL AORTIC COMPRESSION

There´s an interesting case report in Annals of Emergency Medicine. It describes a case where massive bleeding from the lower abdomen and pelvis was successfully stopped by a burly first responder who applied manual aortic compression.

Posted in Emergency Medicine, Trauma | 6 Comments

NOT SO IMPRESSIVE CICV MANAGEMENT

The outcomes from a Canadian questionnaire study of anaesthetists preferences in difficult airway management is disappointing. When faced with establishing an airway in cannot-intubate-cannot-ventilate scenarios, the majority would go for  seldinger- or needle-techniques ie one of the ready-made kits.

Posted in Airway management, Anesthesia, Emergency Medicine | 2 Comments