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A blog on anaesthesia, intensive care and emergency medicine. In-hospital and outside. Mostly focusing on the critically ill patient. Written by two Scandinavian senior anaesthetic registrars.
This is our way of keeping log of articles and interesting things we come across in our work and on the internet. Should any of you out there stumble across this blog and find it useful then all the better.
Please leave comments or questions if you have any. The best way to keep learning is to keep the conversation going.
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Author Archives: K
We traditionally use GCS to triage patients who sustained traumatic brain injury. Some previous studies have reported how the accuracy of using GCS decreases with increasing age. Specifically, the elderly present with a higher GCS than younger patients when suffering the same injury. … Continue reading
A paper in EMJ compares various methods for performing field amputations. I can’t say I ever had to do one myself. However, some of the people I work with have performed amputations on rapidly deteriorating entrapped trauma victims. Most them have relied on the … Continue reading
A trial called ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage II), recently published in NEJM, is likely to temper the enthusiasm for aggressively lowering blood pressure in patients with intracranial bleeds.
Some years ago, while working for an air ambulance, me and an experienced paramedic responded to a pedestrian-vs-car accident. A young female was out driving when she had a flat tire. As she opened the rear compartment to get the spare tire, a second … Continue reading
A fascinating case report was recently published in Resuscitation. A young female speleologist was avalanched in the polish Tatra mountains. As she had access to an air pocket and some degree of ventilation she didn’t to succumb to the asphyxiation … Continue reading
In anaesthetics we are trained to pre-oxygenate and intubate our theatre patients in a flat supine position. Then, when we graduate to intubating the really gnarly ICU/ED patients in severe heart or respiratory failure, we wise up. A paper in Anaesthesia & Analgesia demonstrates how patients who … Continue reading
Interesting paper in AJEM. Hypoxic hepatitis (HH), ‘shock liver’, is defined as an increase in serum aminotransferase levels (20 times the upper normal level) after respiratory or circulatory failure. It is commonly seen in critical illness and after cardiac arrest. In … Continue reading
There´s a nice Best BET mini review in EMJ April 2016. The authors ask if it is safe and beneficial to control hypertension in the acute/hyperacute phase (~<6h from presentation) in patients with acute intracerebral haemorrhage.
Optic Nerve Sheath Diameter (ONSD) on ultrasound has been used to identify patients with high intracranial pressure. ONSD threshold measurements for high ICP range from 5 to 6mm. Unfortunately there´s not really been any reference values. A study in Journal of … Continue reading
The absence of of pain has even been used to differentiate between partial and full thickness burn injury. Traditional teaching is that full thickness burns are painless due to the cutaneous nerve endings being destroyed. A paper in AJEM suggest it´s … Continue reading