Author Archives: K

HUNGARIAN APNOEIC OXYGENATION

Apnoeic oxygenation in anaesthesia is the concept of providing oxygenation without ventilation. The idea is that even without lung expansion, oxygen will passively be dragged into the alveoli along the oxygen gradient caused by alveolar oxygen being transported away by the bloodstream. … Continue reading

Posted in Airway management, Prehospital Medicine | 7 Comments

PREHOSPITAL EXTRICATION TIMES

Car accidents with trapped victims can be incredibly frustrating. There is often very little one can do until the rescue services achieve extrication. Sometimes, because of limited patient access, all you can achieve during extrication is some very basic airway management, pain … Continue reading

Posted in Prehospital Medicine, Uncategorized | 3 Comments

THUNDERSTORM ASTHMA

I always thought ‘thunderstorm asthma’, localised epidemics of asthma associated with thunderstorms, was semi-factoid.  Not so.  Apparently, thunderstorms do cause asthma spikes in asthma ED attendance. This is elegantly shown in a recent Emerg Med J.

Posted in Emergency Medicine | 1 Comment

SCARY ARTERIAL AIRWAY DRAMA

Found an interesting case report in intensive care med. It describes a case where an anaesthetist found a pulsating mass in the lateral wall of the oropharynx. MR revealed the patient’s internal carotid artery was kinked, aberrant and indented way into … Continue reading

Posted in Airway management | 2 Comments

LATERAL VIEW OF THE AORTA

We normally visualise the aorta on ultrasound by scanning down the midline. However, we frequently fail to visualise the entire aorta. The view is often obscured by bowel gas. Abdominal pain often makes the examination intolerable. A small proof-of-concept study in … Continue reading

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

EARLY VS LATE INTUBATION OF BURNS

We are taught to intubate victims with inhalational injury early. If we delay for too long the tongue, epiglottis and other structures can swell and cause airway obstruction, forcing an emergency intubation that is more likely to be difficult or failed. A … Continue reading

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‘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 | 5 Comments