Author Archives: K

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

COPD ICU MORTALITY

In intensive care, we are often called to deal with marginal or crashing COPD patients. Often, we end up intubating them. Then, in the morning rounds there always seems to be at least one passive-aggressive (†) colleague in the back, shaking … Continue reading

Posted in Airway management, Intensive Care | 1 Comment

PNEUMONIA AND ED ULTRASOUND

A study in AJEM sets out to compare diagnostic accuracy between chest x-rays and lung ultrasound for diagnosing pneumonia. Other recent ED studies have consistently shown how lung ultrasound outperforms chest x-rays when diagnosing pneumonia.

Posted in Emergency Medicine, Ultrasound, Uncategorized | 5 Comments

ECMO OUTCOMES IN ACCIDENTAL HYPOTHERMIA

In accidental hypothermic cardiac arrest we are to continue CPR until the patient has been rewarmed to around 34. If available, and appropriate, these patients are to be transferred to a hospital with ECMO capability. ECMO is the most efficient … Continue reading

Posted in ECMO, Prehospital Medicine, SAR | 1 Comment

PRIAPISM AFTER SPINAL CORD INJURY

While the rest of the #FOAMed world went away to fight in the great Cricoid Pressure war, I discreetly retired to my library in order to study the male erection.

Posted in Emergency Medicine, Prehospital Medicine, Trauma, Uncategorized | 7 Comments

THE MOTTLING SCORE

Several methods have been developed for identifying and quantifying microcirculatory dysfunction in septic shock. We can measure buccal, sublingual and subcutaneous microcirculatory CO2-levels. Near infrared spectroscopy (NIRS) measures microcirculatory hemoglobin saturation. Sidestream dark field (SDF) imaging directly visualises the microcirculation. … Continue reading

Posted in Emergency Medicine, Infectious diseases, Intensive Care | Leave a comment

THAT’S HOW I (WAS) ROLL(ED)

We try to avoid putting personal stuff on this blog, but my personal observations from being a trauma patient fits too well with Thomas D’s righteous rant about logrolls a few days ago. He wrote about how the logroll, as a … Continue reading

Posted in Emergency Medicine, Prehospital Medicine | 2 Comments

SEPSIS PROGRESS

The PROCESS and SEPSISPAM studies were serious blows to protocol EGD therapy in sepsis. With all the other dead ends we pursued (activated protein C, colloids, intensive insulin therapy, cortisone and what not) it is tempting to think that little … Continue reading

Posted in Infectious diseases, Intensive Care | Leave a comment

OPEN CHEST COMPRESSIONS IN MEDICAL CARDIAC ARREST

Despite all the thousands of man-hours and gazillions of money going into researching stuff like therapeutic hypothermia and adrenaline in cardiac arrest we really haven’t got the breakthrough we deserve. With the exception of pockets of excellence, ROSC rates have been … Continue reading

Posted in CPR, Emergency Medicine, Prehospital Medicine | 9 Comments

PRESSOR DOSES AND PROGNOSTICS

Just a short post. In fact, I am writing these first two sentences just to make the post somewhat longer. Anyway, a paper in Journal of Critical Care makes vasopressor infusion doses less abstract. The authors correlate adrenaline and noradrenaline … Continue reading

Posted in Intensive Care, Uncategorized | 6 Comments