Category Archives: Anesthesia

SONA – SIDE OF NECK ACCESS

How’s this for thinking outside the box in the approach to the difficult airway!? Difficult airway algorithms and advanced management options for difficult airways mostly concentrate on getting into the trachea. But what happens if getting into the trachea is … Continue reading

Posted in Airway management, Anesthesia, ECMO | 1 Comment

OWN THE O.G.

Passing the orogastric tube can be difficult or sometimes impossible. Unfortunately a lot of patients really need their OGs and in a time-critical scenario you don’t want to spend too much time struggling with it. Here is a simple trick a senior … Continue reading

Posted in Airway management, Anesthesia, Emergency Medicine, Intensive Care, Prehospital Medicine, Uncategorized | 6 Comments

IO DRUGS AS QUICK AS IV

IO needles are always said to be able to deliver any drug, and with the same speed and onset as their IV cousins – also in critical patients. Most of use don’t really trust that fully, I think. The ones … Continue reading

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

PERIPHERAL NORADRENALINE

Peripheral noradrenaline (or norepinephrine), or any peripheral pressor, is shunned in many centers. High doses can cause gangrene. If extravasated, it can cause tissue necrosis. But is this a big risk? Also, weighing against the risks of CVC or delayed … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care | 6 Comments

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:

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STEWART’S ACID TRIP

Acid-base calculations. The ones that make my head hurt. Every time I read up on it, I seem to almost grasp it and get a deeper understanding – which slips away slightly after a week or two. And a few … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care | 2 Comments

PROVHILO – IT’S INDIVIDUAL

New RCT on intraoperative ventilation strategies is out: PROVHILO. Low tidal volume ventilation (LTVV) has been settled as the way to go, but what about PEEP and recruitment maneuvers? Wouldn’t high PEEP and regular lung recruitment make sense in patients … Continue reading

Posted in Anesthesia | 4 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

QUOTE OF THE MONTH

“Damage control resus can help avoid damage control surgery” – Karim Brohi, smaccGOLD.

Posted in Anesthesia, Emergency Medicine, Trauma | 1 Comment

CODE BROWN: EMERGENCY SURGICAL AIRWAY REVISITED

I lost my cric virginity to a man on a beach in Australia. The story told here. After this, I’ve been looking into making crics simpler and safer. Talking to colleagues, reading articles, practicing on cadavers and animals – not … Continue reading

Posted in Anesthesia, Emergency Medicine | 8 Comments