Category Archives: Anesthesia

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 | 6 Comments

CSF TESTING TESTING

If you’re doing a spinal tap or a spinal anaesthesia, and you’re not 100% sure if you’ve got CSF, one quick tip for checking is using yellow chlorhexidine, coloured by phenol red. If the fluid from your needle changes the … Continue reading

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LONG TERM CRICS ARE SAFE

Cricothyroidotomy is the go-to option for emergency surgical airway at the end of a can’t intubate, can’t ventilate scenario. It feels like an extreme measure in a pressing situation, and we’ve also been loaded with the impressions that crics are … Continue reading

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BEST OF 2013

Another year comes to an end. So here’s a selection of posts from 2013. Not sure if it’s the best of ScanCrit 2013, but these are some of the posts that’s gotten the most clicks and discussion, and some we … Continue reading

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IMPROVE YOUR VENTILATION

The IMPROVE group’s trial on Intraoperative Low-Tidal-Volume Ventilation in Abdominal Surgery published in NEJM are supporting lung protective ventilation (LPV). Just as was found in the JAMA 2012 meta-analysis. The IMPROVE trial emphasises that it’s not just low tidal volumes, … Continue reading

Posted in Anesthesia | 4 Comments

ULTRASOUND AND TUBE POSITION

A study in critical ultrasound journal demonstrates how tracheal ultrasound is almost as good as end-tidal CO2 monitoring for verifying ET-tube position. 

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

CENTRAL VS PERIPHERAL PRESSURE

Monitoring of a patient in severe septic shock and with high dose pressor infusions. We happened to have two intra-arterial blood pressures, shown as the red tracings and numbers on the monitor. A central pressure from a PiCCO line in … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care | 10 Comments

OXYGEN, ATELECTASIS AND ANAESTHESIA

An interesting review article called Oxygen and anesthesia: what lung do we deliver to the post-operative ward? challenges much of the usual anaesthetic practice. We love 100% FiO2 for induction and extubation to get longer apnea times – but what … Continue reading

Posted in Anesthesia | 3 Comments

RINGER’S A LOUSY VOLUME EXPANDER

With colloids being miscredited by Cochrane and synthetic colloids being hammered by RCTs, it might seem we’re left with crystalloids. So how good is our standard crystalloid, Ringer’s Lactate, at volume replacing a volume depleted patient? This study withdrew blood … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care | 5 Comments

ULTRASOUND FOR SPINALS AND EPIDURALS

This is a well known, but fairly novel use of ultrasound. Certainly not standard in any place I’ve worked. But ultrasound for epidurals and spinals seems to be in vogue. Here’s a meta-analysis on ultrasound for spinal and epidural access. … Continue reading

Posted in Anesthesia, Ultrasound | 2 Comments