Category Archives: Anesthesia

BCheE

I found an editorial in BJA that describes an issue with succinylcholine I wasn’t really aware of. Butyrylcholinesterase (BCheE) hyperactivity. BCheE is the non-specific cholinesterase that rapidly hydrolyses succinylcholine in the blood so that only 10% of the injected drug … Continue reading






Posted in Airway management, Anesthesia, Emergency Medicine | Leave a comment

DIRECT LARYNGOSCOPY KILLED THE VIDEO STAR?

Videolarygoscopy (VL). Brave new world. VL makes any intubation easy, and solves airway managment problems. Well, it can be a life-saver, but it also brings its own set of problems. Two new RCTs comparing VL and DL are just out. … Continue reading






Posted in Airway management, Anesthesia, Emergency Medicine, Prehospital Medicine | 4 Comments

ULTRASOUND – FASTING FOR SURGERY

We’ve held on to our strict fasting regimes for decades. Gastric ultrasound is here to help us individualise our fasting rules a bit more. Gastric ultrasound has lots of uses, and lately it’s become fashionable to use it for evaluating … Continue reading






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PROPOFOL + LIDOCAINE = MAGIC

Propofol is a great anaesthetic – but it can cause pain on injection. This is one of the tricks of the trade: mix in some lidocaine in your propofol syringe, and the patient is pain free. Sounds like magic. Especially … Continue reading






Posted in Anesthesia | 8 Comments

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 | 8 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 | 8 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