Category Archives: Uncategorized

HEAD-UP INTUBATION

In anaesthetics we are trained to pre-oxygenate and intubate our theatre patients in a flat supine position. Then, when we graduate to intubating the really gnarly ICU/ED patients in severe heart or respiratory failure, we wise up. A paper in Anaesthesia & Analgesia demonstrates how patients who … Continue reading






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SHOCK LIVER AFTER CARDIAC ARREST

Interesting paper in AJEM. Hypoxic hepatitis (HH), ‘shock liver’, is defined as an increase in serum aminotransferase levels (20 times the upper normal level) after respiratory or circulatory failure. It is commonly seen in critical illness and after cardiac arrest. In … Continue reading






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BP MANAGEMENT IN BRAIN BLEEDS

There´s a nice Best BET mini review in EMJ April 2016. The authors ask if it is safe and beneficial to control hypertension in the acute/hyperacute phase (~<6h from presentation) in patients with acute intracerebral haemorrhage.






Posted in Emergency Medicine, Intensive Care, Neurology, Prehospital Medicine, Uncategorized | 1 Comment

FLUID RESPONSE – SMACC DEBATE

This was one of my favourite SMACC CHICAGO debates: “Predicting Fluid Responsiveness is a Waste of Time” on fluid management, Rob MacSweeney pokes at the fluid response hero/enfant terrible Paul Marik. Great points by both, and Rob’s cartoon is epic! … Continue reading






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ONSD NORMAL VALUES

Optic Nerve Sheath Diameter (ONSD) on ultrasound has been used to identify patients with high intracranial pressure. ONSD threshold measurements for high ICP range from 5 to 6mm. Unfortunately there´s not really been any reference values. A study in Journal of … Continue reading






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HITCHEN´S RAZOR

“What can be asserted without evidence can be dismissed without evidence.”  






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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

ON BEING A JERK

Quickie post about an interesting paper I found. Now there is actual evidence of how being a jerk negatively impacts on team performance. An Israeli paper looks at how being exposed to rudeness affects teams in emergent situations.






Posted in Emergency Medicine, Medical teaching, Paediatrics, Uncategorized | 1 Comment

SMACC DUB 2016 JUNE 13-16

After a fantastic SMACC conference in Chicago this Summer, preparations for next year’s SMACC in Dublin is well under way. As a conference for Social Media And Critical Care, the SMACC conference is not just an update on cutting edge … Continue reading






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CRACK THE CHEST – GET CRUCIFIED

This is John Hinds. Recorded at the fantastic SMACC Chicago conference, June 24th 2015. Also, if you do any ICU stuff, go over to EMCRIT at this link and listen to John’s brilliantly provoking ICU talk. This is sheer genius … Continue reading






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