Category Archives: Uncategorized

TBS18, ZERMATT – Feb 7-9 2018

We have worked hard this year on something big that is due to kick off in February next year: TBS18, The Big Sick Conference – a small, social critical care conference with top speakers and deep medical engagement in the amazing alp village … Continue reading

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IMAGING CASE OF THE WEEK

Oxygen can be a real idiot sometimes… via @medschooladvice

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NOSE CLIPS MAY NOT BE THE WAY FORWARD IN MASK VENTILATION AFTER ALL

An small but elegant experimental study in CJA explores the impact of nasal passage occlusion on mask ventilation in the unresponsive patient. Tidal volumes may be reduced by more than half when the nose is totally occluded.

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IMAGE OF THE WEEK – AORTIC STENOSIS

One of the most immediate ways to understand aortic stenosis, and how it affects blood pressure and the heart, is by watching a Transcatheter Aortic Valve Implantation (TAVI) procedure. Catheters are placed in both the left ventricle (LV) and the … Continue reading

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GCS IN OLD PEOPLE

We traditionally use GCS to triage patients who sustained traumatic brain injury. Some previous studies have reported how the accuracy of using GCS decreases with increasing age. Specifically, the elderly present with a higher GCS than younger patients when suffering the same injury. … Continue reading

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BP MANAGEMENT IN BRAIN BLEEDS – ATACH 2

 A trial called ATACH-2 (Antihypertensive Treatment of Acute Cerebral Hemorrhage II), recently published in NEJM, is likely to temper the enthusiasm for aggressively lowering blood pressure in patients with intracranial bleeds.

Posted in Emergency Medicine, Neurology, Uncategorized | 1 Comment

UNDERESTIMATING BLEEDING

Some years ago, while working for an air ambulance, me and an experienced paramedic responded to a pedestrian-vs-car accident. A young female was out driving when she had a flat tire. As she opened the rear compartment to get the spare tire, a second … Continue reading

Posted in Prehospital Medicine, Trauma, Uncategorized | 2 Comments

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