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In response to the uncertainty of which route is better for drug administration in Out-of-Hospital Cardiac Arrest (OHCA) ie., intraosseous (I/O) or intravenous (IV), "we conducted the...
This study looked at the use of intraosseous (I/O) versus intravenous (IV) routes for drug administration in out-of-hospital cardiac arrest (OHCA).
Advanced Life support guidelines require the...
Hypertensive emergencies are defined as sudden and prolonged increases in the arterial blood pressure, with associated organ damage. The degree of increase above that which the patient normally...
I would consider intubation of the neonate(<28 days old) to be a very stressful event. This is not only because the size of the patient makes it technically potentially more difficult, but...
This week we have a podcast with special guest Dr Will Davies, who takes us through a recent interesting case he had of exertional heat stroke. Below is a rapid summary of exertional heat stroke.
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Rapid sequence intubation can be associated with peri or post intubation hypotension and in a small group of patients, cardiac arrest. In the lecture on Resuscitative sequence intubation (July 2024...
Cervical spine injuries in children are uncommon and radiation risk from CT scans can be significant. We don’t have specific paediatric prediction rules for potential cervical spine injuries...
Post Intubation hypotension has been linked to induction agents, although the studies for this are few. It is moreso related to age and Shock Index. In a registry-based study there was no...
The Use of Ultrasound in Cardiac Arrest: An Interview with Professor Paul Middleton.
The use of ultrasound in cardiac arrest has increased significantly. The false belief that we need to be ECHO...
Right Ventricular(RV) failure presents a significant challenge in the emergency department. It can affect our resuscitative efforts. The only way to diagnose it is with echocardiography. That may...
There is a significant difference in Out of Hospital Cardiac Arrest (OHCA) survival, in the order of 10 to 20 times, between non-shockable(2% survival) and shockable rhythms(25-50% survival) (1).
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When an infant of <60 days of age presents with skin lesions such as pustules or vesicles and there is a fever, there are algorithms that we can use to predict the chance of a serious bacterial...
I recently had the pleasure of speaking to Dr Ben McKenzie, Emergency Physician and researcher into anaphylaxis. Ben has developed the AMAX 4 algorithm. The AMAX4 algorithm gives a cognitive aid to...
A patient is brought to the emergency department with a complaint of central pressing chest pain. The patient's ecg is shown below. Is this QRS fragmentation (QRSF) and what does that mean?
It has...
Adrenaline is recommended for all cardiac arrests not due to shockable rhythms and is associated with increased survival, especially if given in the first 10 minutes post arrest (1).
The rate...
The rates of Pulseless Electrical Activity (PEA) in out of hospital cardiac arrests (OHCA) is rising, however survival from PEA is low. The majority of survivors from OHCA have an initial rhythm of...
When you're suspicious of entrapment in an orbital floor blowout fracture following trauma, you ask your patients to look up, to check for diplopia. Do you cardiac monitor them when you do...
How do you manage the patient in Status Epilepticus? Dr Michael takes us through the treatment of status epilepticus in this Clinical Podcast. 30% of patients have refractory status epilepticus....
The ambulance phone rings. They are 5 minutes away with a 32 yo patient with history of asthma who has had two hours of shortness of breath and wheeze. She has a heart rate of 120bpm, a...
A 62 yo patient with a previously diagnosed spontaneous coronary artery dissection (SCAD) presents with sudden onset 10/10 central severe chest pain. Examination is normal, with no pulse deficit...