Coda Change

Daniel Lichtenstein wants to make his past your future. Join him on a journey through the history of lung ultrasound in critical care and resuscitation. The scene is over 20 years ago in the desert of Mauritania. It is a noisy environment full of trucks and planes and motorbikes whipping up sand in a frenzy. You are attending a chest trauma and suspect a pneumothorax. However, in this chaotic envi...

Emotion has a profound effect on decision-making. Chris Hicks demonstrates this as he discusses medical simulation and its ability to teach us skills to manage challenging emotions. As scientists and rational beings, we like to believe that we can control our emotions and make good decisions regardless of the context in which those decisions must be executed – The reality is, that is far from the...

Doctors are usually the ones who rule the resuscitation. They are the ones in charge, the boss, the person giving all the instructions. By design, doctors rule the resus. But what if they didn't? In order to optimise teams to be seamlessly effective at resuscitation, we need to change the way that resuscitation is done. We need to challenge healthcare to embrace a new model. Ashley Liebig proposes...

Haemostatic resuscitation of haemorrhagic shock by Wolfgang Voelckel Haemostatic resuscitation of haemorrhagic shock is an area great leaps forward can be made, as Wolfgang Voelckel discusses. Exsanguination and brain injury are the leading causes of death after major trauma. During the last decades, significant progress has been made in the fight against haemorrhage. Nevertheless, the window of o...

A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social work, women in medicine, medicine in the developed work, and the health of healthcare workers. It should be novel, it may get heated, and it is not scripted. Sometimes to comfort the afflicted you also need to afflict the comfortable. This is why no prisoners wil...

Leanne Hartnett is a massive fan of bedside ultrasound. Here, she tells a story of using ultrasound for the diagnosis of acute pulmonary embolus and the decision-making process for management. This is the story of a 65-year-old man who was brought into the Emergency Department with acute shortness of breath and chest tightness. This was on a background of motor neuron disease, due to which he was...

The arrested heart surgery patient is a unique beast in surgery and critical care. Dr Nikki Stamp gives a whirlwind tour of post cardiac surgery resuscitation. She will discuss how to spot the potential arrest, how to manage it and some special situations to be aware of in this special group of patients Post cardiac surgery resuscitation is complex. Nikki describes them as "brown trouser moments"....

Management of Status Epilepticus in Neuro Critical care Brandon Foreman talk about the management of status epilepticus in neuro critical care. What are seizures? Why is this important? There are 1 million ED visits due to seizures every year with a quarter getting admitted to the hospital. 1 in 10 people will have a seizure in their lifetime. It is common. Status epilepticus is defined as seizure...

Maaret Castren passionately delivers her take on how to improve outcomes from out-of-hospital cardiac arrests. Maaret brings resuscitation back to the basics. Using science, education and local organisation factored together, we can drastically improve the chance of survival in out-of-hospital cardiac arrest. Currently, the best systems in the world only garner 20% survival rates in these situatio...

Resuscitation is complicated, but the solutions don't have to be. Chris Hicks brings you four psychological strategies that will help you manage complex resuscitations. It is a fascinating time to be a resuscitationist with ROBOA, ECMO and EPR. Chris explains that as we learn more about critical illness, we learn more about the complexities of resuscitation. Therefore, we need ways to manage and c...

Neurologic airway manipulation is unforgiving; errors lead to hypoxia and secondary injury. Managing the airway with an eye towards success, the first time, every time, without allowing sats to drop below 90% is the holy grail of neuro airways. Selection of RSI techniques, DSI techniques, and pharmacologic management is critical for success. The TBI airway with ICP issues and the post tPA airway p...

Interprofessional issues in critical care Meeting of the Tribes brings together clinicians from a broad range of health professions, including medicine, nursing, social work and physiotherapy, to explore interprofessional issues in critical care. In addition to their clinical work, panelists have unique perspectives on education, simulation and resilience in healthcare. In discussing issues relate...

Ronan O'Leary discusses reversing coagulopathy in traumatic brain injury. The PATCH trial was a trial look at the use of platelets to reverse the effects of aspirin and clopidogrel in patients with spontaneous cerebral haemorrhage. Ronan asserts that overall platelets are harming patients. Through his talk he highlights many studies that have been inconclusive about the benefits of giving platelet...

Moderate panel discussion on FOAM Open Access Medical Publishing Data sharing

The door to needle time for acute stroke in Critical Care is a key variable when striving for good outcomes. Rhonda Cadena answers the question - Who should pull the trigger on tPA for acute ischemic stroke? Medical management of acute strokes has changed dramatically over the years. We used to rely on clinical exams for diagnosis, prescribe strange medications and undertake interventions that wer...

Claire Park delivers a riveting talk, bringing military trauma lessons from MERT (Medical Emergency Response Team) back home. Claire tells two stories from her tours in Afghanistan. The first begins in the early hours of the morning when the MERT team is tasked on a job. They receive word of five casualties including two above knee amputations and one unconscious without a radial pulse. On arrival...

Join the debate between Bill Knight and Fernanda Bellolio as they go head-to-head, discussing diagnosing subarachnoid haemorrhage in neuro critical care headache. Should you rely on CT and lumbar puncture or, CT followed by CT angiogram. Why should you care? Acute headache accounts for 4% of all visits to the emergency departments. These patients will often describe the "Worst headache of life" –...

Prehospital high acuity transport by air rescue has the capability to deliver the sickest of patients to high quality, advanced care, and support. However, not all patients are transferred. Why? Per Bredmose tells the tale of Emma. Emma is a 12-year-old girl who developed a cough. She is admitted to local peripheral hospital, correctly diagnosed with pneumonia, and treated with IV antibiotics. Emm...

Dr Suman Biswas is a UK based anaesthetist known for his musical talents. He and a fellow medical student began performing hilarious medical parody songs, perhaps the most famous is his 'London Underground song'. The two students were catapulted to fame as the "Amateur Transplants" but sadly parted ways in 2011. Suman works full-time as an NHS EnglandAnaesthetist. Here he performs live on-stage at...

Clare Richmond discusses medical simulation and its ability to provide a safe working environment anywhere. Simulation is a tool which allows us to rehearse our skills and scenarios before they happen in real life, to real people, our patients. Many clinicians dislike simulation, they know it is good for them, but find it challenging to drop into a world of manikins, fear performing in front of th...

Michelle Johnston presents her thoughts on acute myocardial infarction, thrombolysis and haemorrhage. She delves into David Foster Wallace, evolution, and what do when the thrombolysis bisque hits the fan. Michelle's interest into acute myocardial infarction, thrombolysis and haemorrhage began one day when she received a call from a peripheral hospital. A local farmer has presented to the Emergenc...

A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social work, women in medicine, medicine in the developed work, and the health of healthcare workers. It should be novel, it may get heated, and it is not scripted. Sometimes to comfort the afflicted you also need to afflict the comfortable. This is why no prisoners wil...

For Trish Henwood, ultrasound use in resource limited settings is a perfect fit. Nowhere has Trish seen ultrasound have more of an effect on patient care and outcomes, and save more lives, than in resource limited contexts. Trish uses the example of a training program in Zanzibar to highlight the scope that ultrasound provides. Using ultrasound on a daily basis to the medical centre is able to scr...