The Resus Room

Debrief is an extremely important topic both in the prehospital and in-hospital environment. It offers the opportunity to clarify, reflect and improve on future practice. But partaking in and running a debrief can be challenging. So in this episode we'll be exploring debrief in a lot more detail. We'll be covering both hot and cold debriefs, frameworks for debriefing and tips on what works well, a...

Welcome back to March '22 Papers Podcast! This month we have a think about causes and coping strategies for Emergency Clinicians involved in stressful cases; what can trigger us and more importantly what can we do to mitigate these circumstances? In our other two papers we have a think about ECMO-CPR and Resuscitative Thoracotomy, both relatively low frequency but high skill interventions. The pap...

So in our last Roadside to Resus episode we covered narrow complex tachycardias. In that we delved pretty deep into the normal cardiac conductance along with the clinical assessment and their management. This episode is going to build on some of that…so if you haven't already given it a listen, we'd recommend you pause here, take a listen….and then come back on board!!  But for those of you that h...

This month we've got three papers covering a wide variety of topics and practice in emergency care. First up we'll be looking at whether pre-charging the defibrillator prior to rhythm analysis in cardiac arrest can decrease our hands-off time. Next we take a look at a paper that can help inform our assessment and investigation of trauma patients; looking at the risk of concomitant injuries with re...

So in this episode we run through narrow complex tachycardias, not I hear you say a perfect visual topic for an audio platform like a podcast, but hold your horses… No matter what your level, or your depth of understanding of narrow complex tachycardias, we really hope this will offer some extra knowledge and contemplation for both those of you, like us, that have been treating patient with NCT fo...

Happy New Year! Well we've got three really excellent papers to start off your new year with! First up we take a look at the complication rates seen when performing a prehospital thoracostomy; how frequent are complications and what could this information hold in improving our ongoing practice? Next up we take a look at an RCT on the use of Calcium in the context of cardiac arrest. Can it's inotro...

Critically unwell patients often present with inadequate oxygenation and ventilation, in this episode we're going to explore some of the physiology of critical illness, look at how we can improve oxygenation and ventilation, take a look mechanical ventilation and have a think about how we can deliver this to a really high level. We'll be covering the following; Type 1 & 2 respiratory failure Breat...

Welcome back to December's paper of the month podcast! In the first paper this month we take a look at a paper that assesses the utility of CT scans for patients presenting with fever of an unknown origin; could this help us identify the source more frequently and if so how often? Next, we often focus on the specific of medical management in cardiac arrest, but what impact does witnessing a cardia...

Being involved in Emergency Care, by it's very nature, sadly means that we will have to break bad news to patients and families both in the prehospital & in-hospital setting. Breaking bad news well has benefits to both the recipient of that news and also to the provider delivering it. Teaching and education on the topic can be difficult to access and not always prioritised. In this episode we run...

Welcome back to the papers of the month podcast! First up we take a look at a paper assessing the importance of symptoms and sings in suspected Cauda Equina cases and consider which factors we should be giving weight to, including whether a PR is appropriate. Next up we take a look at a paper looking at electrical injuries presenting to the Emergency Department, the risk of significant injury and...

So following on from the Roadside to Resus episode on intubation there were a lot of questions from listeners that we didn't have the opportunity to answer. These included some clinical aspects and also some really tricky issues around competency, governance and importantly who should and shouldn't be intubating. We've separated this out from the main episode as a lot of the conversations are heav...

Intubation is a key part of advanced airway management. Although some of you out there may not intubate, we'll be covering aspects where the identification of the need for intubation and how contributing as a team to the process can make a real difference to patient outcomes. Intubation is subject of a considerable amount of evidence and debate. Increasing use of supraglottic airways both in theat...

Welcome to October's papers of the month! Should patients who gain a ROSC following an out of hospital cardiac arrest go for an immediate angiogram if their ECG does not show an STEMI or Left Bundle Branch Block? We've looked at this before with the COACT trial which only looked at those patients with a shockable rhythm but this months paper looks at all ROSCs from all rhythms. Next up we take a l...

So this time we're going to be looking at the HUGE topic of acute coronary syndrome (ACS)! ACS ranges from patients who appear well at the time of their presentation, to those that have arrhythmias, haemodynamic instability, to those that are in cardiac arrest! There are around three quarters of a million ED chest pain attendances per year for acute chest pain and it accounts for around 25% of ED...

Welcome back after our summer hiatus to September's Papers Podcast! Firstly we take a look at two different strategies for managing agitation in the Emergency Department, to achieve rapid control. Is haloperidol and midazolam, or ketamine alone, a better strategy? Then we take a look at the results from RECOVERY-RS. We covered the design of the trial at it's conception last year and this trial ess...

Welcome to August 2021's papers podcast! Three more great papers for you this month which have challenged and informed our practice. First up we look Impact of ambulance deceleration with patients lying flat vs 30 degrees head up on intracranial pressure in patients with a head injury. Next, is a patient with a refractory VF arrest more likely to have a positive finding on coronary angiography tha...

So welcome back to another Roadside to Resus episode! Pre alerts are a key part of the interface between pre hospital and in hospital care of the critically unwell patient, when made and received in an effective manner they can really benefit the patient and the system. But too often we hear of friction associated with pre alerts and recent discussions on social media has really highlighted this....

Another month and 3 more papers! First up we have a look at a paper that has grabbed a lot of recent headlines in the form of TTM2. So we now seem to have the answer to whether comatose patients following out of hospital cardiac arrest benefit from therapeutic hypothermia over maintenance of normothermia. Next up we take a look at a paper which adds some real value to our assessments of maxillofac...

So this time we're going to be talking about subarachnoid haemorrhage. So this is going to be a short and punchy look at a really important and interesting topic in subarachnoid haemorrhage. We run through the approach to headache and then focus on the specific features and findings that we should be looking for with regards subarachnoid haemorrhage. We then consider who we should be investigating...

This month we've got three papers that have challenged our practice both from an in-hospital and pre-hospital perspective. Firstly we consider a paper that looks at admission saturations for patients with exacerbations of COPD and compare this to the BTS guidance on oxygen therapy, regarding altering oxygen saturations for those proven not to be hypercapnoeic. Should we be aiming for 88-92% or 94-...

So the Resuscitation Council UK have today published new guidelines on resuscitation based on the European Resuscitation Council 2021 Guidelines and recommendations from the International Liaison Committee on Resuscitation. We were lucky enough to catch up with two key members of both ERC and RCUK, Gavin Perkins and Jasmeet Soar, gaining their valuable insights into the new guidelines. As well as...

Welcome back to May's Papers of the Month Podcast! Three more papers for you on three varied topics. We start off with the use of end tidal carbon dioxide in the content of prehospital head injuries. Taking a look at a paper delving a bit deeper into the utility of end tidal CO2 when compared with arterial CO2 measurements on arrival in ED, in patients having received a prehospital anaesthetic; ho...

So last month we considered Maternal Emergencies and the approach and interventions we can make in order to minimise complications during pregnancy and during childbirth. As promised this month we're looking at the next step along the process and focussing on Newborn Life Support. Dealing with newborns has the potential to be really stressful but hopefully by concentrating on the fundamentals and...

Well if last month was based on cardiac arrest, this month takes a deeper look at airways! First up we take a look at a paper that benchmarks the use of video laryngoscopy, specifically with the C-MAC and gives some really useful information from a Swiss HEMS service on first-pass success, the relevance of operator experience on success and factors that alter intubation success. Next up we're look...

So this is the first of a pregnancy related double-header, with the focus being firmly set on the mother this month and next month we'll focus in on NLS. This month though we're going to be discussing maternal emergencies. Now many conditions that could fall into this category but, as much as we love a good yarn, we really can't be here all day, so we've decided to focus on are the conditions that...