The Resus Room

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...

So this month we've got a cardiac-arrest-fest for you! With 3 papers centered on the management of cardiac arrest, with some key points that will help inform and improve our practice. First up we have a think about where patients with a presumed cardiac cause of their arrest should be transported to. Trauma networks in the UK have changed destinations for patients, but is there a patient benefit t...

Welcome back to the podcast and our next Roadside to Resus episode, this time we're taking a look at Diabetic Ketoacidosis, DKA. In this episode we'll be getting our heads around the pathophysiology that underpins DKA, consider the clinical picture and severity of patients that present and look at both the in-hospital and pre-hospital management of these patients including topics such at fluid cho...

So three very different papers for you this month... We start off having a look at a paper on the HINTS examination. This exam came to prominence a few years ago as a way to distinguish between central and peripheral causes of vertigo with a pretty amazing sensitivity and specificity. Since then many EM clinicians have brought it onto their practice and this paper seeks to assess how good the test...

So in this episode we're going to have a deeper think about advanced airway management and specifically supraglottic use in the prehospital and ED environment.  Many prehospital service have seen the removal of intubation from their scope of practice, and that's understandably been received with mixed thoughts. But this isn't the end of 'expert advanced airway care for all; in fact far, far from i...

Happy New Year! Well 2020 certainly wasn't what we were all expecting, so here's hoping for a phenomenally better 2021. We've got some really exciting episodes for you this year including Supraglottic Airways, Neonatal Resuscitation, Diabetic Emergencies, New Resuscitation guidelines and much much more! We're kicking off the podcast year with three really interesting papers! First up we consider t...

So for decades people have talked about Contrast Induced Nephropathy…or Contrast Induced Acute Kidney Injury, depending on the decade and location of discussion. The theory being that diuresis, increased urine viscosity and changes in vasoconstriction and vasodilation leads to a worsening of renal function following iv contrast administration. It seems to come from the 1950's where some patients w...

Welcome back to December's Papers of The Month Podcast! Three more papers for you which will challenge and inform you practice. First up we have a look at a systematic review and meta-analysis which considers the fluid choice in resuscitating those patients with suspected traumatic brain injury in the prehospital setting; should we be reaching for the hypertonic solutions, or is an isotonic fluid...

Welcome back to the podcast! In this episode of Roadside to Resus we're going to take a look Anaphylaxis, which has been highlighted on a national level of concern as NICE state 'many people do not receive optimal management following their acute anaphylactic reaction'. Much of the problem lies within a lack of understanding of what actually constitutes an anaphylactic reaction and the knock on ef...

Welcome to November's papers of the month podcast! This month we kick things off looking at TXA in trauma and consider in complex scenes and resource limited environments if TXA could be administered effectively in an IM rather than IV route? We also get an authors inside view from Professor Ian Roberts. Next up; does the anatomical location of a head injury affect the risk of an intracerebral ble...

So in our Toxidrome Roadside to Resus episode we covered the initial management of a poisoned patient, some of the constellation of features to look out for and the specific management. But what about specific agents and circumstances that require particular knowledge and management both in the prehospital environment and in ED? Well in this episode we'll cover these by running through; Paracetamo...

Welcome back to the Papers of the Month podcast, once again we've got 3 more papers to inform, discuss and hopefully improve our practice. First up we have a look at a paper which looks to quantify the prognostic utility of lactate in our sick Resus patients; we often look at the initial lactates and draw conclusions for what they mean, but this paper helps us understand the results a bit further....

Drug ingestion both accidental and intentional accounts for a significant proportion of attendances at UK Emergency Departments and 999 calls. In 2016 there were >2,500 registered deaths in England and Wales related to drug misuse, which had increased by nearly 60% in a decade. So without a doubt we are all going to come across critically unwell patients with drug ingestions. But inappropriate dru...

Welcome back!! So we've had a small summer hiatus and are now back with another Papers of The Month and a jam packed line up of episodes for the rest of the year! We start off this month with a paper which looks to evaluate if there is any benefit on mortality with the use of checklists for endotracheal intubation. Next up we take a look at the factors in cardiac arrest that are most important wit...

So this is our last episode before a small summer hiatus, so it better be a good one! Journals are littered with some great articles at the moment, so we've chosen 3 great papers that cover a number of really important EM topics. Over the last few years more emphasis has been put on a more conservative management on pneumothoraces and following that trend we take a look at a paper evaluating the s...

The more you delve into cardiac arrest, the more it seems that delivering the essentials well is the key to great outcomes; timely recognition, high quality chest compressions, with early and appropriate defibrillation. But is ultrasound in cardiac arrest a layer that we should all be adding in as a standard. It holds the potential to not only prognose outcomes from cardiac arrest, both medical an...

There are more great pieces of research to enjoy this month! We start off with a paper following on nicely from our Roadside to Resus episode on Stabbing, which looks at the ability of prehospital providers to predict whether stab injuries penetrate to deep structures, or are purely superficial from clinical assessment. Next up we take a look at a paper using high sensitivity troponin and their li...

Tranexamic Acid (TXA) has gained a significant amount of attention over the last few years as multiple studies have shown it's utility in decreasing haemorrhage and associated mortality. It has become part of major trauma guidelines, post part haemorrhage protocols and many have adopted it to the management of traumatic brain injury. The findings have been very similar across a spectrum of haemorr...

Welcome back to June's Papers Podcast! Traditionally when you're taught about working a patient up for a potential diagnosis you'll find a list of signs, symptoms and tests that you need to perform in order to obtain your diagnosis. What that teaching doesn't tell you is how important each of those aspects is and this month we take a deeper look at this for pneumonia. We look two papers, one focus...

Transfers of patients happen all the time. It's easy to think about transfers as only those that involve an ambulance and moving patients from one hospital to the next, but in reality it's far more extensive than that. We all move patients all the time, whether that be the unwell patient in the upstairs of their house to the ambulance, the patient in the Emergency Department to the CT scanner or a...