The Resus Room

Hypothermia is a common problem for both pre and in-hospital clinicians. Understanding the underpinning physiology helps us deliver first class care to our patients, decreasing associated morbidity and mortality. There is some extremely difficult decision making to be done in severe cases of hypothermia and the podcast gives us an opportunity to explore them further. We'll cover the subject in dep...

Ketamine and trauma are the topics for this months papers. The three papers we cover are really important for all of us involved in the care of critically unwell patients. Hypotensive resuscitation in the context of trauma has been an evolving area of practice in the treatment of our acute trauma victims. A paper published in SJTREM this month meta-analyses the data that exists out there on the to...

If you're involved in the care of critically unwell patients then you will frequently encounter patients who are shocked. The European Society of Intensive Care Medicine defines shock as; 'Life-threatening, generalized form of acute circulatory failure associated with inadequate oxygen utilization by the cells. It is a state in which the circulation is unable to deliver sufficient oxygen to meet t...

Happy New Year!! Hopefully you got a bit of downtime over the festive period and are feeling suitably refreshed and ready to attack 2019! We've got 3 great papers to kick off the year. First up we look at the recent PReVENT trial which looks at ventilator strategies in patients without ARDS with respect to tidal volumes. This paper continues the work from the much cited ARDSNet paper from 2000, an...

Festive greetings to all! We hope you've had a fantastic 2018 and have some time off over Xmas and New Year to celebrate with friends and family. We thought we'd bring you some of the most influential papers that we've read over the last 12 months, that haven't necessarily fitted in that closely with some of the topics we've covered...we hope you enjoy! Thanks for all of your support with the podc...

Cardiac arrest management is core business of a resuscitationist and practice is constantly evolving in the pursuit of improving patient outcomes.  We were lucky enough to be invited to the London Trauma Conference's Cardiac Arrest Masterclass stream, where Matt Thomas put on a superb array of talks around all things cardiac arrest.  We managed to borrow a bit of time from some of the speakers and...

Well the year maybe coming to a close but the high quality papers keep on coming out! We've got 3 great articles to cover in this episode which have some key points to reflect on in our practice. First up we take a look at the application of Canadian c-spine rules by ED triage nurses and the potential impact this approach could hold. Next up we have a look at the addition of magnesium to current E...

We were delighted to be back to cover the joint Faculty of Prehospital Care and BASICS conference, day 2,  held at the Royal College of Surgeons of Edinburgh. Again we were absolutely spoilt for choice when it came to content for the podcasts but we managed to catch up with: • Dr Anne Weaver – a consultant in Emergency Medicine and Prehospital Care working for the Royal London Hospital and London...

We were delighted to be invited to cover the joint Faculty of Prehospital Care and BASICS conference held at the Royal College of Surgeons of Edinburgh. This two-day prehospital extravaganza covered a broad range of topics and the content was delivered by some excellent speakers. As such, we were absolutely spoilt for choice when it came to content for the podcasts but we managed to catch up with:...

We've heard a lot about advanced airway management recently, with some really significant publications over the last few months and in the last few weeks in JAMA we've had another! Cricoid pressure during emergency anaesthesia and for those at high risk of aspiration has been common place for more than half a century. But it's a topic that has caused quite some debate. On one hand it has the poten...

Welcome back to November's Papers Podcast! We've got 3 great papers for you again this month. First up we take a look at a paper that looks to quantify the amount of experience needed to be a proficient intubator, in this case in arrest. Next we have a look at a paper which shows a significant difference in mortality in cardiac arrest dependant on the intravascular access route used. Finally we ha...

With bonfire night approaching we thought it would be a good time to have a think about burns. However burns are a significant issue at all times of year with around 130,000 presentations to UK EDs annually, 10,000 cases are admitted to hospital, 500 of these have severe burns and 200 of these will die. But most importantly intervention that we make can make a big difference to both morbidity and...

Welcome back to October's Papers Podcast, this month we move airway from advanced airway management and bring you a broad array of papers. First up we have a look at the relative success of a variety of pharmacological strategies for managing the acutely agitated patient in ED. Next up we have look at the well know CURB-65 score and it's ability to predict the need for critical care interventions....

So we're back with September's papers of the month a little later than usual but we wanted to give you a little time to digest AIRWAYS-2... before we give you some more prehospital research on advanced airway management in cardiac arrest! The American version of AIRWAYS-2, PART, has just been released in JAMA, looking at the laryngeal tube versus endotracheal intubation as a primary strategy for a...

So we're back from our summer hiatus with a real treat. The long awaited AIRWAYS-2 paper has just been released and we've been lucky enough to speak with the lead author, Professor Jonathan Benger, about the paper and discuss what the findings mean for cardiac arrest management. AIRWAYS-2 looks at the initial advanced airway management strategy for paramedics attending out of hospital cardiac arre...

Welcome to August's papers of the month. So this is our last offering for the summer until whilst we take a short break until September, so we had to finish off we 3 great papers! First up we look at the drug of the moment (or decade...) in tranexamic acid and the effect that it has on outcomes in primary intracerebral haemorrhage. Next, what role does point of care ultrasound (POCUS) hold in the...

Drugs in cardiac arrest are controversial. Prehospital research is notoriously difficult to perform. PARAMEDIC2 has just published in the New England Journal of Medicine and is a multi centre randomised placebo controlled trial looking at adrenaline (or epinephrine depending on which side of the pond you reside) in out of hospital cardiac arrest, no mean undertaking and a landmark paper. The paper...

Head injury worldwide is a significant cause of morbidity and mortality. Besides prevention there isn't anything that can be done to improve the results from the primary brain injury, there is however a phenomenal amount that can be done to reduce the secondary brain injury that patients suffer, both from a prehospital and in hospital point of view. In the podcast we run through head injuries, all...

Welcome to July's papers podcast.  There has been a plethora of superb and thought provoking papers published this month and we've got the best 3 that caught our eye for you. In this episode we look at the potential benefit of early vs late endoscopy in patients presenting with an acute upper GI bleed.  Next we look at both intra and post ROSC hyperoxia and the associated outcomes. Finally we have...

Managing external haemorrhage is easy right?! Then why does haemorrhage remain a major cause of death from trauma worldwide? Ok, some of that is from internal sources, but…. No one should die from compressible external haemorrhage With the right treatment applied in a timely fashion, the vast majority of these bleeds can be stopped. But with new advances like haemostatic agents, changing advice su...

Welcome back to our monthly round up of the best papers in the resuscitation world. Again we've got 3 great papers covering some really important points of practice. First up we have a look at one of the most talked about diagnostic tests in Emergency Medicine, Troponin. We're are always looking to increase the sensitivity of the assay and test in order to ensure the patient hasn't got Acute Coron...

The management of a cardiac arrest can be stressful at the best of times, but add into that the patient being a child and you have the potential for an overwhelmingly stressful situation. Fortunately the major resuscitation bodies have some sound guidance on the management of paediatric arrests. In this episode we run through some of those guidelines and also the evidence base on the topic (scant...

Professor Simon Carley from St. Emlyns caught up with us at the superb Trauma Care Conference and talked through his top papers in trauma from the last 12 months. There's something for everyone from diagnosing arterial injuries, blood pressure targets in the head injury patient, to i.v. contrast all the way through to imaging in kids. If you haven't already, make sure you go and check out the St E...

Dare we say it, we think this month's papers podcast is the best yet, we've got 3 superb papers and topics to consider! The literature has been pretty airway heavy this month so we've got 3 papers on and around the topic for you. First up we have a look at a really interesting paper from London HEMS looking at the risks v benefit of prehospital rapid sequence intubation in patients who are awake b...

Evidence based medicine (EBM) allows us to deliver the best care to our patients and understanding the concepts involved is crucial. Over the last 18 month we've been building an online course to give people a sound understanding of EBM and we thought we'd give you a free taster of what it's all about. Have a listen to one of our episodes here on statistics and if you want to find out more have a...