Monthly Archives: October 2009

Paramedics apply cervical spine rule successfully

The Canadian C-Spine rule – a decision instrument designed to clinically rule out important cervical spine injuries in alert patients – was successfully and safely applied by Canadian paramedics in a study of 1949 patients. Any misinterpretation erred on the … Continue reading

Posted in Uncategorized | 1 Comment

emergence with ketamine overstated

A prospective study of 746 children sedated in the emergency department with iv or im ketamine revealed 2.1% may have experienced ‘emergence delirium’ although the authors concede this was difficult to define. In contrast, 291 (38%) reported pleasant altered perceptions. … Continue reading

Posted in Uncategorized | Tagged , | Leave a comment

Etomidate versus ketamine for rapid sequence intubation

Finally a well designed blinded randomised controlled trial on this subject. 0.3 mg/kg etomidate was compared with 2mg/kg ketamine for RSI in 655 patients requiring emergency intubation in the pre-hospital, emergency department, or intensive care unit environments. No difference was … Continue reading

Posted in Uncategorized | Tagged , , | Leave a comment

Ambulance transport induces stress

Plasma levels of adrenaline and noradrenaline increased signficantly in patients with acute coronary syndrome during ambulance transportation – a finding in keeping with studies on normal volunteers. I wonder how much more of an effect helicopter retrieval might have? Emergency … Continue reading

Posted in Uncategorized | Tagged , | Leave a comment

Ketamine lowered ICP in brain-injured kids

Ketamine lowered ICP in brain-injured kids Ventilated children between the ages of 1 and 16 with traumatic brain injury and elevated intracranial pressure (ICP) were given ketamine and effect on cerebral perfusion pressure (CPP) and ICP was measured. Ketamine decreased … Continue reading

Posted in Uncategorized | Tagged , , , | Leave a comment