Monthly Archives: September 2010

Give all sick patients oestrogen?

Posted on September 26, 2010 by

A thought provoking article in Critical Care Medicine outlines basic science, animal, and human studies that suggest oestrogen may have a protective effect in a wide range of critical illnesses from cardiac arrest to trauma to stroke. It urges clinical … Continue reading →

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No benefit from pre-hospital trauma doctor in Holland

Posted on September 24, 2010 by

Being human, I suffer from confirmation bias: I’ve become aware that I’m always on the look out for studies that show benefit from physician-provided pre-hospital care and therefore it’s possible I miss the ones that show no benefit. Of course, … Continue reading →

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EZ-IO outperformed B.I.G

Posted on September 23, 2010 by

A small randomised trial of adult emergency department patients showed faster insertion and higher success rates with the EZ-IO compared with the Bone Injection Gun (B.I.G). This is in keeping with my own experience and that of several services I … Continue reading →

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Scene time not linked to outcome in large cohort

Posted on September 20, 2010 by

Okay – I admit to loving this paper, partly because it blows away the dogma of short scene times and ‘scoop & run’, and the oft-quoted but obnoxious assertion that the only pre-hospital fluid of benefit is gasoline. A massive … Continue reading →

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Increased mortality with non-trauma centre care

Posted on September 20, 2010 by

A trauma database was analysed to see if patients who were transported from the field to a non-trauma centre (NTC) and subsequently sent on to a trauma centre (TC) for definitive care fared worse than similar patients who were transferred … Continue reading →

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Peripheral vasoactive infusions

Posted on September 15, 2010 by

It is often recommended that vasoactive agents are infused via central lines because of the risk of infiltration and tissue injury. The Children’s Hospital Boston transport team describe transport of 73 infants and children who were treated during interhospital transport … Continue reading →

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rFVIIa did not reduce trauma mortality

Posted on September 14, 2010 by

An industry sponsored placebo-controlled multicentre randomised controlled trial has shown no mortality reduction from recombinant activated Factor VII (rFVIIa) in patients with trauma. rFVIIa acts physiologically by enhancing clot formation in the presence of tissue factor expressed on injured or … Continue reading →

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Paediatric Tube Cuff Pressures

Posted on September 12, 2010 by

A paediatric critical care transport service encountered elevated tracheal tube cuff pressures (>30 cmH20) in 41% of 60 consecutive care studied, and over 60 cmH20 in 30%. This measurement was taken on arrival at the bedside, not in flight. Cuffed … Continue reading →

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Alternative toothless mask position

Posted on September 10, 2010 by

An alternative position for holding the facemask when bag-mask ventilating edentulous patients is described and evaluated. 49 patients with inadequate seal and air leak during two-hand positive-pressure ventilation had significantly improved ventilation as measured by reduced air leak and increased … Continue reading →

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Taming the Ketamine Tiger

Posted on September 9, 2010 by

A paper of great interest for those of us who spend a lot of time teaching the use of ketamine describes its history from initial synthesis in the early 1960s. Ketamine pioneer Edward F. Domino, M.D describes how it was … Continue reading →

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