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Author Archives: jmlboss
OXY’s LOG – ‘Between shock and a hard place…’
Cardiogenic shock – occurs in 10% of uncomplicated myocardial infarctions, suggests greater than 40% loss of functional left ventricule and has an 85% mortality.1, 2 John Hunter, a famous London surgeon during the 18th century, described his personal experience of myocardial infarction. … Continue reading
PEEP SHOW – ‘CARDIOGENIC SHOCK’
CARDIOGENIC SHOCK (summary) . Confirm the diagnosis during the initial resuscitation phase. Rule out mechanical defects (with US) and correct any reversible conditions. Optimise pre-load, contractility and afterload by: correction of hypovolaemia (especially if right ventricle affected), use of vasodilators (where … Continue reading
Posted in General PH&RM
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PEEP SHOW – (New to NSW-HEMS)
“Due to popular demand…ok it was just one guy…but he did mention that there was not enough time in his day to read the whole of each OXY’s LOG. So I figured I would release a summary called ‘PEEP SHOW’ … Continue reading
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OXY’s LOG – ‘Anisocoria and Stardust…’
Take caution if you ever get tasked to a pre-hospital trauma at David Bowie’s house. His reduced level of consciousness and blown pupil might just be due to a copious amount of mind-bending drugs and the accident as a school-boy … Continue reading
OXY’s LOG – ‘Tourner sur une nouvelle feuille de route…’
The term tourniquet originated from the French ‘‘tourner’’ meaning ‘‘to turn”. The first reported use of a tourniquet for haemorrhage control after wounding was by a french army surgeon called Etienne Morel in 1674. 1 . . Tourniquets: villain or … Continue reading
OXY’s LOG – ‘Blue-lights and Sirens…’
In Greek mythology, the Sirens were dangerous creatures, portrayed as femme fatales who drowned sailors with their enchanting music and voices.1 Drowning is a process resulting in primary respiratory impairment from submersion /immersion in a liquid medium.2 . A liquid/air interface … Continue reading
OXY’s LOG – ‘That tricky fella, human error…’
‘Errare humanum est’ Adapted by Alexander Pope1 in 1711 into the famous quote: ‘To err is human, to forgive divine.’ Case: A MVA victim (later retrieved by GSA-HEMS) comes into a rural trauma unit with a head injury and facial fractures. They need … Continue reading
OXY’s LOG – ‘Sadly just too big a hole in that pearl…’
Clam shell thoracotomy – Indications and outcomes Case: A multiple gun shot wound victim was found at the roadside barely conscious. He was intubated, ventilated and given bilateral thoracostomies by our HEMS crew. He went into cardiac arrest and so … Continue reading
OXY’s LOG – ‘Sux it, don’t stroke it…’
Succinylcholine and the hemiplegic patient (This is a follow-up post to a previous blog regarding Suxamethonium and neurological disorders). The hemiplegic patient does indeed present a risk. There are a number of case reports of stroke patients arresting on the … Continue reading
OXY’s LOG – ‘It totally sux…’
Suxamethonium and neurological disorders Case: A relatively innocuous case concerning the transportation of a Parkinson’s disease1 sufferer lead onto that age-old discussion about our old friend the depolarising neuromuscular blocker2 and which weird and wonderful neurological or neuomuscular problems it could or … Continue reading
Greater Sydney Area HEMS 