Author Archives: Cliff Reid

EM trainee RSI experience

A single centre observational study of rapid sequence intubation (RSI) was performed in a Scottish Emergency Department (ED) over four and a quarter years, followed by a postal survey of ED RSI operators. There were 329 RSIs during the study … Continue reading

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AED Use in Children Now Includes Infants

From the new 2010 resuscitation guidelines: For attempted defibrillation of children 1 to 8 years of age with an AED, the rescuer should use a pediatric dose-attenuator system if one is available. If the rescuer provides CPR to a child … Continue reading

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Resuscitation Guideline Changes

The European Resuscitation Council’s Summary of Major Changes in the 2010 guidelines can be downloaded here

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CAB rather than ABC

The 2010 ILCOR resuscitation guidelines were published today. Key changes and continued points of emphasis from the 2005 BLS Guidelines include the following: Sequence change to chest compressions before rescue breaths (CAB rather than ABC) Immediate recognition of sudden cardiac … Continue reading

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New CPR Guidelines

The International Liaison Committee on Resuscitation has published its five-yearly update of resuscitation guidelines. The American Heart Association Guidelines can be accessed here The European Resuscitation Guidelines can be accessed here 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and … Continue reading

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Evidence refutes ATLS shock classification

I have always had a problem with the ATLS classification of hypovolaemic shock, and omit it from teaching as any clinical applicability and reproducibility seem to be entirely lost on me. I was therefore reassured to read that real physiological … Continue reading

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In-flight cooling after out-of-hospital cardiac arrest

Aeromedical retrieval specialists in Scotland developed a simple, cheap, effective in-flight cooling protocol using intravenous (IV) cold Hartmann’s solution and chemical cooling packs. Fluids cooled in a fridge (4°C) were transported in an insulated cool box; the patient was sedated, … Continue reading

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Burr holes by emergency physicians

Emergency physicians at Hennepin County Medical Centre (HCMC) are trained in skull trephination (drilling a burr hole) for patients with coma, anisocoria and epidural (extradural) haematoma (EDH) who have not responded to osmotic agents and hyperventilation. This may be particularly … Continue reading

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RCT of 7.5% saline in head injury

Over a thousand patients in North America with blunt traumatic head injury and coma who did not have hypovolaemic shock were randomised to different fluids pre-hospital. 250 ml Hypertonic (7.5%) saline was compared with normal (0.9%) saline and hypertonic saline … Continue reading

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Two smaller lines may be quicker

Using Poiseuille’s law and standardized gauge sizes, an 18-gauge (g) intravenous catheter (IV) should be 2.5 times faster than a 20-g IV, but this is not borne out by observation, in vitro testing, and manufacturer’s data. A nice simple study … Continue reading

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