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AiR Videos- [131] Hot Floppy Bougies
- [130] Hyoepiglottic Ligament
- [129] Fluid Flow During Laryngoscopy; OOHCA
- [128] Laryngoscope Too Deep - Then Pops Down
- [127] Parker Tip Tube Grabs Epiglottis
- [126] Dentures
- [125] Cuff Herniation
- [124] Black ETT Lines Visible - Becomes Extubation
- [123] CMAC after iGel AScope
- [122] Ambu AScope via Flexi ETT Through iGel3
Category Archives: General PH&RM
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
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
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
Posted in General PH&RM
Tagged ALS, arrest, critical care, hypothermia, neuroprotection, retrieval
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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
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
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
Scoop minimises cervical movement
A cadaveric study using a 3-dimensional electromagnetic tracking device to asses cervical motion compared the application of a scoop stretcher with two other manual transfer techniques, including log rolling onto an extrication (spine) board. The scoop method restricted cervical spine … Continue reading
Pre-hospital cooling post arrest
An Australian randomised controlled trial assessed the effect of pre-hospital cooling (using 2 litres ice cold Hartmann’s) of post-cardiac arrest patients on functional status at hospital discharge. The intervention group were marginally cooler on arrival but did not have improved … Continue reading
Posted in General PH&RM
Tagged ACLS, arrest, critical care, hypothermia, outcome, pre-hospital
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Give all sick patients oestrogen?
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
No benefit from pre-hospital trauma doctor in Holland
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
Greater Sydney Area HEMS 