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Recent Posts
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
Archives
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Sydney HEMS acknowledges the Australian Aboriginal and Torres Strait Islander peoples as the first inhabitants of the nation and the traditional custodians of the lands where we live, learn and work.
Category Archives: General PH&RM
Peripheral vasoactive infusions
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
rFVIIa did not reduce trauma mortality
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
Paediatric Tube Cuff Pressures
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
Alternative toothless mask position
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
Taming the Ketamine Tiger
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
Unexpected survivors after pre-hospital intubation
Data on patients with moderate to severe traumatic brain injury from the San Diego Trauma Registry were analysed using modified TRISS methodology to determine predicted survival, from which an observed-predicted survival differential (OPSD) was calculated. The mean OPSD was calculated … Continue reading
Weight formula for kids
The traditional ‘APLS formula’ for weight estimation in children based on age (wt in kg = [age+4] x 2) is recognised as underestimating weight in ‘developed’ countries, with the degree of underestimation increasing with increasing age. Several authors have attempted … Continue reading
ETCO2 and ROSC
One for the ‘hardly surprising’ category…. A study of end-tidal CO2 during out-of-hospital adult and child cardiac arrest resuscitation showed a sudden rise in CO2 was associated with return of spontaneous circulation (ROSC), suggesting that witnessing this would be a … Continue reading
Etomidate in RSI – systematic review
A systematic review of 20 included studies comparing a bolus dose of etomidate for rapid sequence induction with other induction agents resulted in the following conclusion: “The available evidence suggests that etomidate suppresses adrenal function transiently without demonstrating a significant … Continue reading
Tracheal tube cuff pressure in flight
Tracheal tube cuff pressures increased from a mean 28.7 cm H2O pre-flight to 62.6 cm H2O in flight (mean altitude increase 2260 feet) in a Swiss helicopter-based study. At cruising altitude, 98% of patients had intracuff pressure >30 cm H2O, 72% had … Continue reading
