Tag Archives: neuroprotection

Intraosseous hypertonic saline is probably safe

A previous study on swine with uncontrolled haemorrhagic shock who were given intraosseous (IO) hypertonic saline demonstrated a high rate of complications such as soft tissue necrosis and venous thrombosis(1). This led to a recommendation of caution in patients requiring … Continue reading

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Clinical Governance Day 10 September 2014

We started off the new term with a series of interesting presentations based around the theme of drowning and water rescue. Inland Water Rescue in the UK Thanks to the wonders of the internet, Matt Ward, Head of Clinical Practice at … Continue reading

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Ketamine for TBI: Why not?

The 1970s were a dark time for ketamine use in patients with intracranial pathology. In patients with non-traumatic lesions, ketamine was suggested to increase intracranial pressure (ICP) using various markers as end-points to suggest this (see references below). Although this … Continue reading

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CGD 9th April 2014 – Neurosimulation

Harnessing the experience of colleagues in the morbidity & mortality meeting, the manual dexterity of Karel Habig, the technological spectacularness of Skype to deliver a world expert to our meeting, the enthusiasm of two of our registrars, and the dynamism … Continue reading

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Ketamine update

Anaesthetist Dr Jan Persson from Stockholm has published an updated review of recent ketamine literature. The following interesting facts about our favourite drug are extracted from Dr Persson’s paper: Action on multiple receptors earns it the nickname: ‘the nightmare of … 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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