Tag Archives: procedures

Escharotomy

Sydney HEMS retrieval specialist and intensivist (and emergency physician, by the way) Dr Craig Hore covered a workshop on escharotomy for severe burns at the Bedside Critical Care Conference in 2013 EXPLAINED: Emergency Escharotomy from Oliver Flower on Vimeo.

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Always Bring Your Scalpel

In this 28 minute audio podcast recorded at the SMACC conference in 2013 Sydney HEMS physician Dr Brian Burns talks about being prepared for life, limb & sight saving procedures in the prehospital environment. http://traffic.libsyn.com/smacc2013/know-your-weapons-burns.mp3 You can download the podcast by right-clicking here Here … Continue reading

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Delivering salbutamol to an intubated prehospital patient

Chris “Willko” Wilkinson (SCAT paramedic) shared this handy trick of the trade during a recent simulation session. Scenario Road primary job to a school where a 6 year old girl is in severe respiratory distress with known asthma. On arrival … Continue reading

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Needle crike: low rate and allow exhalation

Two dedicated devices for transtracheal oxygen delivery through a cricothyroidotomy needle are available, the ENK Oxygen Flow Modulator (ENK) and the Manujet. Both maintain oxygenation, but the ENK is thought to achieve better ventilation (as previously shown in a pig … Continue reading

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Pre-hospital amputation

British trauma surgeon and pre-hospital pioneer Professor Keith Porter describes how to do a pre-hospital amputation in this months EMJ. Thankfully the procedure is only rarely necessary and often only requires cutting remaining skin bridges with scissors. The indications are: … Continue reading

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LMA not always successful; needle crike fails often

A meta-analysis of pre-hospital airway control techniques evaluated alternative techniques to tracheal intubation. The outcome was placement success; there were no data on effectiveness of ventilation or other clinical outcomes. Although limited by poor quality studies, there are some interesting … Continue reading

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Pre-hospital RSI by different specialties

This aim of the study was to evaluate the tracheal intubation success rate of doctors drawn from different clinical specialities performing rapid sequence intubation (RSI) in the pre-hospital environment operating on the Warwickshire and Northamptonshire Air Ambulance. Over a 5-year … Continue reading

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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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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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EZ-IO outperformed B.I.G

A small randomised trial of adult emergency department patients showed faster insertion and higher success rates with the EZ-IO compared with the Bone Injection Gun (B.I.G). This is in keeping with my own experience and that of several services I … Continue reading

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