Remember that 2 am cric where no one knew what size ET tube you needed? How about that time you did an ED thoracotomy and no one knew what a vascular clamp was? This podcast is about how to avoid it while still having a good time doing some Kickass Medicine!
Episodes
Wednesday Mar 29, 2017
Wednesday Mar 29, 2017
....or an argument against throwing the baby out with bathwater. Invariably we've all heard it on the podcasts, blogs and at the conferences. The reasons why we shouldn't do panscans are all over the internet. From conspiracy theories that radiologists and hospital admins are doing it for the money to the argument that it dulls clinical accumen.
IMHO panscans are a product of technology moving too fast for the literature. We keep asking questions like we did in 1999 when we're seeing the technology of 2017.
The question shouldn't be do panscans influence outcome or "flow" in the ED. The question should be: "In which patients has focused history, examination and selective CT scanning failed us?"
By and large the studies on which we've based our arguements against panscans are based on older CT scanners, retrospective data and radiation "risk" that is miniscule compared to the risk of missed injuries. You cannot use retrospective studies in which hemodynamically unstable patients are taken for a CT in 2000 (17 years ago) to make a point that panscans are evil. You can however say "just because the microwave is there doesn't mean we have to use it every day" . Like your microwave your panscan should have indications for use (never try and make pancakes in a microwave BTW), the trouble is we haven't figured them out yet.
Some alternative points of view that are probably more valid than mine :
ALIEM Top ten trasons not to Panscan.
Tuesday Mar 21, 2017
Tuesday Mar 21, 2017
well .... most times ....
This podcast can't be about resuscitation if I didn't include an airway talk in the first 5 episodes.
It happens to all of us from time to time, you get called at 2 am for a can't intubate, can't ventilate disaster that's been going on for far too long .... this episode is about how to avoid it. FRom pre planning to setting up a comfortable bailout plan.
References Mentioned:
Laryngoscope as a murder weapon.
RSI from Life in the Fast Lane.
C. Frerk, V. S. Mitchell, A. F. McNarry, C. Mendonca, R. Bhagrath, A. Patel, E. P. O’Sullivan, N. M. Woodall and I. Ahmad, Difficult Airway Society
intubation guidelines working group
British Journal of Anaesthesia, 115 (6): 827–848 (2015) doi:10.1093/bja/aev371
Apologies if I didn't recap at the end .... completely forgot.
Saud
Monday Mar 13, 2017
Monday Mar 13, 2017
In my mind this is probably the first real episode of the podcast.
Time and time again and see people pontificate over the amount of blood to give and whether it's being used for resuscitation or oxygen exchange or both and what cut off to use so I figured why not start with some basic numbers and fun facts on the ultimate colloid.
Some useful links mentioned in the podcast:
The JPAC transfusion handbook. PDF.
That animal model crit/concentration paper .
That paper where they bled healthy volunteers and gave them back their blood.
Monday Mar 13, 2017
Monday Mar 13, 2017
Figured I'd start with a little about my self and why I'm doing this.
The reality is that I'm not sure.
More (better) sources of #foamed and another introduction to it:
Monday Mar 13, 2017