HEFT EMCAST

This week we're changing our hosting services and we thought we'd better let you know what you'll notice...'

A look at the BTS & ICS guidelines just realeased on the topic

What's the best place to decompress a pneumothorax? Today we here from Zaf Qasim on some pearls about this topic'

SHere is a overview of the papers that caught our eye this month and the accompanying podcast. As always make sure you go and check out the papers yourself as this is just a whistle stop tour to wet your appetite......

So NICE has published it’s guidelines on ‘Major trauma; assessment and initial management’, obviously it would be ideal for you to run through the full document yourself but to give you a flavour of the key points that we think will affect our practice here are what we consider to be the headlines

Fitting is a really common reason to attend the Emergency Department. In the vast majority of cases the seizure has terminated before the patient arrives in the ED. But in some cases it’s still on going and by virtue of the length of time it takes for a patient to arrive in your ED that means they will have been fitting for quite some time when they pitch up in your Resus room.

Here is a overview of the papers that caught our eye this month and the accompanying podcast. As always make sure you go and check out the papers yourself as this is just a whistle stop tour to wet your appetite......

This podcast covers anaphylaxis, have a listen and let us know what you think. Below are a few of the key take home messages, enjoy!

Hypotension is a feature of many conditions affecting critically unwell patients in the emergency department. Foremost amongst these is septic shock, which we have looked at in a number of podcasts over the last few months; early use of vasopressors, in particular noradrenaline (NA) via infusion, improves outcomes in this setting. However, vasopressor infusions take time to mix and central venous access may not be immediately available. But what about the use of bolus (‘push-dose’) vasopressors when hypotension is transient or predictable?

Following on from your feedback from our user survey at the back end of 2015 there seemed to be a thirst for summary podcasts to compliment our papers of the week. So starting from now we'll be bringing you monthly round ups of the papers that caught our eye. As always don't just take our interpretation of the papers, go and have a look at them yourself and let us know your thoughts.

Cervical collars have been used since the Vietnam War and after their implementation in the ATLS guidelines they have been considered the benchmark in trauma patients when there were any concerns about the C-Spine stability. Studies about the real utility of these devices to date haven’t shown a clear benefit, mostly of them have been poorly conducted with a limited number of patients due to the potential catastrophic consequences of secondary spinal injuries. Subsequently the pre-hospital and intra-hospital management hasn’t changed for years. In this podcast we'll run through a bit of the background to immobilisation, look at the evidence base and see how it might change our practice.

Intraosseous (IO) access, in order to provide medication and fluid products to the central circulation, was first suggested in 1922 By Drinker. Between 1922 and the 1980’s there's been sparse evidence mentioning IO due to the arrival of intravenous (IV) access devices able to deliver the same treatments.

So you’ll all probably be aware to the Difficult Airway Society (DAS) Guidelines for airway management. They centre around the need to have an airway strategy that is already determined for when an airway crisis occurs. As we’ve previously mentioned having those plans to hand makes stressful situations an awful lot easier by decreasing the cognitive load. DAS has just released an updated version of their Emergency Intubation guidelines.....

Lets be honest, Emergency Medicine clinicians don't like checklists. They're slow, organised and deliberate tools that get in the way of our fast, impulsive and dynamic resuscitation and they're just not cool! But what's the background to checklists, is there much uptake and what have we got to gain by using them?

10 papers that have made a difference to my care in the resuscitation room. This talk is taken from the fantastic EMCEF conference organised by Alon Duby.

What is it, how do I do it and is there any evidence to back it up?

A summary of the ERC 2015 guidelines on changes to Advanced Life Support

A summary of the ERC 2015 guidelines on traumatic cardiac arrest

We all dish out paracetamol in fever but should we? A paper out this week from the NEJM sparked our interest in the topic and here's what we found'

Lets have a think about fluids in trauma.........