Tips & Tricks

iGel thread which should be of use to first responders and EMS providers, emergency department and ICU staff, and even novice anaesthetists https://twitter.com/cliffreid/status/1598460503629926400

Remember when you admit a patient with ROSC post CPR, as well as their medical condition you are also admitting a patient with significant thoracic trauma

HT ⁦@precordialthump⁩ https://journals.lww.com/jtrauma/fulltext/2021/12000/chest_wall_injuries_due_to_cardiopulmonary.9.aspx

Regardless of who intubates in your ED all EM clinicians should have a clear understanding of certain anaesthetic drugs and approaches to intubation like RSI

This is covered in detail on the Critical Care in the Emergency Department course
London 9 Dec

https://www.eventbrite.com/e/critical-care-in-the-emergency-department-one-day-seminar-tickets-467286455367

Could not agree more.
@resuscitology 💯 the best course I’ve done to date. Magnificent, run by magnificent teachers & mentors

@cliffreid @_NMay @Aidan_Baron @precordialthump et al. https://twitter.com/KangarooBeach/status/1595952478742544384

🚨A reminder to all that work with sick children that @ 9am tomorrow we’re running the @PaedEmergencies course on @YouTube for free
A great success the last 2 2 years with>2000 live participants & >20,000 streams per course to date
Link👇
https://bit.ly/3VtQS77
#FOAMed
#PedsICU

One of over 50 cases I use on the Critical Care in the Emergency Department course to convey as many resuscitation principles as I can in a single day!

Registration now open for Critical Care in the Emergency Department One Day Seminar at the Royal College of Emergency Medicine
https://www.eventbrite.com/e/critical-care-in-the-emergency-department-one-day-seminar-tickets-467286455367?aff=estw&utm-campaign=social&utm-content=attendeeshare&utm-medium=discovery&utm-source=tw&utm-term=listing

Male 70s prev well walks in with chest pain of one hour duration. Cath lab staff called in after 1st ECG. Gets aspirin, ticagrelor, heparin. 10 mins later SBP is 60, increasing pain. 2nd ECG done. Cath lab now ready. What treatment will you give to get him to cath lab alive?

Raised lactate - so much more than just sepsis and dead gut! #SepsisKills #ButItDoesntKillPatientsWhoDontHaveSepsis

https://resus.me/understanding-elevated-lactate/ h/t @cliffreid

#Resuscitology13

You could say those who attend @resuscitology are somewhat competitive 😂

@cliffreid isn’t on the beach though so he can’t allocate himself extra points 😂

#Resuscitology

#Resuscitology13 day 2 kicking off with a gnarly trauma case discussion, facilitated by @HawkmoonHEMS. So much in this one - human factors, airway, haemorrhage control, leadership, decision-making. We rely on our participants’ vulnerability, sharing hard stuff so we can all learn

“The fundamental attribution error is the tendency to assume that other people perform poor actions because of their personality, not due to valid reasons, ignoring situational factors or genuine reasons which might have played a part.” https://productiveclub.com/fundamental-attribution-error/ #Resuscitology13

How can we sustain ourselves, during our careers as Resuscitologists?
The answer is multifactorial, says @cliffreid - and we should recognise the spiral of exhaustion, courtesy of @nhscommentary (via the legend @iceman_ex)
#Resuscitology13

2

Talking #CardiacArrest management with @karelhabig at #Resuscitology13.
Dual sequential defib? Maybe not… but vector change in refractory VF is worth a try
Ref: https://www.nejm.org/doi/pdf/10.1056/NEJMoa2207304
Reviews:
- https://first10em.com/dose-vf-a-double-sequential-defibrillation-game-changer/
- https://www.stemlynsblog.org/jc-alternate-defibrillation-strategies-in-refractory-vf-the-dosevf-trial-st-emlyns/

Been espousing benefits of zero point survey for use in prehospital, ED and OT use for some years now…But just stumbled across this 4 min video from @cliffreid - take the time to watch it https://www.youtube.com/watch?v=EtlaU7GzD_Q - then read the published paper. Share w trainees & colleagues

Faculty discussions before @resuscitology course deciding which submitted cases convey the greatest amount of learning points that will help participants save more lives in future

Familiarity between staff inc’d nursing perception of team relationships & led to ⬆️ team function

Perhaps explains strength of team bonding in Emergency Departments & some of the implicit challenges of specialty teams coming down the ED

https://pubmed.ncbi.nlm.nih.gov/36215043/

HT @cliffreid

@Damian_Roland @cliffreid Our research work out of tertiary ED (soon to be published!) echos the critical nature of familiarity found in this study. Creating team and leader familiarity should be a key goal for leaders on the floor and guide critical decisions around rostering and shift design,

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The art and science of saving lives