Tips & Tricks

@iceman_ex Mate I miss you. As soon as travel is allowed I need to recharge my élan vital from your presence. Looking forward to the next #ResuscitologyUK
@EMManchester

@Cap1llary

@_NMay

@Resuscitology

This weekend a #COVID press conference by the State Government included @HawkmoonHEMS outlining the response by State Retrieval Services including
@SydneyHEMS

His closing remarks speak powerfully of our collective responsibility

Inhaled budesonide improves time to recovery, with a chance of also reducing hospital admissions or deaths, in people with #COVID in the community who are at higher risk of complications

The UK PRINCIPLE trial in @TheLancet

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01744-X/fulltext

In a porcine submassive pulmonary embolism model (RV dysfunction without MAP drop), supplemental oxygen therapy improved right ventricular haemodynamics with the same magnitude as seen for pulmonary vasodilatation with nitric oxide

https://pubmed.ncbi.nlm.nih.gov/33870917/

In a randomised controlled study in cadavers, tracheal tubes inserted via a surgical cricothyroidotomy technique were more resistant to extubation force when secured with a suture compared with fabric tape methods

https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00925-y

Changes to intubation practice as a result of #COVID resulted in increased incidence of hypoxia in non-COVID patients

One factor may be the removal of apneic oxygenation

More rigorous ED intubation analysis from @cjgroombridge and team

https://pubmed.ncbi.nlm.nih.gov/34080299/

Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference. https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00841-1

Challenges in the PREHOSPITAL emergency management of geriatric trauma patients – a scoping review. https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00922-1

Use of regional analgesia and risk of delirium in older... : Journal of Trauma and Acute Care Surgery.
Regional anaesthesia in elderly rib fractures reduces delirium by 35%. https://journals.lww.com/jtrauma/Abstract/2021/08000/Use_of_regional_analgesia_and_risk_of_delirium_in.3.aspx

1/3 Milrinone vs Dobutamine in Cardiogenic Shock
Hats off to the investigators

However small study, often randomised hours after ICU admission, & not selected based on underlying cause or hemodynamics

https://www.nejm.org/doi/full/10.1056/NEJMoa2026845

Therapeutic Anticoagulation with Heparin in NON-CRITICALLY ILL Patients with Covid-19

- improved survival to discharge without organ support at expense of increased bleeding events

http://nejm.org/doi/full/10.10…

#COVID19

Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19
- no major benefit compared with prophylactic dose

https://www.nejm.org/doi/pdf/10.1056/NEJMoa2103417?articleTools=true

#COVID

The South African Flag sign in High Lateral STEMI from @LITFLblog

https://litfl.com/high-lateral-stemi-ecg-library/

“I am very concerned about this patient, this patient is dying, I need all of you to help us save this persons life.”

I really can’t think of a more amazing clinician or human being than @cliffreid and I like to believe I become a little more like him after every talk I hear.

When critically important stuff you should have known already but learned from Twitter friends finally makes mainstream news…

Covid: Pulse oxygen monitors work less well on darker skin, experts say https://www.bbc.co.uk/news/health-58032842

Persistent Racial/Ethnic Disparities in Out-of-Hospital Cardiac Arrest - Annals of Emergency Medicine https://www.annemergmed.com/article/S0196-0644(21)00303-6/fulltext

Hot off the press: Engagement of the Median Glossoepiglottic Fold and Laryngeal View during Emergency Department Intubation https://www.annemergmed.com/article/S0196-0644(21)00312-7/fulltext @brian_driver @airwaycam @ErinKarl_MD

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Really enjoyed this one - I think there’s something in it for everyone involved in acute care. 30 mins of important learning on identifying those patients about to die if you don’t act fast https://twitter.com/_NMay/status/1420161932594720769

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The art and science of saving lives