The Resus Room

Here's a look at some of the papers that caught our eye this month. We have a look at patient positioning for RSI, the implication of hypothermia on arrival in the ED and the reliability of clinical assessment of syncope in our elderly patients. Make sure you go and have a look at the papers yourself to see what the evidence means to you. Head-Elevated Patient Positioning Decreases Complications of Emergent Tracheal Intubation in the Ward and Intensive Care Unit. Khandelwal N. Anesth Analg. 2016 Apr;122(4):1101-7. doi: 10.1213/ANE.0000000000001184. Reliability of clinical assessments in older adults with syncope or near syncope. Nishijima DK. Acad Emerg Med. 2016 Mar 29. doi: 10.1111/acem.12977. [Epub ahead of print] Effects of prehospital hypothermia on transfusion requirements and outcomes: a retrospective observatory trial. Klauke N. BMJ Open. 2016 Mar 30;6(3):e009913. doi: 10.1136/bmjopen-2015-009913.

So this is a talk I gave at the EMCEF 22 conference. This covers a few of the papers we've discussed in the last 6 months on the podcast but a bit of spaced repetition is never a bad thing! We'll be running through topics on heart failure, sedation, intubation, anaphylaxis and duration of cardiac arrest. The papers are well worth a look and whilst not all high quality evidence they do bring to the front some really interesting questions about are practice and prompt us to challenge our habits. Enjoy! References Diagnosing Acute Heart Failure in the Emergency Department: A Systematic Review and Meta-analysis. Martindale JL. Acad Emerg Med. 2016 Mar;23(3):223-42. doi: 10.1111/acem.12878. Epub 2016 Feb 13.Martinda Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis. Bellolio MF. Acad Emerg Med. 2016 Feb;23(2):119-34. doi: 10.1111/acem.12875. Epub 2016 Jan 22. Utility of gum-elastic bougie for tracheal intubation during chest com

In this episode we were lucky enough to catch up with Sam Sadek, EM Consultant at The Royal London hospital and HEMS doctor and also Zaf Qasim EM Consultant in Delaware in the United States. Both have been heavily involved in the setup and delivery of REBOA service in their respective posts. In this podcast they share their experience and expertise on the topic of setting up a REBOA service. A huge thanks to both of them as this is a superb podcast for anybody considering getting involved in REBOA. Recent podcasts on REBOA on ERCAST and EMCrit are essential listening and serve as great preludes to our discussion so make sure you check them out. Please pop any comments or questions at the bottom of the page and we will come back with a Q&A podcast on the topic really soon! References Resuscitative endovascular balloon occlusion of the aorta: a gap analysis of severely injured UK combat casualties. Morrison JJ. . Shock. 2014 May;41(5):388-93. doi: 10.1097/SHK.0000000000000136. Resuscitative endovascular bal

So we were lucky enough to be asked to cover the Trauma Care Conference and specifically today's day focussing on Major Trauma in the Emergency Department. We managed to to get a few minutes of time from some of the superb speakers and get their  take home messages from their talks. Enjoy! Relevant Resources TraumaCare PHEMCAST  KIDS Calculator Perimortem C-section

Rob Fenwick talks to us about this common condition and amongst others throws up a few surprises about the risks of rewarming. Enjoy

Here's a look at some of the papers that caught our eye this month. We cover the best way to diagnose heart failure, the risks associated with hyperopia and the utility of ETCO2.  Take the time to have a look at the papers yourself and leave any feed back or comments at the bottom of the page, enjoy!

So in this short podcast we're going to run over the summary of recommendations just published by the British Thoracic Society and the Intensive Care society on the Ventilatory Management of Acute Hypercapnia Respiratory Failure in Adults. This isn't in anyway intended as a replacement for reading the document itself so please make sure you take the time to do that.

Needle decompression of a pneumothorax is a time critical and life saving procedure. Classical teaching is to perform this in the 2nd ICS midclavicular line but is this the easiest and most effective place to perform it? In this podcast I speak with Zaf Qasim, an EM physician in the US about the topic and the underpinning EBM. Below are some of the papers we'll be discussing. Enjoy! Simon

This month we're looking at the JAMA paper on the new sepsis definitions, adverse event rates in ED sedation, interventional treatment for the over 80's with ACS and more!

A look at the headlines from the newly released guidance from NICE. Some bits of this may prove tricky to implement with current systems including the time to RSI....

We talk through some core content on epilepsy, some algorithims for treatment, some of the evidence base that surrounds the topic and some of the difficulties surrounding decision making

Welcome to February's papers of the month. This time we're talking about decompressing tension pneumothoraces, nasal oxygenation, prognosis of cardiac arrest with respect to duration and more!

Rob Fenwick talks us through some key points regarding anaphylaxis and some recent literature which may be a surprise regarding biphasic reactions, enjoy!

Here are the papers that caught our eye this month including direct vs video laryngoscopy, ultrasound for shortness of breath, ecg findings in PE and more!