The Resus Room

Exploring the challenges of providing medical care to newborns, the podcast discusses differences between newborn and pediatric life support. It covers newborn transitional processes, resuscitation strategies, neonatal techniques, and management in critical situations. The episode also highlights challenges in resuscitating preterm babies and key points on newborn life support.

Well if last month was based on cardiac arrest, this month takes a deeper look at airways! First up we take a look at a paper that benchmarks the use of video laryngoscopy, specifically with the C-MAC and gives some really useful information from a Swiss HEMS service on first-pass success, the relevance of operator experience on success and factors that alter intubation success. Next up we're looking at blood in the airway with epistaxis...okay it's a tenuous link, but it pretty much works! The NOPAC study looks at the use of TXA in atraumatic epistaxis and compare it to placebo use, will TXA come up trumps in this setting? Finally we take a look at the use of scalpel cricothyroidotomy within the London HEMS service over a 20 year period, with a number of things we can learn from this experience. Once again we'd love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom. Simon & Rob

In this podcast, the hosts focus on maternal emergencies that are commonly encountered in prehospital or emergency medical practice. They discuss conditions such as antepartum and postpartum hemorrhage, cord prolapse, breech presentation, and shoulder dystocia. They also emphasize the importance of allowing nature to take its course during birth and highlight the significance of quick transfer to specialized facilities for prompt obstetric care. The podcast provides insights into managing these emergencies and emphasizes the importance of minimizing unnecessary intervention during childbirth.

So this month we've got a cardiac-arrest-fest for you! With 3 papers centered on the management of cardiac arrest, with some key points that will help inform and improve our practice. First up we have a think about where patients with a presumed cardiac cause of their arrest should be transported to. Trauma networks in the UK have changed destinations for patients, but is there a patient benefit transporting this patients to a cardiac arrest centre and if so how much? Next we look at the potential benefit to nurse-led cardiac arrests with a study that might change some thoughts on how we best run and collaborate our cardiac arrests. Finally we take a look at an open access paper from SJTREM, looking at the use of serum markers to help us prognosticate in hypothermic cardiac arrest and in these really challenging cases there is some great stuff to take from the paper. Once again we'd love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom. Simon & Rob

Welcome back to the podcast and our next Roadside to Resus episode, this time we’re taking a look at Diabetic Ketoacidosis, DKA. In this episode we’ll be getting our heads around the pathophysiology that underpins DKA, consider the clinical picture and severity of patients that present and look at both the in-hospital and pre-hospital management of these patients including topics such at fluid choice, insulin boluses and nasal ETCO2 for diagnosis of DKA. Let us know any thought and comments you have. Enjoy! Simon, Rob & James

So three very different papers for you this month... We start off having a look at a paper on the HINTS examination. This exam came to prominence a few years ago as a way to distinguish between central and peripheral causes of vertigo with a pretty amazing sensitivity and specificity. Since then many EM clinicians have brought it onto their practice and this paper seeks to assess how good the test is at the bedside in real life practice. Next up we take a look at a paper assessing the injury patterns in trapped patients and consider the prevalence of injuries both with regard to spinal and other injury patterns and then consider the impact that this holds with respect to extrication. Finally we have a look at a paper focussing on the inhospitable management of hypertension; the treatment strategies and the outcomes comparing those being treated during their inpatient stay versus this left untreated with some surprising outcomes... Once again we'd love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom. Simon & Rob

So in this episode we’re going to have a deeper think about advanced airway management and specifically supraglottic use in the prehospital and ED environment.  Many prehospital service have seen the removal of intubation from their scope of practice, and that’s understandably been received with mixed thoughts. But this isn’t the end of ‘expert advanced airway care for all; in fact far, far from it… we’ve all heard people talking about ‘whacking in an i-gel’, but really utilising a supraglottic device to its maximal potential can make a huge difference to our critically unwell patients.  We'll be running through an overview of supraglottic devices, the evidence surrounding their use, patient selection, patient positioning and size selection, placing a supraglottic device, troubleshooting and finally ongoing ventilation with a supraglottic device. We'd love to hear any comments or feedback you have and make sure to take a look at the references and resources below. Enjoy! Simon, Rob & James

Happy New Year! Well 2020 certainly wasn't what we were all expecting, so here's hoping for a phenomenally better 2021. We've got some really exciting episodes for you this year including Supraglottic Airways, Neonatal Resuscitation, Diabetic Emergencies, New Resuscitation guidelines and much much more! We're kicking off the podcast year with three really interesting papers! First up we consider the importance of first pass success of both supraglottic airways and endotracheal intubation in the context of cardiac arrest; a lot of attention has been shone recently on question of which approach we should consider after bag valve mask ventilation, but how important is the first pass of either of the approaches to the outcomes of our patients? Next up we have a look at a paper that challenges the use of TXA in our patients with a severe traumatic brain injury after the publication of CRASH 3. Finally we have another look at the mantra of 'GCS 8-intubate' with a systematic review which draws together all of the evidence across the age ranges and both traumatic and non-traumatic presentations. Make sure you take a look at our new CPD apps on both Android and iOS to log your time listening to this episode. Enjoy! Simon & Rob  

So for decades people have talked about Contrast Induced Nephropathy…or Contrast Induced Acute Kidney Injury, depending on the decade and location of discussion. The theory being that diuresis, increased urine viscosity and changes in vasoconstriction and vasodilation leads to a worsening of renal function following iv contrast administration. It seems to come from the 1950’s where some patients were seen to develop acute kidney injuries following iv contrast. Now times have changed and treatments and contrasts evolved but the discussion around contrast induced nephropathy continues. At times these discussion can mean that some patients wait for scans in the Emergency Department whilst waiting for blood tests to come back first. But is this the right thing to do? In this episode we take a look at the origins of contrast induced nephropathy, consider some recent publications on the topic and see how this translates to practice and applications of the most recent guidelines. Reading around the topic has been hugely informative for us and we hope will be of benefit to you too! Enjoy Simon & Rob

Welcome back to December's Papers of The Month Podcast! Three more papers for you which will challenge and inform you practice. First up we have a look at a systematic review and meta-analysis which considers the fluid choice in resuscitating those patients with suspected traumatic brain injury in the prehospital setting; should we be reaching for the hypertonic solutions, or is an isotonic fluid such as normal saline adequate? Next we take a look at a paper that has received a lot of online discussion which looks at the two approaches of antibiotics or surgery for an appendicitis. This is a randomised control trial that looks to answer a question that the literature has dipped into over the last few years, but this RCT goes that bit further and will help give patients a good idea of the pro's and con's of each approach. Finally we take a look at the UK national approach to oxygenation strategies in those patients receiving a prehospital emergency anaesthetic. How many clinicians provide PEEP, how commonly implemented is apnoeic oxygenation and do we all ventilate through apnoea? Gaining an understanding as to where our practice sits compared to others gives us the opportunity to consider the potential benefits and downsides of various strategies and may help unify practice to more streamlined working and better outcomes for our patients. We also get the opportunity to hear thoughts on the subject from one of the authors Dr. Amar Amshru, Emergency Medicine and and Pre Hospital Doctor in London and with Kent Surrey and Sussex Air Ambulance. Enjoy! Simon & Rob