The Resus Room

This podcast episode covers interesting topics like using ultrasound to diagnose acute heart failure, adverse events during sedation, refining intubation techniques, and biphasic anaphylactic reactions in patients.

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 balloon occlusion of the aorta might be dangerous in patients with severe torso trauma: A propensity score analysis. Inoue J. J Trauma Acute Care Surg. 2016 Apr;80(4):559-67. doi: 10.1097/TA.0000000000000968. The inflammatory sequelae of aortic balloon occlusion in hemorrhagic shock. Morrison JJ. J Surg Res. 2014 Oct;191(2):423-31. doi: 10.1016/j.jss.2014.04.012. Epub 2014 Apr 13. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales. Barnard EB. Emerg Med J. 2015 Dec;32(12):926-32. doi: 10.1136/emermed-2015-205217. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Rossaint R. Crit Care. 2016 Apr 12;20(1):100. doi: 10.1186/s13054-016-1265-x. Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for noncompressible truncal hemorrhage. Moore LJ. J Trauma Acute Care Surg. 2015 Oct;79(4):523-30; discussion 530-2. doi: 10.1097/TA.0000000000000809. The AAST Prospective Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) Registry: Data on contemporary utilization and outcomes of aortic occlusion and resuscitative balloon occlusion of the aorta (REBOA). DuBose JJ. J Trauma Acute Care Surg. 2016 Apr 5. [Epub ahead of print]

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

Discussion on hypothermia including the risks of rewarming, understanding causes and challenges of cardiac arrest, treatment options and symptoms, effects on the body such as decreased CNS metabolism and coagulopathy, stages of severe hypothermia, and methods of rewarming patients in cardiac arrest.

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!

Exploring the new NICE guidelines on Major Trauma practice, including airway and chest trauma management, fluid resuscitation, and comprehensive patient management strategies. Highlights include recommendations for rapid transport to a Major Trauma Centre, use of tranexamic acid, and emphasis on staff training and family support in trauma rooms.

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