The Resus Room

This episode covers the topics of ECMO-CPR, ultrasound for testicular torsion, and a quality improvement project on paramedic intubation. Highlights include a trial comparing eCPR and conventional CPR, identifying diagnostic factors for testicular torsion, and significant improvements in first-pass success rate for intubation.

So in this episode we’re going to be covering crush injury.  When you think about it, visions of falling rocks, industrial accidents and high speed RTCs may come to mind, but actually a crush injury can be sustained in a huge variety of ways without such vivid circumstances. Definitions according to the Faculty of Prehospital Care are that; ‘A crush injury is a direct injury resulting from crush.  Crush syndrome is the systemic manifestation of muscle cell damage resulting from pressure or crushing’ So in the episode we’re going to run through all of the bits that we normally cover, from pathophysiology, to presentation and onto treatment. We'll also be looking at the controversy and evidence behind tourniquet use, fluid therapy, electrolyte management and much, much more! Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James

This podcast covers three interesting topics. They discuss improving outcomes in refractory VF by changing pad position, limiting adrenaline use, and using beta blockers. They also talk about the use of fentanyl lozenges for pre-hospital pain relief, showing significant decrease in pain levels. Finally, they explore the management of acute behavioral disturbance, emphasizing the use of sedation and de-escalation strategies.

Welcome back to our first Roadside to Resus episode for 2023! We're back with the huge topic that is COPD. In this episode we're going to delve into the depths of the topic, helping us to deliver the best possible care for this frequently encountered presentation. Along with the standard coverage from incidence, to pathophysiology, to presentation and treatment, we'll also be covering those topics that you've specifically asked for; The mechanism behind hypercapnoeic respiratory failure, in those patients given to much oxygen Is there a role for end tidal CO2 interpretation in those spontaneously ventilating in acute exacerbations of COPD How do we tease out those for home care versus those that require hospital admission What is the role of Magnesium in these patients Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James

In this podcast, they discuss the benefits of thrombolytics or anticoagulants for patients in cardiac arrest due to a presumed MI, the potential harm of administering steroids to COVID-19 patients not requiring supplemental oxygen, and the use of point of care lactate in predicting the need for in-hospital blood product resuscitation.

So following on from our Bradycardia episode, we're going to look in detail at cardiac pacing. Setting up emergency pacing in those compromised bradycardia patients can make a significant difference to patient outcomes, and doing so in a timely and slick fashion can be a real challenge. In this episode we'll be discussing all forms of pacing, strategies for ensuring the greatest likelihood of success and the details of setup and analgesia/sedation strategies for external pacing. Once again we'd love to hear any comments or questions either via the website or social media. Enjoy! Simon, Rob & James

Welcome back to 200th episode of the podcast! A huge thank to all of you for your support and engagement. Three more papers for you this month to challenge thinking across a board range of Emergency Care. First up we take a look at DOSE VF, an RCT look at the best defibrillation strategy for refractory VF. Next we take a look at another RCT looking at the potential benefit of dexamethasone, in order to reduce pain in patients suffering with renal colic. Last up, we've talked a lot about the importance of first pass success in advanced airway management, but what (if any) is the association with mortality in prehospital RSI? Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom. Simon & Rob

Acute Behavioural Disturbance (ABD), one of the most challenging, dangerous and serious presentations that we will encounter in emergency management of patients. There is no widely accepted definition of ABD. Really it’s an umbrella term for a patient presenting with a triad of features, secondary to a specific underlying cause, made up of; Delirium Severe agitation and aggressive behaviour Autonomic dysfunction In this episode we're going to run through ABD, it's causes, the approach and investigation. Excellent management of these cases relies upon high quality team working, planning, communications and strategies to keep all involved safe and we'll be discussing each of those in turn. Enjoy! Simon, Rob & James  

This podcast covers three interesting topics: challenging guidelines on nitrate administration during myocardial infarction, different blood pressure targets for post cardiac arrest patients, and healthcare professionals' perceptions of interprofessional teamwork in critical incidents.

We’ve covered tachycardias, both narrow and broad before, but we need to complete the set.  So this time we’ll be looking at the slower end of the spectrum, with bradycardias. Bradycardias can be a physiological state in athletes, but they can also be of significant concern. They occur due to a multitude of reasons, some cardiac and some not and they can require no treatment at all right up to those peri-arrest patients where you’ll be cracking open your critical care drugs and starting to pace them externally before getting them to definitive care. In this episode we take an in-depth look at the cause, electrophysiological pathways, assessment and treatments for bradycardias. Enjoy! Simon, Rob & James