Resus & Crit Care

JC: Salt or Sugar? Hypertonic saline for head injury at St.Emlyn’s.

‘Why did you give Mannitol?’ asked the Registrar. ‘Hypertonic saline was the standard of care for head injury at St.Elsewhere and I was told it reduced mortality’. OK, so that’s a paraphrased recollection from some time ago. Our patient had…
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The European Guideline on Management of Major Bleeding – are you in or out?

After my recent, hugely enjoyable, trip to Austria and attendance at the “notfallmedizin 2016” where, as well as doing a talk about FOAMed, I chaired a session on “Volume and Coagulation” I became aware that the view of our colleagues…
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JC: Arrested Developments. St.Emlyn’s

  Good quality, practice-changing prehospital research is difficult to come by for a number of reasons, not least the fact that the standalone specialty itself is in relative infancy. Issues of consent and ethics, combined with the very urgent nature…
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When to withdraw resuscitation in the Emergency Department. St.Emlyn’s with Richard Taylor.

When can and should we withdraw from continuing resuscitation in the ED? The standby phone rings: Post cardiac arrest patient, approximately 50. Intubated, BP 80/40, GCS 3. ETA 5 minutes. You meet the crew in resus and get the story….
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Holy Smokes! Batman, the SOFA and the Latest Sepsis Definitions

We can be a confused bunch when it comes to sepsis.  We have seen definitions, debates and controversies as to how we treat and what we treat.  Today a new definition was unleashed on the world and you can read…
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Robocop gets the NICE 2016 major trauma treatment. St.Emlyn’s

Today, to much excitement, we saw the release of the NICE major trauma guidance.  Nat did an excellent review of the draft guidance, which you can read here.  We now have the full guideline which you can download from this…
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