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This trial looked at "whether indirect laryngoscopy with a video laryngoscope would result in increased success on the first attempt at urgent oral endotracheal intubation in neonates".
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Adrenaline is recommended for all cardiac arrests not due to shockable rhythms and is associated with increased survival, especially if given in the first 10 minutes post arrest (1).
The rate...
A 62 yo patient with a previously diagnosed spontaneous coronary artery dissection (SCAD) presents with sudden onset 10/10 central severe chest pain. Examination is normal, with no pulse deficit...
We're back to an old question of should we give antibiotics for otitis media? The factors always being weighed up have been around the benefit which includes reduction in pain and resolution...
The patient with vertigo can be a clinical challenge. Patients may describe their symptoms as vertigo, or the room spinning, or dizziness, or a problem with balance, or use other descriptors....
Here's a case I have presented to me frequently. The resident presents the case of a 78 yo who had a mechanical fall at home. The patient may or may not remember a head strike. I am asked the...
Patients with acute aortic syndrome, may be very difficult to diagnose. Patients who present with textbook ripping severe chest pain and accompanying focal neurology and have findings of a pulse...
Here is a common scenario: The resident presents a case of a 58 yo patient who has presented with shortness of breath. They go over the examination, the ECG findings and then say ".... and the...
The 'zero-point survey' is the pre-primary survey. It is about preparing self, the team, the environment and the equipment. It is a 'cognitive roadmap' to prepare for complex resuscitation cases.
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Survival from out of hospital cardiac arrest varies from region to region. This makers sense as it depends on resources, such as medical and nursing staff, expertise of that staff and resources...
Cohen AL et al. Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest. Resuscitation 2022;173: 157-165.
When we are in the ACLS...
Non-traumatic subarachnoid haemorrhage (SAH) accounts for 5% of acute headache presentations to the emergency department. The urgency to make a diagnosis when patients have a 'warning leak'...
This is a review of the Pragmatic Trial Examining Oxygenation Prior to Intubation (PREOXI) trial(1).
The aim of this trial was to determine to determine the effect of preoxygenation with...
Paroxysmal Supraventricular Tachycardia (PSVT), is a non-ischaemic tachyarrhythmia, with which patients, not uncommonly, present to the emergency department. Methods currently available for...
The HALT-IT Trial(1) is an important trial and one we should know well. It looks at the use of Tranexamic Acid (TXA) in gastrointestinal bleeding. Prior to this trial a Cochrane systematic review...
Upper Gastrointestinal bleeding (UGIB) affects approximately 1 in 1000 of the population per year and has an overall mortality of up to 10%.
The cause of the UGIB in the patient in front of...
You might ask; "Why's is subclinical Atrial fibrillation important?" We know that patients in atrial fibrillation(AF) have a 5 x risk of stroke compared to those not in AF and that even short...
Up to one third of patients with out-of-hospital cardiac arrest(OHCA) have impaired myocardial contractility and vasodilatation. The mainstay of treatment is either adrenaline or noradrenaline.
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The GARFIELD-AF tool allows a single calculation for mortality, stroke and bleeding and can assist in risk/benefit decision-making.
The GARFIELD-AF(Global Anticoagulant Registry in the...
When I cardiovert AF, I use the highest energy possible energy in the first cardioversion attempt. I consider this to be a resistant arrhythmia and want to have the best chance of...
You might ask; "Why's is subclinical Atrial fibrillation important?" We know that patients in atrial fibrillation(AF) have a 5 x risk of stroke compared to those not in AF and that even short...
When cardioverting patients in new atrial fibrillation, we want our first attempt to be our best attempt.
The EPIC Trial(1) (Electrode Position In cardioverting Atrial Fibrillation) helps us...
Atrial Fibrillation is the most common arrhythmia we see. Conversion to sinus rhythm of recent-onset of atrial fibrillation is proven to be safe. How do you cardiovert? Is a pharmacological...
Here we review the RACE7 ACWAS (Rate Control vs Cardioversion Trial7-Acute Cardioversion versus Wait and See) Trial (1).
What they did
This was a multicenter, randomised, open label,...
