One of the most stressful interventions for every one involved in the ED and the time to keep use a prompt card and live by Kipling’s recommendations: “If you can keep your head when all about you Are losing theirs and blaming it on you, ………………. If you can fill the unforgiving minute … More Emergency thoracotomy – clear head in a stressful situation.
One of the few moments in the ED where you actually look like George Clooney….but actually there is more to DCCV than just pressing the button and it does need at least 3 trained staff to ensure safe sedation and DCCV. The first question is always could this be done non-urgently and the second is … More More than just pressing the button?
Sometimes it is not the expert patients who know to ask for hydrocortisone that we need to worry about. How many patients on chronic steroid treatment (7.5mg prednisolone or equivalent for 3 weeks or more in the last 3 months) are managed as adrenal insufficiency? Note that hydrocortisone is every 6h – in a world … More Adrenal insufficiency – Hydrocortisone every 6h.
Easier said than done to think through all the options when faced with a critically ill patient. So rather than getting side-tracked by the question “Which fluids doctor? Normal saline or Hartmann’s?” work though the causes. Even better don’t reinvent the wheel but go to a prompt card which has been prepared with a cool … More Unexplained hypotension? Think!
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We describe the use of a novel endothermic surface cooling device, CAERvest®, on 3 marthon runners who had rectal temperatures (proxy for core body temperature, CBT) above 40°C. Two recovered rapidly and completely and were discharged home from hospital the same day. The third runner, with a rectal temperature of42.1°C, cooled to 37.5°C within 32 minttes. He required hospital admission for severe heat illness-‐associated complications but survived. There were no adverse effects from CAERvest use. Mean rates of CBT fall were 0.126°C/min. User acceptability was high, with positive qualitative feedback on ease of use and efficacy. In these patients, CAERvest has reduced CBT rapidly and safely in heatstroke. For the full text click here: Successful out of hospital treatment of heatstroke in 3 marathon runners-2. And for more information from the manufacturer click here: http://caervest.com/