#c3ap6

JC: Rocuronium or Suxamethoniun for RSI. Equivalence, non-inferiority or difference???? #journalclub #airway #RSI #foamed #roc #sux

We’re always a little cautious (scared) about entering any sort of emergency airway debate on social media as opinions are usually strongly held, and evidence is often of the lighter variety. One of the more controversial questions is in the use of first choice paralytics for ED RSI. In the past we used suxamethonium for its rapid action, but it does have rather a lot of side effects which have…

JC: Macintosh vs. McGrath laryngoscopy in pre-hospital care.

There has been an ongoing debate about the use of video laryngoscopy (VL) in emergency and critical care​1–4​. Proponents speak of the better visibility and ability to teach using video systems whereas those preferring a direct laryngoscopic (DL) approach speak to a more rapid, tried and tested technique. A few studies exist which in general have favoured DL owing to the increased time,…

JC: Ventilation during RSI. St Emlyn’s

Over the last few years there has been much effort and a fair bit of #FOAMed activity around ensuring that RSI in critical environments is as safe and efficient as possible. Concepts such as first pass success1, apnoeic oxygenation2–4, positioning5, bougies6,7 and more have all aimed to promote safe practice. An overarching principle behind these innovations and adaptations is the aim of…

JC: Should we premedicate for ketamine sedation? St Emlyn’s

Here in Virchester we believe that we were early pioneers of conscious sedation in the UK. It’s something we adopted as a routine procedure back in the 90s, in both adults and children, and so over the years we have tried to refine and adapt our techniques as the evidence changed. If you want to read more about our philosophical approach to sedation in the emergency department then you can read…

Podcast: September 2018 round up of the St Emlyn’s blog

Here’s the September podcast round up of the St Emlyn’s blog.

For some reason this did not get published back in 2018, so here it is now 🙂

The following blogs are discussed.

OOHCA and airway management. Do we need a tube?  http://www.stemlynsblog.org/jc-oohca-and-airway-management-do-we-need-a-tube-st-emlyns/

The Zero Point Survey. Optimising resuscitation teams in the ED. https://www.stemlynsbl…

JC: Cricoid Pressure and RSI, do we still need it? St Emlyn’s

This blog reviews the first large randomised controlled trial of cricoid pressure in emergency patients as published in JAMA Surgery, October 2018.

Cricoid pressure is controversial. Although it has been taught in anaesthesia practice as an essential requirement when performing RSI, the evidence for its benefit and lack of risk is far from compelling1. The late Dr John Hinds famously brought this…

JC: OOHCA and Airway management. Do we need a tube? St Emlyn’s

  If out-of-hospital cardiac arrest and outcome data is the topic, long is the list of research and passionate is the debate on every possible measurable outcome from pit crew CPR to methodology of compression delivery or the merits of load-and-go vs. stay-and-play.  Another loved and frequently debated topic among prehospital enthusiasts is that of the prehospital airway: the provider, the…