From our fellow anaesthetist Lars Prag Antonsen comes this eye-opening essay on cognitive processes and how we apply them in high-pressure settings. Very relevant for anaesthetic practice as well as being an enjoyable read. Find the full-text article in the Journal of the Norwegian Medical Association here.
Patients with head- and neck injuries can have challenging airways. We often use videolaryngoscopes or flexible fibrescopes (single use scope) when performing intubation in such patients. Our colleagues in Copenhagen have put together a useful website with videos and other learning resources on that subject. They also arrange an annual two-day airway course with a very extensive workshop. Read more… Continue reading A Few Handy Resources on Airway Management
Brain impact apnoea causes secondary brain injury. The duration of the apnoea reflects the energy in the injury. We often see these patients in our trauma center as they come intubated. CT-scan can reveal structural brain damage or bleeding. In some pastients the CT-scan is “normal”. However, the brain may have suffered hypoxic injuries undetectable with… Continue reading More Brain Impact Apnoea
Follow the link to read the article: http://jamanetwork.com/journals/jama/fullarticle/2577957
In a recent article in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine by Pakkanen et al, retrospective data from a Finnish prehospital service is presented. They looked at prehospital management of severe TBI (severe head injury with GCS 8 or lower) over a 6-year period, including some 458 patients for analysis. They found a… Continue reading SJTREM: Physician Staffed EMS Associated With Improved Outcomes From TBI
Immediate apnea after acute head trauma is a concept that has received renewed focus lately. BIA/IBA (Brain Impact Apnea or as some call it, Impact Brain Apnea) was described in animal models as far back as 1874 by Koch and Filehne (1). A number of subsequent studies (2-5) have established a clear link between severity of impact and duration of… Continue reading Brain Impact Apnea
“Dry them out”; use glycopyrrolate (no central effects). How to use local anesthetics and more… emcrit.org Listen to the podcast here. EMcrit recommend: Airway Regional Anesthesia for Awake Fiberoptic Intubation, Simmons et al, Regional Anesthesia and Pain Medicine 2002. Read the review article here. Fibreoptic vs videolaryngoscopic (C-MAC(®) D-BLADE) nasal awake intubation under local anesthesia. Kramer et al. Anaesthesia. 2015… Continue reading Awake Intubation Lecture from SMACC