Category: Critical Care
What is the Bezold-Jarisch Reflex and why do I care?! St Emlyn’s
Bradycardia in the trauma patient can be a perilous sign. One might observe a typical course of events in which a bleeding trauma patient progresses through the compensatory mechanisms in response to shock. It is …
JC: More on pulse oximetry and racial bias. St Emlyn’s
This week we are reviewing a paper on the accuracy of pulse oximetry in patients being assessed for ECMO. This is an interesting group as they represent and extremely unwell group of patients where small …
JC: The BASICS trial. 0.9% saline vs balanced solution. Does it matter?
I’ll admit that my long term clinical practice has been to prefer balanced solutions (in my case Hartmans) over 0.9% saline in the management of the critically ill patient. It’s a topic we’ve blogged and …
JC: Convalescent plasma (still) does not work in COVID-19. St Emlyn’s
The latest results on the use of convalescent plasma in Covid-19 are now out from the RECOVERY trial as a pre-print. As you know we have already covered the trial quite extensively and thus far …
Tocilizumabulous? A special offer on IL-6 with Tocilizumab.
It’s very rare we produce three instalments on one particular drug for one particular condition, and certainly not within such a short time frame. However, tocilizumab has been worth it. Maybe not the one intervention …
Tocilizumorelikeit? The latest data on Tocilizumab. St Emlyn’s
Hot on the heels of a terrific pun and blog post about the use of Tocilizumab, capturing all the intrigue, hope and caution with the potential use of this novel therapeutic agent for patients with severe …
Tocilizumaybe? Immune modulation in COVID-19 @StEmlyns
I am sure many of you saw the breaking news on the BBC the other week, about a new wonderdrug to strengthen our defences against the tidal wave that is COVID19. This follows a press …
VTE and COVID-19: Would you like to know more?
That’s a leading question. Of course you would. Who wouldn’t want to know more about a disease that has killed >1 million people to date, worldwide. Who wouldn’t want to know more about the thromboembolic risk associated …
JC: Can we give tranexamic acid (TXA) via the IM route? St Emlyn’s
Tranexamic Acid (TXA) is a mainstay of trauma management. CRASH 2 (2) demonstrated its effectiveness in bleeding patients and CRASH 3 (1,5) (in my opinion) showed that we should also be using it in mild/moderate …
JC: Effect of Ascorbic Acid, Corticosteroids, and Thiamine on Organ Injury in Septic Shock. The ACTS Randomized Clinical Trial St Emlyn’s
Back in 2017 the sepsis world had a rather strong reaction to a paper published by Paul Marik that suggested that a combination of steroid, vitamin C and Thiamine could cure sepsis. The data, published …
