Category: respiratory

The ‘Roid’ to Recovery? REMAP-CAP @ St Emlyn’s

This week JAMA published three important trials on the use of steroids in patients with severe COVID-19, with an additional cherry on top; a subsequent inclusive meta-analysis (totalling 7 RCTs and 1703 patients) from the

JC: Conservative management of pneumothoraces.

When I trained here in Virchester we had a fairly aggressive approach to the management of pneumothoraces. All trauma pneumothoraces got chest drains, a chest drain meant an open one, the size was as big

2019 Novel Coronavirus (Wuhan) at St Emlyn’s

Thursday afternoon, I brazenly told my director that the coronavirus needn’t warrant immediate concern.  I didn’t want to add to the typical hysteria that leads to people purchasing too many medical supplies that then results

JC: Should we continue ventilations 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

JC: The last breath for apnoeic oxygenation?

Apnoeic oxygenation in emergency intubation in the ED is a concept that has emerged in the past few years and has been promoted by the FOAMed community quite extensively. I have to admit it is

An Introduction to the Breathless Patient in the ED

Patients with “shortness of breath” are a challenge in the ED. Shortness of breath can be a frightening presenting complaint for both patients and doctors. When you think about it, it represents the body struggling

JC: Hypertonic Saline for Bronchiolitis. St.Emlyn’s

My initial impression when this article popped up on email was that this is old news. We’ve been using 3% nebulised saline for Bronchiolitis in infants for many years (despite major concerns from paediatricians when

JC: Should we use Heimlich Valves for ambulatory pneumothorax management? St. Emlyn’s

Here at St. Emlyn’s we have been managing patients with pneumothoraces as out patients for many years. The approach in the UK has been ‘guided’ by the BritishThoracic Society guidelines. For many PNXs we simply

JC: Does Magnesium work in asthma? St.Emlyn’s

This is a roller coaster journey  for me. Many years ago Virchester ED was one of the first hospitals to start using Magnesium for the treatment of acute severe asthma. This prompted great concern amongst


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