Category: Resus & Crit Care

JC: The REST trial. St Emlyn’s

Some years ago I remember speaking to a rather well known intensivist who was advocating for the extracorporeal removal of CO2 in ICU patients. His logic was that in patients with hypoxic lung failure we


JC: CTCA for cardiac chest pain in the ED. St Emlyn’s

Computed Coronary Angiography (CTCA) has been advocated as a useful adjunct in the investigation of acute coronary syndromes (ACS) in the ED. Although we’ve made huge progress in the diagnosis of ACS through the use

Top 10 Trauma Papers for Trauma UK conference. 2020-2021. St Emyln’s

It’s that time of year again when the Trauma Care UK conference comes around and I get to talk about 10 interesting trauma papers from the last 12 months or so. This is a regular

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

targeted temperature management

JC: The TTM2 trial. Normothermia or hypothermia post cardiac arrest.

A quick update on an TTM2 trial published in the NEJM last month. As part of the chain of survival it’s important to optimise the post resuscitation phase, primarily to preserve neurological function as this

Big Shock…..Do we ❤ POCUS?

‘Red Standby 4 mins’ tannoys the nurse in charge. ‘It’s a 70yr old male BP 68/49, pulse 120, GCS 14/15, O2 sats 98% on 15L NRB, temperature 37.5°C’ you are reliably informed by a colleague.

Anaphylaxis – A Guideline Update

Although this post is mainly about the new Anaphylaxis Guidelines published recently, please bear with me while we get a little nerdy with some physiology first… For anyone starting out in Emergency Care, diagnosing and


JC: Thromboprophylaxis on the ICU for COVID-19 patients. St Emlyn’s

The prevention of venous thromboembolism (VTE) has been a real concern in the management of hospitalised patients with COVID-19. We have previously discussed the role of prophylactic anticoagulation (thromboprophylaxis) for these patients as it was

convalescent plasma

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


JC: Real world cricothyroidotomy experience. St Emlyn’s

Cricothyroidotomy is a procedure that worried many emergency physicians. Partly because it’s a rare procedure, but also because we are likely to embarking on it at a time when things are ‘going wrong’. The most

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