#FOAMed

On June 15th 2016, I delivered an 8 minute talk arguing that we strongly consider the administration of systemic thrombolytics in patients with submassive pulmonary embolism at SMACCDub. This talk became infamous not for the content but for the masterful counterargument1 given by Iain Beardsell2.

Depending on your department the frequency with which you are faced with the need to transfer a critically ill intubated patient may vary but it is something we think all departments face at some point.

The concept of cardiac arrest centres is not entirely new and is something we've been talking about in Virchester for some time. Indeed, there are several articles in the literature and a fairly reasonable patho-physiological argument for them1–3.

Those days are gone.

I think it's probably fair to say that stroke physicians and emergency physicians disagree about the utility of thrombolysis in acute ischaemic stroke. They love it, probably because of its occasionally amazing effects in restoring an apparently dense hemiplegia with aphasia to almost normality.

This post is the second in a series recording my reflections on the past twelve months, which I have spent working for Sydney HEMS in prehospital and retrieval medicine. The first post covers medical education - you can find it here.