PHEMCAST

Further reading Matt has kindly provided a list of references from his Trauma Care talk which this podcast is based on: Peri-operative and critical care management of the brain – current evidence. Anaesthesia: Vol 77, No S1. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition Vasopressors in Trauma: A … Continue reading Vasopressors in Trauma

Read more about the Cochrane injuries group: https://injuries.cochrane.org/about-us-0 Have a listen to the earlier TXA podcast here: https://phemcast.co.uk/2018/01/18/episode-26-tranexamic-acid/ Do you want to revise your clotting pathways and the mechanism of action of TXA?! Here are some links to the excellent Life in the Fast Lane: https://partone.litfl.com/clotting.html https://partone.litfl.com/unclotting.html The Resus Room podcast which discusses Tim and … Continue reading TXA – an update

Road traffic collisions are a leading cause of death and injury. Following a road traffic collision many patients will remain trapped in their vehicle. Extrication is the process by which injured or potentially injured people are removed from their vehicle by the rescue services. Rescue service training focuses on the absolute movement minimisation of potentially … Continue reading Extrication

This is the book Jon quotes, “Pain is a symphony…” The International Association for the Study of Pain’s revised definition of pain is available here. If you’d like to read more about ‘nocebo’ i.e. the non-pharmacological adverse effects of an intervention, have a look at this article. Penthrox For more information on Penthrox, you can … Continue reading Pain (& analgesia)

Before you listen to this new podcast, we encourage you to go back and have a listen to Episode 16: Blood which we released in 2017 outlining the available evidence about prehospital blood, and the background to the RePHILL trial. The RePHILL (Resuscitation with Pre-Hospital Blood Products) original paper is available here, and you can … Continue reading RePHILL

This podcast is dedicated to the memory of Emmanuel Cauchy. George’s adventures! Grading frostbite The GELOX study The Hyperbaric oxygen study described by Carron is now in print and available here. Guidelines The guidelines mentioned by Chris can be found on the Wilderness Medical Society website. References Cauchy et al. The value of technetium 99 … Continue reading Cold Injury

Some useful videos: Hopefully you found the podcast interesting, but since this is quite a visual topic we have put together some videos to demonstrate some of the pathologies discussed and what they look like on ultrasound: How does ultrasound work? Want to know how to use ultrasound? This is a whole 45 minute introductory … Continue reading Ultrasound

Definitions UK definition (RCEM): It describes the sudden onset of aggressive and violent behaviour and autonomic dysfunction, typically in the setting of acute on chronic drug abuse or serious mental illness. Australian definition (NSW Health): Behaviour that puts the patient or others at immediate risk of serious harm and may include threatening or aggressive behaviour, … Continue reading Acute behavioural disturbance

This was a joint podcast with our friends & colleagues at WEMCast – to hear more from them, have a look at their podcast back catalogue, and there’s more information on the World Extreme Medicine website. Mosquito born disease Malaria is transmitted through the bite of an infected female Anopheles mosquito. It is widely distributed … Continue reading The Jungle

Guidance documents College of Paramedics Statement on Intubation, available here. AAGBI Safer Prehospital Anaesthesia 2017, available here. Positioning Recommended Rich Levitan resources Airway axes Epiglottoscopy Bimanual Laryngoscopy Further resources Apnoeic Oxygenation in Resuscitation: Is it time? https://anaesthetists.org/Home/Resources-publications/Guidelines/Safer-pre-hospital-anaesthesia Click here to hear what our friends over at the Resus Room think about Airways 2 References (kindly … Continue reading Intubation

From: https://www.bbc.co.uk/news/uk-wales-46441129 From: https://www.ultimatekilimanjaro.com/blog/should-i-use-supplemental-oxygen-on-kilimanjaro/ Want to know more? This is one of the organisations Lucy mentions: British Exploring And this is the Global Health MSc The Wilderness Society Guidelines are available here. This is the link to the Wilderness Medical Society. Consensus statement from the UIAA on People with Pre-Existing Conditions Going to the Mountains, … Continue reading Altitude

Some facts Drowning is important: 1,000 people drown every day, 2 every 3 minutes, 41 per hour. It is the world’s 3rd leading cause of accidental death: 3.6 million people over 10 years. Disease of youth 64% < 30 years old 43% < 15 years old 25% < 5 years old Male: female ratio 2:1 In … Continue reading Drowning

Case definition Current case definition for COVID-19 can be accessed here. Risk stratification This is the Emergency Medicine Specialty guide we discussed in the podcast, which includes use of the NEWS and 40 step test (edit: since recording the podcast yesterday (!) we’ve been made aware of the Sit to Stand test). Here is a … Continue reading Episode 36: COVID-19

A: Optimal airway position for infants Note how a rolled towel is placed under the baby’s shoulders to allow space for the occiput and avoid flexion of the neck and airway. ‘B’ assessment Video links to examples of children with signs of respiratory distress: Stridor Grunting Increased work of breathing ‘D’ assessment Example video showing … Continue reading Episode 35: The collapsed infant

So, where is the Cauda Equina? From Core EM How does a herniated disc cause CES? This fab infographic summarising the key points about the CES guidance was produced by @DrLindaDykes and @saspist. Here is the full guideline from The Society of British Neurological Surgeons and The British Association of Spinal Surgeons. NICE guidance on Low back … Continue reading Episode 34: Back pain

Many thanks to Suzanne O’Sullivan for her time in putting this podcast together. Her excellent books “It’s all in your head” and “Brainstorm” are well worth a read.   It is certainly one of the PHEMcast recordings which is going to change my own practice the most.   We can all find these patient’s challenging … Continue reading Episode 33: Psychosomatic Illness

      Huge thanks to the team at World Extreme Medicine and WEM Cast for sharing the interview with Richard Harris.       Dosing These are a guide only, each patient will need a bespoke approach depending on their pre-existing condition, degree of cardiovascular compromise, conscious level and drugs already administered. Clearly you … Continue reading Episode 32: Ketamine

  The Danish mnemonic to help remember the elements of a cerebellar neurological examination: There are lots of Youtube videos to demonstrate these signs, here are a few which I thought were particularly helpful: Disdiadochokinesis Ataxia Nystagmus Intention tremor If you would like to read more, there is a blog post Martin and I wrote … Continue reading Episode 31: Stroke & Dizziness

Quite a few of our previous podcasts include content which is relevant to this Head Injury one. Why not go back and have a listen to: Episode 3: Hyperoxia Episode 20: End Tidal Carbon Dioxide Episode 28: LOST (Low Output State in Trauma) Munroe-Kellie Doctrine The Munroe-Kellie Doctrine is illustrated by the following pictures: Or, … Continue reading Episode 30: Head injury

  Another invitation to the Trauma Care Conference this year inspired us to combine two of the excellent speakers into this podcast considering major incidents. Thanks to both our speakers for sharing their talks from the conference.   Trauma Care offer more than the annual conference; there are monthly webinars and regional meetings too, click … Continue reading Episode 29: Major Incidents