The Resus Room

Simon Laing, Rob Fenwick & James Yates
The Resus Room

Emergency Medicine podcasts based on evidence based medicine focussed on practice in and around the resus room.

  1. 1 АПР.

    April 2025; papers of the month

    Welcome back to April's Papers of the Month! First up this month we have a think about posterior circulatory strokes, which can mimic benign vertigo, and can be really tricky to differentiate between a completely benign issue or a stroke that is really important to pick up. Clearly imaging everyone is one option but completely impractical when you consider the gold standard of MRI. So having a bedside tests to rule in or out the diagnosis of stroke would be a huge help. Our first paper looks at the use of three bedside scoring systems; HINTS, TriAGe+ and ABCD2 scores in ED for patients presenting with possible posterior circulatory strokes. How accurate are they and can we reliably incorporate into our practice? Next up is traumatic cardiac arrest. This has obviously got a very high mortality rate. One of the interventions that might improve mortality (for some mechanisms and patients) is a resuscitative thoracotomy, however this is a really significant intervention and we want to ensure we are targeting it at the patients that may benefit. A great paper has just been published from London Air Ambulance which might just help us to identify those patients who would benefit with more certainty, along with those where futility has already been reached. Finally we take a look at acute kidney injury (AKI) and its association contrasted scans. Contrast induced nephropathy (CIN) has historically been a concern, particularly for patients with chronic kidney disease, with contrast causing direct injury and limited blood flow. But recent studies have questioned the actual risk of CIN & there’s been a more recent RCEM statement on the topic, but we thought this might be a nice opportunity to refresh and look at a recent paper on the topic. Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

    33 мин.
  2. 18 МАР.

    Electrical Injuries; Roadside to Resus

    Welcome back to The Resus Room! This time, we’re diving into the fascinating and often overlooked world of electrical injuries. From household mishaps and workplace accidents to tasers and even lightning strikes, electrical injuries can range from minor shocks to life-threatening cardiac arrests. As always, we’ll be taking you through the full spectrum of care, from first contact at the roadside to critical management in resus. And let’s be honest, there’s a real lack of clear guidance out there when it comes to managing these cases. So, we’ve done the legwork, scoured the literature, and we’re here to make sense of it all. In this episode, we’ll cover: Pathophysiology; how electricity interacts with the body and why not all shocks are created equal. Classification; what makes a low-voltage injury different from a high-voltage one, and why that matters. Prehospital & ED Management; who needs an ECG, who needs admission, and what to do with those tricky "seemingly fine" patients. Special cases; tasers, lightning strikes, and the unique challenges they pose. One of the big questions we’ll be tackling: Does everyone who gets an electric shock need to go to hospital? We’ve all seen them, the patient that has a shock at work, but they feel fine. So, do they need a work-up, or can they safely go home? So, grab a coffee (or maybe a non-conductive beverage of choice), and let’s get stuck in to Electrical Injuries! Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

    1 ч. 4 мин.
  3. 12 ФЕВР.

    Maternal Arrest; Roadside to Resus

    Cardiac Arrest in pregnancy affects around 1: 12-30,000 women in the developed world. As you’d expect the risk of death for mother and child is extremely high, but some causes of arrest are reversible and we can make a real impact with our care and treatment of these cases Now it goes without saying that these are some of the most emotive, complex and technically challenging Resuscitations that you could think to be involved in; by definition young female arrest with unborn babies involved. Thankfully this is not going to be a case that many of us see, but with the stakes so high and potential to impact on the outcome of two patients, it’s an area that’s worth real consideration, preparation and mental rehearsal in case we are one of the few that may need to deal with it! In this episode we’re going to run through all the same stuff that you’d expect; pathophysiology of pregnancy, aetiology and the way in which we should approach these arrests. But then we’re lucky enough to be joined by Caroline Leech, an EM and Prehospital doctor who’s an expert in the area having just published a key paper that’s prompted loads of discussion in crew room and online on the topic of maternal arrest and Resuscitative Hysterotomy which will really challenges our perception on survival for both mum and the unborn baby if a RH is indicated. So we’ll be running through that paper with some really valuable insights from Caroline and wrap up with some questions to her exploring experience from cases, along with potential strategies for how approach and manage these cases for those working both in prehospital and in-hospital settings. Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon, Rob & James

    1 ч. 6 мин.
  4. 1 ЯНВ.

    January 2025; papers of the month

    Happy New Year!!! We hope you've had some time off over the festive period and now we're back to kick start the new year with three more great papers. Syncope is common presentation to the Emergency Department, accounting for 1% of presentations. Without a clear precipitant of the event it can be challenging to identify those patients who have a higher risk of associated morbidity and mortality, and furthermore those who would benefit from further investigation and observations. Our first paper looks at syncope risk-stratification tools and sheds some light on their utility. Acute exacerbations of COPD with acute type 2 respiratory failure and frequently treated with non-invasive ventilation (NIV), with high flow nasal oxygenation a treatment normally for patients in type 1 respiratory failure. However our second paper is a fantastic RCT looking at the the application of either NIV or high flow nasal oxygenation in those type 2 COPD exacerbations, are both options for our patients? Finally, since the advent of trauma networks in the UK, prehospital patients have been triaged to the most relevant centre based upon trauma triage tools. Our third paper looks at the performance of these tools and gives valuable insights for both those clinicians using the tools and those receiving trauma patients in both MTCs and other trauma units. Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom! Simon & Rob

    34 мин.
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Emergency Medicine podcasts based on evidence based medicine focussed on practice in and around the resus room.

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