PHARM Podcast 21 – Australian Emergency Perspective June 2012 with Dr Amit Maini

Tune in to hear Amit and I discuss current affairs in EM and Critical Care for June 2012!

Hi folks!

This episode is the start of a regular monthly one with Dr Amit Maini, an Australian Emergency Physician who will provide a regular current affairs update and opinion on all things EM and Critical care for the PHARM Podcast.

He runs his own superlative EM/CC blog site called ED Trauma Critical Care . Check it out!

On this episode we discuss some hot EM/CC topics currently being debated on the blogsphere and twitterverse!

1.DSI – Damn Sexy Intubation or Dumb Silly idea?

2.Femoral vein access – the root of all evil

3. Thrombolytics in submassive PE – do you feel lucky?

4. ETI vs SGA in OHCA – why pigs should be intubated

Amit came and did my Prehospital Anaesthesia and Airway course back in May. Here are some awesome photos of him in action during our extrication exercise.

 

Stay safe and enjoy the interview

Minh

Now on to the Podcast

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3 thoughts on “PHARM Podcast 21 – Australian Emergency Perspective June 2012 with Dr Amit Maini”

  1. great discussion! 2.5 comments (I’ll separate them just in case they generate discussion…):

    1- re: nasal cannula during intubation. it can interfere with mask seal. as discussed briefly earlier, in the truly PEEP-dependent patient, it may be necessary to hold the nasal cannula until you start laryngoscopy (obviously with communication & coordination with the team beforehand)

    1.5- in most patients, a nasal cannula at 15 lpm is annoying but tolerable. I’ve tried it personally, and I know some others including Minh have as well. I used to keep it at 3-4 lpm as you discuss in the podcast until the meds were pushed, but the med/apneic time is truly time-dependent, there’re a lot of things going on, the stress level is high as you just paralyzed a patient and are waiting for laryngoscopy… adding one more task into that period seems like a bad idea to me. given how innocuous 15 lpm nasally is, I just put it on the patient and tell them it’s annoying but they’ll feel better soon.

    1. just listening to your new post on DSI with Scott Weingart & both of these points are just what he talks means about sterile cockpit– nothing unnecessary during grown-up time.

  2. 2- re: femoral lines. I agree with Matt Pirotte’s characterization of the femoral line as not something to avoid altogether, but a distant 3rd choice. that being said, I believe that a femoral line REQUIRES ultrasound for placement. the anatomy is too variable. Sinai’s US director, Bret Nelson, does a great job with our residents every time we sono anyone’s groin — look at the proper, textbook anatomy, then move up and down and watch the artery and vein dance back and forth. then reposition the leg and watch a whole new set of anatomic relationships. there is far too much inter- & intra- patient variability in groin anatomy to permit a landmark only approach.

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