Load-Play-Go and “6 minutes approach” in Out of Hospital Cardiac Arrest . Is this just fool?

medest118's avatarMEDEST

PROTOCOLLO ELS da plastificare_engI’m really surprised of the great debate that the previous post (Load-Play-Go in Out of Hospital Cardiac Arrest. The “6 minutes approach”) arouse around the “6 minutes approach”, and all the comments on the “load-play and go” way to manage the OHCA patients potentially candidate to Externa Life Support.

Most of the comments affirmed that 6 minutes to run a code is an utopia, and that stay and play is the right and only way to manage out of hospital cardiac arrest (OHCA).

“This is silly. 6 minutes to work a code into the back of your ambulance?….”, “I just wish I could convince more people that out-of-hospital cardiac arrest is a “stay and play” and not a “half ass cpr that provides nothing to the patient and rush to the hospital” kind of call……”, “There’s next to nothing that will be done in the hospital that you can’t…

View original post 619 more words

Better Pink or Better Blue? Dealing with Cardiac Kids

songsorstories's avatarSongs or Stories

OK, here we go. This is the first in a 2 part series on a general approach to kids with cardiac disease. This post, by Dr Andrew Weatherall, is on key points of assessment. The second post in the series will be an attempt to provide simple goals of anaesthesia when looking after these kids. Dr Andrew Weatherall is a paediatric anaesthetist and prehospital doctor, working mostly at The Children’s Hospital at Westmead. He spends some time doing cardiac anaesthesia, including a couple of aid trips. This post also had a check by Dr Justin Skowno, also a cardiac anaesthetist at The Children’s Hospital at Westmead. 

Better Pink or Better Blue? The Kid with Congenital Heart Disease

We all have nightmares. They might have been monsters once. They might relate to Elvis Presley’s diet. For anaesthetists, it can be any number of clinical scenarios. Or sometimes the quality of the next cup of coffee.

View original post 1,507 more words

French SMUR : Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study

Important open access paper from a few years ago from France on role of prehospital critical care in severe trauma.

Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study

This paper in my opinion, is not about physician vs paramedic model of prehospital care. It is more about what meaningful interventions may improve care. Here they argue prehospital RSI is a major factor. The use of prehospital vasopressors to minimise IV fluids is a controversial policy in trauma but may have a role in select cases. Love to read your comments on this notable paper!