Time- 0100
A 55-year-old man brought in by ambulance with a history of hematemesis.
His initial vitals are-
GCS15, Pulse- 125, BP- 110/70, Sats- 97%, Temp- 36.5
- Outline your assessment of this patient?
Category Archives: Critical Care
Case of the week 16
Time- 2100 (Cold winter night)
Priority 1 call
A 3-year-old boy, Jack was found face down in the bathtub at home. PEA arrest on scene.
ETA 5 minutes
- How will you prepare for his presentation?
Case of the week 15
In a busy night shift, a 42-year-old man was brought in by police after found in the train station agitated. He is still in the police van and very uncooperative.
The shift coordinator wants you to assess the patient.
- How will you approach the situation?
Case of the week 14
Time- 0200
A 51-year-old male with a history of diabetes and hypertension presented to the hospital with left facial droop, slurred speech, and left-sided hemiparesis. His initial CT scan was negative for acute hemorrhage. As he has no contraindication for thrombolysis the stroke team decided to treat him with tPA.
After the infusion finished patient developed left-sided facial swelling.
- How will you approach this situation initially?
Anaphylaxis
Basic Airway Management
Purpose (Description)
- Provide support to optimise oxygenation and ventilation using basic techniques of
- airway opening manoeuvres
- airway adjuncts
- oropharyngeal device (OP)
- nasopharyngeal device (NPA)
- bag valve mask (BVM)
Continue reading
Bag Mask Ventilation
Purpose (Description)
Indication
- administration of high flow O2
- provision of PEEP
- provision of controlled ventilation
- provision of augmentation of spontaneous ventilation
Contra-indication
Bite-Sized Basics: Urgent Endotracheal Intubation
The Urgent Endotracheal Intubation (UEI) describes the primary intubation scenario that occurs in the ED where intubation must proceed in a semi-rapid or rapid fashion due to the patient’s clinical state.
We discuss the Rapid Sequence Intubation, the mainstay of the UEI with the longest history and firmest evidence base.
In Beyond the Basics we look at alternatives to RSI including:
– Modified RSI
– Rapid Sequence Airway (RSA)
– Delayed Sequence Intubation (DSI)
– Awake Intubation
– Inevitable Surgical Airway
Bite-Sized Basics: Apnoeic Oxygenation
We take a look at the relatively new airway management technique of Apnoeic Oxygenation, explaining
– what it is and how we perform it
– how it works
– what’s the evidence
– when we should use it
and include some techniques that are BEYOND THE BASICS.
Bite-Sized Basics: Preoxygenation
This is our very first Bite-Sized Basics post and the topic is Preoxygenation.
Preoxygenation (PreOx) is a critical step performed prior to intubation or sedation to extend the period of safe apnoea. We take a look at:
– how best to perform it and the choice of Preox devices in the ED
– what to do when we run into problems achieving PreOx