Rank #1: Best Emergency Medicine literature of the year 2018/19
Ken Milne the author of skeptics guide to emergency medicine SGEM reviews the hottest critical care literature for 2018 2019. Ken reviews articles from the Lomaghi trial on magnesium for rate control in Atrial fibrillation, Expulsive therapy for renal calculi with Tamulosin, Oxygen therapy in critical illness in the Iota trial and finally aromatherapy for nausea and vomiting.
Dec 09 2019
Rank #2: Hardcore EM: How an Emergency Physician Thinks
Hardcore EM: How an Emergency Physician Thinks
Mar 02 2019
Rank #3: Neuro ICU: SAH: Cerebral salt wasting (real or imaginary)
Neuro ICU: SAH: Cerebral salt wasting (real or imaginary)
Mar 01 2019
Rank #4: Muscle wasting in ICU: Fat, Feed and Futility
Muscle wasting in intensive care is the thief of future health. Hugh Montgomery shows us what a big issue this is and what can be done to mitigate the problem.
Jan 24 2020
Rank #5: Cutting Edge Cardiac Arrest
A panel with the chairs of ILCOR discussing their two newest protocols. Hosted by Scott Weingart.
Jan 24 2020
Rank #6: Disruption, danger, and droperidol: emergency management of the agitated patient - Reuben Strayer
Agitation poses a direct threat to the safety of both patient and staff, as well as being an important manifestation of dangerous conditions that require rapid identification and treatment. Management of agitation consists primarily of physical and chemical restraint, and the details of how restraint is carried out–usually based more on tradition than considered plans or thoughtful protocols–directly determine case outcome. In this talk, we’ll discuss the initial approach to agitation, focusing on the appropriate role of physical restraint, as well as best practice technique for physical restraint. We will then deliberate the options for chemical sedation and propose a menu of the safest and most effective agents for a variety of common agitation scenarios. Some of the questions we will address include: What are the most important dangerous conditions that cause–or are caused by–agitation? What are dangerous restraint holds, and how can physical restraint be accomplished in the safest manner? In the initial management of an agitated patient, should chemical restraint be administered by the intravenous or intramuscular route? How do haloperidol and droperidol compare speed in efficacy when used for calming the agitated patient? How should providers manage concerns around prolonging the QT interval when using butyrophenones for sedation? Which benzodiazepine is preferred, as a treatment for agitation? How should neuroleptics and benzodiazepines be used as monotherapy or in combination? In which type of patient should ketamine be used as a sedation agent? How should ketamine be dosed for tranquilization, and what adverse effects should providers be mindful of when using ketamine for this indication? Can ketamine be used in patients with hyperdynamic vital signs? What is the role of crystalloids in managing the agitated patient? Once the agitated patient has been calmed, what are the primary, secondary and tertiary resuscitative maneuvers (diagnostics and therapeutic)?
Dec 03 2016
Rank #7: Hardcore EM: EBM - Papers of the year
Oct 05 2018
Rank #8: The Aorta Will %$#@!& You UO - David Carr
The talk focuses on why clinicians miss the diagnosis on aortic dissection. It breaks down the key pearls on history and physical exam that guide you into correctly suspecting a dissection. Aortic dissection is a challenging diagnosis that you can not afford to miss. The talk aims to give you the framework to avoid missing the diagnosis. I want to raise the bar so that the standard of care is not to miss a dissection when it presents atypically. The talk will also highlight strategies on what to do when you suspect the diagnosis. It will guide you to order the right imaging tests and begin the treatment promptly. Sit back and be ready to see dissections in a different light.
Apr 06 2017
Rank #9: Defending Bawa-Garba: When Healthcare Becomes a Crime
Delivery of safe healthcare currently faces unprecedented challenges in the UK and globally. This arises, at least partly, from a rising involvement of the criminal law in the investigation of medical errors apparently conflicting with the need to respect a "duty of candour". As a result, doctors face enormous pressures in fear of being blamed for medical errors. David Sellu is a consultant surgeon who was convicted for gross negligence manslaughter in late 2013 after the death of a patient in a private hospital. I (@DrJennyVaughan) was the medical lead for a group of David Sellu's friends as we launched a campaign to overturn his conviction. There has never been a successful 'out of time' appeal in this area of the law so we were dealing with almost impossible odds from the start. The positive result was extraordinary, both for David and our whole profession (www.medicalmanslaughter.co.uk). Since these events, I have supported other doctors facing criminal conviction, such as the paediatrician Dr Hadiza Bawa-Garba, through my work with the Doctors Association UK (DAUK, @TheDA_UK). Thousands of doctors crowd-funded a campaign and successfully overturned a court decision to erase her from the UK medical register. Her case proved to be a lightning rod in the UK for a profession at breaking point. Many healthcare staff are working on critically under-staffed wards and in under-resourced departments, with an increasingly unmanageable workload.
DAUK have since launched a "Learn Not Blame" campaign to improve safety for patients and healthcare professionals. We believe that the involvement of the criminal justice system in these cases often does not allow an appreciation of the interplay of individuals within complex health systems. We also remain particularly concerned that a recent analysis of conviction trends shows an excessive conviction rate of black and minority ethnic (BME) healthcare staff.
Dec 18 2019
Rank #10: A diagnostic challenge: Turning a Zebra into a Horse
David takes us through a tricky case that might test you! Can you pick the diagnosis before Dave reveals all?
Jan 24 2020
Rank #11: SMACCMini: I am the Decider
SMACCMini: I am the Decider
Mar 06 2019
Rank #12: Neuro ICU: SAH: Diagnosis/vasospasm (prevention and management)
Neuro ICU: SAH: Diagnosis/vasospasm (prevention and management)
Mar 01 2019
Rank #13: SMACCMini: The snakes and ladders of paediatric DKA - how to win every time
SMACCMini: The snakes and ladders of paediatric DKA - how to win every time by Heather Murray
Mar 06 2019
Rank #14: Hardcore ICU: What does raised ICP mean?
Hardcore ICU: What does raised ICP mean?
Mar 04 2019
Rank #15: Is the Answer Really “Always Ketamine”? - Peter Brindley interrogates: Reuben Strayer
A no-holes barred series of 6 provocative medical interrogations. We challenge the state of research, social media, pharmacology, social work, women in medicine, medicine in the developed work, and the health of healthcare workers. It should be novel, it may get heated, and it is not scripted. Sometimes to comfort the afflicted you also need to afflict the comfortable. This is why no prisoners will be taken, no topic is out of bounds, and no ego will be pampered. It may even offend: you have been warned.
Apr 29 2018
Rank #16: Making Complex Problems Simple by Chris Hicks
Resuscitation is complicated, but the solutions don't have to be. These are the psychological hacks that will help you conquer complexity and excel in dynamic environments.
Aug 01 2018
Rank #17: Airway management in Neurologic Emergencies (Pharmacology, etc) - Jordan Bonomo
Neurologic airway manipulation is unforgiving; errors lead to hypoxia and secondary injury. Managing the airway with an eye towards success, the first time, every time, without allowing sats to drop below 90% is the holy grail of neuro airways. Selection of RSI techniques, DSI techniques, and pharmacologic management is critical for success. The TBI airway with ICP issues and the post tPA airway present unique problems and the failed extubation in the neurologic patient is as common as the day is long. We will explore the latest theories and data (if there are any) and debunk some common myths together during this session.
Jul 26 2018
Rank #18: The latest on Myocardial Infarction
This presentation will give you an update of the current chest pain protocols; including risk scores (HEART, TIMI, EDACS) with / without high sensitive troponin. But also on the newer pathways with rule out of acute coronary syndrome with a high sensitive troponin below the limit of detection or two troponins with a delta. How do we use these chest pain protocols in tomorrow‚Äôs clinical practice? How do you choose a protocol that fits in your institution? Which chest pain patient can we discharge safely from the emergency department and for whom should we organize outpatient follow up? And how do you share your decision with the patient in front of you.
Jan 29 2020
Rank #19: Hardcore EM: Vasopressors in the ED
Hardcore EM: Vasopressors in the ED by John Greenwood
Dec 14 2018
Rank #20: How Resuscitation Works - David Halliwell
This talk uses a case study approach to discuss why resuscitation practitioners should focus upon technical accuracy when resuscitating, focussing on all of the facets of a resuscitation, compression, decompression, trans-thoracic impedance. It suggests that many of the smallest of subtleties can have a dramatic effect on patient survival. We focus on the physiological effects of Manual Chest Compression and use historical reference to underpin modern techniques.
Oct 16 2016