Dave McKean
Choking in Children

A quick run down on management of choking in children (and how to write on window blinds).

#FOAMed of the Week: Acute Heart Failure via heftEMcast.co.uk

An excellent EBM based summary of the management of Acute Heart Failure for UK based EM trainees. Podcast below, but go to the website and subscribe to the podcast to get the full warm glowing feeling of knowing your up to date in an EM staple. 

heftEMcast is produced by the Heart of England NHS Trust Emergency Department. They aim to help keep our practice up to date with the latest EBM. 

#FOAMed of the week: ACID-BASE EMCrit Style - All time classic!

This we're going back to some pretty old posts from EMCrit - but an all time classic!!

Acid Base is a traditional brain melter for me and these podcasts have been amazing in helping get to grips with it from the ground up. Its in...... (gulp) 5 parts....BUT there was a recent related post from EM Nerd (Rory Spiegel) on EM Crit talking through the equally confusing anion and osmolar gap. 

Click the links below to go straight to the relevant EMCrit page with all the associated show notes, or to get started watch the videos below. 

One things for sure......we'll all gonna be a lot....SMARTER! 

ACID BASE Part IV: (Fluids)

#FOAMed of the Week: #weneedtotalkaboutLACTATE via stemlyns

Another publication from the illustrious EMERGE landed on my doormat on Friday, this time exploring the utility of lactate in the Emergency Department. Yet my understanding of lactate was turned on its head at SMACC Chicago, and it's head has never been the same since.....

Lactate NOT an acid?  Lactate NOT just caused by tissue hypoxia?

There's no doubt lactate is invaluable in assessing critically ill patients, but if we are to use it more, shouldn't we understand it better?

Another chance for #FOAMed to shine, as St Emlyns step up (again) in the hour of need. Richard Carden (EM Trainee) writes an excellent blog covering dead parrots, whoop whoops, AND some physiology my brain can actually digest. 

Check out the blog here: Lactate = LactHATE

Don't forget to look at the links at the bottom of the article and also look out for the SMACC Chicago talks on the same in the future. 

Viva la #FOAMed

#FOAMed of the Week: Induction podcasts via St Emlyns and HEFTEMCAST

The Edinburgh Festival Fringe is the largest arts festival in the world. The thousands of visitors and performers arriving in the city make for a great atmosphere, but also mean we can rely on August being a busy month for our new doctors in the ED. 

Hopefully you are all finding their feet now and are ready for some new induction podcasts from the great folks at St Emlyn's and HEFT EMCast. Check out their websites for the accompanying blogs and notes. 

St Emlyns bring you:

Back to Basics: Back Pain

HEFT EMCAST bring you up to date with a classic ED diagnosis:

AF in the Emergency Department

Finally please check out the new #FOAMed Induction Course recently released at St Emlyn's website. 

#FOAMed of the week: Surgical Cricothyroidotomy via Emcrit/Levitan

We had our first Edinburgh EM BossSIM this week, which amongst other nightmares included an unexpected 'Can't intubate, Can't ventilate' Scenario.  There was some great chat in debrief about the procedure and the different techniques taught and used. 

So this inspired a review of some vodcasts on a #FOAMed favourite - the surgical airway. 

This is a rare, critical and therefore stressful procedure.  Thinking it through well before you find yourself doing it is essential preparation.  #FOAMed is here to help!

EMcrit.org features some great info on how to avoid the stress of the context from bringing you off track, making  this procedure as simple as it should be. 

Below is a talk from Richard Levitan at the Emcrit conference in 2014. Critical points include the ergonomics of your approach, making the landmarks simple to find under pressure. 

#FOAMED of the Week: Get Plastered - via LITFL

If ever (in desperation) you resort to Googling your patient's symptoms in search of a diagnosis, you will soon discover Life in the Fast Lane, Australia's gold mine of everything ED and critical care.  #FOAMed to the core, they have been developing Online Meducation for years.

Last week they put up a selection of videos going through some of the common casts we do in the ED. Perfect as a wee refresher, but also useful if you're just starting your ED rotation.....not looking at anyone in particular......

Obviously there's sometimes some local variations but this gives a great starting point for learning the practical skills involved in managing fracture in the ED.

Viva la #FOAMed! Videos Below:


Trauma in the Elderly, its not only HECTOR that cares....

Of the 64 billion people living in the UK, about 11 million are over 65. As an expanding demographic, we see more of this population in the ED than ever before. 

Now arguably becoming the bread and butter of our day to day work, the spotlight is being turned on how we can do better in the management of trauma in the elderly. 

The HECTOR (Heartlands Elderly Care Trauma & Ongoing Recovery, @HECTORcares) Project seeks to improve our understanding of trauma and how to apply it in the the elderly population. They are starting to run courses of the next few years and have released the first 6 chapters of the course manual on www.heftemcast.co.uk.

The emphasis is simple - trauma care needs to be patient centred. Designing systems to be patient centred is unfortunately a nightmare so its up to us as clinicians to make sure its done right. We have to Care!

Check out the website for more info on the project including podcasts with its founder Dr Dave Raven. 

Plus check out the first 6 chapters of the course manual below: 

Chapter 1 – An Introduction to HECTOR

Chapter 2 – Triage

Chapter 3 – The Primary Survey

Chapter4 – Imaging after the Primary Survey

Chapter 5 – The Secondary Survey

Chapter 6- The Silver Survey