This talk reviews both the prevention of VTE and its treatment.  Thrombotic risk assessment of patients are reviewed then appropriate methods of thrombosis prevention are recommended.  Options and dosing of anticoagulation is discussed with a focus on the direct oral anticoagulants.  Various treatment choices are next reviewed ranging from bed-rest to thrombolytic therapy.  Finally there is a discussion of how to decide duration of therapy.

To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

This talk reviews several bleeding emergencies. Three causes of thrombocytopenia – immune thrombocytopenia (ITP),  thrombotic thrombocytopenia purpura (TTP) and disseminated intravascular coagulation (DIC) – are reviewed.  ITP presents with severe thrombocytopenia and is treated with steroids/IVIG. The presentation of TTP varies from mild thrombocytopenia to severe mental status changes and is treated with plasmaexchange.  DIC is always due to an underlying illness and treatment is focused on factor replacement plus treatment of the primary cause. Finally treatment of bleeding due to antithrombotic therapy is reviewed.

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This talk goes over the most common causes of inhirted bleeding disorders.  There are two major types of hemophilia – deficiency in factor VIII and IX – which predominant occur in men.  Hemophilia A is deficiency of factor VIII and is the most common form of hemophilia treated with factor concentrate.  Hemophilia B is less common but treatment principles are the same.  There are multiple types of von Willebrand Disease as this is a complex molecular that both carries factor VIII and forms large multimers essential for platelet function.   Mild forms of vWD can be treated by desmopressin but von Willebrand factor is needed for more severe types.

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This talk covers the most common causes of anemia.  Iron deficiency – probably the most common acquired anemia – is discussed with details about testing and treatment.   Serum ferritin is the most efficient test for iron status  Oral iron only needs to be given once a day and for patients who can’t replete or tolerate oral iron, intravenous iron is a safe option.  Thalassemia – defects in the protein part of hemoglobin – is the most common cause of inherited anemia.  Most patients are carriers present with microcytosis and varying degrees of anemia but severely affect patients are transfusion dependent.   Increasingly B12 deficiency is being found.  Diagnosis is better made by use of metabolic testing with assay of methylmalonic acid.  Oral therapy suffices for most patients. Finally recommendations are made for evaluating anemic patients.

To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway

Basic and advanced airway management in emergency circumstances are frequently complicated by the occurrence of contamination with regurgitated material or frank bleeding in cases of gastrointestinal bleeding or head and facial trauma.  Airway contamination prevents effective and safe oxygenation and ventilation, and furthermore, severely complicates advanced airway management when endotracheal intubation is attempted.  The Suction-Assisted Laryngoscopy Airway Decontamination (SALAD) Technique is intended to simplify the care of patients with contaminated airway in both basic and advanced airway management scenarios.  SALAD utilizes a large bore rigid suction catheter to simultaneously evacuate the oropharyngeal airway contaminants as well as the hypopharyngeal airway contaminants proactively, to improve the effectiveness of the various airway management procedures.  Furthermore, SALAD teaches the caregiver to utilize the rigid suction catheter as a tool to simplify the insertion of basic (oropharyngeal airway) and advanced (laryngoscope and supraglottic airway) airway tools, improving the effectiveness of these techniques in emergency situations.

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This is a talk on how to manage tracheostomy in the Emergency Department. During the talk, we shall go through the definitions, indications and contraindications of the procedure, the types of tubes, the various techniques of tracheostomy available, the procedure itself and how to manage some of the complications in the ED.This talk has open access video links available at the end from the New England Journal of Medicine. These video links will describe the different techniques that are out there and their use can be guided by the resource settings and local management protocols in place.

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Obesity is becoming a worldwide health problem and a challenge for clinicians. Managing the airway requires an understanding of the physiology and anatomic features of obesity. The daily practice of elective bariatric surgery has provided experience and expertise but emergency situations are still the cause of morbidity. The advent of video-laryngoscopy has provided a welcome solution to many problems and supraglottic airways are also useful in providing needed ventilation. In addition, postoperative respiratory management is also essential.

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The invention of the laryngeal mask by Dr. Archie Brain in 1988 began an era of airway management and anesthetic innovation that continues today. The supraglottic airway is an alternative to mask ventilation and endotracheal intubation yet provides another solution to management of the difficult airway. The device has undergone an evolution in design and function and today exists as an invaluable tool in managing our challenging patient population and surgical demands.

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In this talk, Jon does a deep dive into airway management in critical care. Using a patient story, he examines the airway team: their experience, training and readiness, and argues that critical care practitioners may be under-prepared, under-confident or out-of-practice, with poor access to immediate senior help. He emphasises the importance of structured in-theatre airway training and refresher training for senior practitioners. He makes the case for streamlining and standardising equipment, and for the routine use of video-laryngoscopy, capnography, checklists and cognitive aids. He ends with a message of hope - that it is possible to move away from the high adverse event rates seen in NAP4 and the INTUBE studies, and improve patient safety during airway management in critically ill patients.

To watch the lecture, and learn more about the speaker, please visit www.continulus.com/library/?collection=emergency+medicine&chapter=airway