heft emcast archives

heft emcast archives episodes:

• 06.22.2016

  Sedation in the ED

  An overview of sedation in the Emergency Department

  
• 06.22.2016

  Sepsis SMACCback

  So we're here at SMACC being treated to a fantastic conference and some superb talks. Last night (Day 1) closed with a superb panel of experts from across the globe talking on sepsis including Melvyn Singer, Paul Marik, John Myburgh,...

  
• 06.22.2016

  Peripheral vasopressors and preshospital LMA vs ET Tube in Cardiac Arrest

  Over the last few episodes we’ve talked about the use of vasopressors and their utility in resuscitation. It is a commonly held belief that giving vasopressors peripherally puts patients at high risk of extravasation and secondary skin necrosis. In an...

  
• 06.22.2016

  RSI in the ED; should EM be taking the lead?

  Rapid sequence induction, or RSI, is the preferred method of emergency tracheal intubation outside the operating room because it results in a rapid state of unconsciousness (induction) and neuromuscular blockade (paralysis). The Scottish Intensive Care Society defines RSI as follows........

  
• 06.22.2016

  The Hector project, Heartlands Elderly Care Trauma & Ongoing Recovery; a progress report

  We catch up with Dr David Raven, Consultant in EM at HEFT regarding his Hector project, Heartlands Elderly Care Trauma & Ongoing Recovery, with a progress report.

  
• 06.22.2016

  Presyncope, what does it mean for our patients in ED?

  What does presyncope mean to you? If you ask this question to a handful of doctors you’ll get a multitude of different answers, you’ll also get a huge variety of opinion as to their understanding of it’s significance or associated...

  
• 06.22.2016

  Vasopressors & Inotropes in the ED

  In this podcast we are going­­­­­­­­­­­­­­­ to be talking about inotropes and vasopressors. And we’re going to be talking about them with respect to septic shock. In the UK we use the definition of septic shock as a patient who...

  
• 06.22.2016

  The PROMISE trial; is this the end of EGDT???

  Trial of Early, Goal-Directed Resuscitation for Septic Shock NEJM March 17 2015   Sepsis has been in the EM literature a lot over the past 12 months. The phenomenal reduction in mortality that Rivers Early Goal Directed Therapy (EGDT) demonstrated...

  
• 06.22.2016

  Thrombolysis for presumed MI in cardiac arrest

  You’re in resus leading a cardiac arrest. Lying on the trolley is Dave, a 45 year old male, known hypertensive and type 2 diabetic. He collapsed whilst putting a big bet on in the bookies, having just complained of some...

  
• 06.22.2016

  Assessing fluid status; USS and the IVC?

  Fluid resuscitation represents the bedrock of initial treatment in the critically ill and injured patient with shock. In septic shock, fluid loading as part of early goal directed therapy was shown to confer a huge mortality benefit. It seems intuitive...

  
• 06.22.2016

  Central Venous Pressure and fluid responsiveness

  Since Rivers’s publication of Early Goal Directed Therapy (EGDT) at the turn of the century clinicians have talked about aggressive resuscitation for septic shock. One of the goals underpinning this technique is the insertion of a central line with targeted...

  
• 06.22.2016

  Framingham Risk Factors in the ED; from the RCFN

  Everyone asks about Framingham risk factors when taking a history for possible ACS but what significance do they actually hold?

  
• 06.22.2016

  HIV testing in the ED

  A contentious subject in the ED but how would it work??

  
• 06.22.2016

  A shocking pause

  A look at the impact that a prolonged cause in CPR has on the associated outcome.

  
• 06.22.2016

  Lactate and lactate clearance

  A patients lactate is something that we often want to know, but how much do you really understand about it’s significance and what is lactate clearance all about?

  
• 06.22.2016

  One year of EBM

  A round up of some of the key papers that we’ve reviewed over the 12 months that HEFTEMCAST has been running

  
• 06.22.2016

  Blood and Sepsis; the TRISS trial

  Sepsis is a hot topic at the moment. In this episode we look at the transfusion targets for patients with septic shock when on ITU

  
• 06.22.2016

  Video laryngoscopy; can you see the cords?

  Whilst the embedded management of the airway in ED is via direct laryngoscopy, advances in technology and equipment leads to multiple alternatives in the form of video laryngoscopy. We look at a recent systematic review looking at this topic.

  
• 06.22.2016

  The ARISE trial

  The ARISE trial, following on from the ProCESS trial, is there a different message or is EGDT a thing of the past?

  
• 06.22.2016

  Diagnostics in EM from the RCFN podcast

  Everything we do in the Emergency Department is a test, be that a question, looking for a clinical finding or performing a ‘traditional’ test. Truly understanding this concept and applying it will help lift your diagnostics to a higher level.

  
• 06.22.2016

  Point of care ultrasound in the ED; the POCUS trial

  Ultrasound is becoming a key part of Emergency Medicine. It’s potential applications are vast and use throughout the UK is spreading fast. We look at a recent paper focusing on its utility in aiding diagnosis in the ED to respiratory...

  
• 06.22.2016

  Upper GI bleed; what's your transfusion threshold?

  Controversy exists over the transfusion thresholds and goals in patients with acute upper GI bleeds. In this episode we look at scoring systems associated with the management of acute GI bleeds and a key paper on transfusion strategies.

  
• 04.16.2016

  Collapse ? cause; the San Francisco Syncope Rule

  A look at a risk stratifying tool for patients presenting with an undiagnosed collapse. Is this of use in this tricky and common presentation.

  
• 04.16.2016

  The HECTOR Project

  We hear from David Raven, Emergency Medicine Consultant at The Heart of England Foundation Trust about the exciting new HECTOR Project; Heartlands Elderly Care Trauma and Ongoing Recovery project

  
• 04.16.2016

  NSAID prescribing in the ED

  What we need to know regarding prescribing these drugs in the ED

  
• 04.16.2016

  Magnesium in asthma; the 3Mg trial

  In acute severe asthma how much difference will magnesium make to our patients and what is the best route?

  
• 04.16.2016

  CT scanning in the context of trauma

  An evidenced based look at CT scanning in trauma.

  
• 04.16.2016

  5,4,3,2,1.....surgical airway

  A look at recent guidelines on the management of a failed intubation drill.

  
• 04.16.2016

  The PROCESS trial; is there a place for EGDT in septic shock?

  A look at this really important paper on the use of early goal directed therapy in septic shock. Is it time to change our practice?

  
• 04.16.2016

  The PERC rule; do we really need the d-dimer this time??

  Is there an easy and safe way to decrease the number of D-dimers we are requesting??

  
• 04.15.2016

  The intoxicated patient; will i.v. fluids speed up the time to discharge?

  We all get encouraged to prescribe i.v. fluids as soon as a drunk patient pitches up to the ED but does it actually convert into a speedier time to discharge? In this podcast dr. Mark Winstanley talks us through a...

  
• 04.15.2016

  Subarachnoid haemorrhage, ruling out the disease; is CT alone ever enough?

  A look at a key paper from Perry in the BMJ looking at the sensitivity of non contrast CT head scans soon after the onset of a thunderclap headache. This paper is changing the way that many clinicians think and...

  
• 04.15.2016

  Acute coronary syndrome

  On initial glance the diagnosis or rule out of acute coronary syndrome is easy but the more you read the more complex it becomes. In fact working up a suspected acute coronary syndrome is a real art form. In this...

  
• 04.15.2016

  Capnography for the diagnosis of pulmonary emboli; a useful tool or a load of hot air?

  So previously we've discussed the utility of ETCO2 for the prognostication of cardiac arrests but what about it's role in the diagnosis of everybody's favourite differential, the pulmonary embolus?

  
• 04.15.2016

  Revisiting the CRASH II trial

  A look back at a practice changing publication from the Lancet on TXA in trauma.

  
• 04.15.2016

  Therapeutic Hypothermia; TTM trial

  Is cooling patients following cardiac arrest following the recent NEJM Targeted Temperature Management paper (TTM)?

  
• 04.15.2016

  Clinical predictors of neurological outcome following ROSC

  Fixed dilated pupils following ROSC, surely that's destined to be a devastating neurological outcome? In this episode we look at this and other predictors of neurological outcome following ROSC.

  
• 04.15.2016

  End tidal CO2 as a predictor of ROSC

  Welcome to the first episode of HEFT EMCAST, this episode we'll be looking at a paper specifically on the utility of ETCO2 and it's value in predicting return of spontaneous circulation (ROSC) in patients in cardiac arrest.