Episode three already! And a bit of a longer one this time...

In a bit of a one-off, I got in touch with Ben Paul, student Critical Care Paramedic and Senior Lecturer, about COVID-19 in pre-hospital critical care. You're probably sick of hearing about it, but on the off-chance you're not we put together this episode to try and provide some clarity to those of us working outside of hospital.

To be clear... Neither of us are experts and clearly the knowledge of COVID-19 is changing daily but we have managed to muddle through the wealth of literature out there to bring a summary of what we think is useful for people to know. Our discussion encompassed R-nought, pathophysiology, diagnosis, treatment of respiratory failure and OHCA, and (of course) PPE. 

Hopefully you find this useful. And if you do, please subscribe / rate / share - you know the drill!  Thanks, 

--

Silas

 

References

• Background and pathophysiology:
  • Coronavirus Disease 2019 (COVID-19) overview (Medscape, 2020)
  • COVID-19 risk factors (NHS, 2020)
  • COVID-19 Insights: cytokine storm / massive immunomodulation (Drbeen, 2020)
  • COVID-19 (Internet Book of Critical Care, 2020) #Pulmcrit
  • Innate vs adaptive immunity (Khan Academy)
  • Cytokine storm and sepsis disease pathogenesis (Chousterman et al, 2017)
  • Berlin Criteria for Acute Respiratory Distress Syndrome (MDCalc)
• Diagnosis:
  • COVID-19: guidance for ambulance trusts (Public Health England, 2020)
  • Anosmia in COVID-19 (ENT UK, 2020)
  • COVID:Diabetes (Diabetes UK, 2020)
  • Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes (Yang et al, 2010)
  • Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area (Richardson et al, 2020)
• Aerosol Generating Procedures:
  • TBC
• Treatment (respiratory failure):
  • CPAP for COVID-19 (NHS England / Improvement, 2020)
  • Guidance for Prone Positioning of the Conscious COVID Patient (Intensive Care Society, 2020)
  • Treatment of ARDS With Prone Positioning (Scholten et al, 2017)
  • Prone Position and Mechanical Ventilation (Nickson, 2020) #LITFL
  • Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome (Richard et al, 2006)
  • Endocrinology in the time of COVID-19: Management of adrenal insufficiency (European Society of Endocrinology, 2020)
• Treatment (cardiac arrest):
  • Resuscitation Council UK Statements on COVID-19 (Coronavirus), CPR and Resuscitation (RCUK, 2020)

 

Sound recordist

• Jack Neuman

Hosted on Acast. See acast.com/privacy for more information.

We're back!    Thank you all so much for listening, and for your kind feedback. Its really encouraging to see so much engagement and I'm looking forward to sharing some more meaningful conversations with you in the future.   In part two of my discussion with Critical Care Paramedic Scott Hardy, we spoke about the management of foreign body airway obstruction, airway management in trauma patients, out-of-hospital cardiac arrest, and paramedic intubation. Scott is such a knowledgeable practitioner and it was great to hear his thoughts on the nuances of these topics.   I hope you find this episode useful. Please do subscribe, leave us a quick review, and feel free to get in touch with any comments, opinions, or feedback.     Peace!     --  

Silas

 

References

• Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like? (Glouberman and Zimmerman, 2002)
• Iatrogenic intracranial placement of nasopharyngeal airway after trauma (Swanson, Nickele, and Kuo, 2015)
• Busting Top Trauma Myths (Collopy et al, 2015)
• Rapid Sequence Intubation (Lafferty, 2020)
• The AIRWAYS-2 Trial (Benger et al, 2018)
• The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis (Crewdson et al, 2017)
• Prehospital endotracheal intubation: elemental or detrimental? (Pepe, Roppolo, and Fowler, 2015)
• Advanced airway management during adult cardiac arrest: A systematic review (Granfeldt et al, 2019)
• International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (Soar et al, 2019)
• A Critical Reassessment of Ambulance Service Airway Management in Pre-Hospital Care (JRCALC Airway Working Group, 2008)
• Airway management policy and procedure (London Ambulance Service, 2018)
• Paramedic Intubation Consensus Statement (College of Paramedics, 2018)
• The PART Trial (Wang et al, 2018)

 

Sound recordist

• Jack Neuman

Hosted on Acast. See acast.com/privacy for more information.

Where better to start than with airway management? 

In this episode I speak to Scott Hardy. Scott is a Critical Care Paramedic and medical educator with over ten years experience in the speciality. He has a professional interest in airway management and teaches on the Difficult Airway Course. 

We actually ended up chatting for a bit longer than expected so I've broken the episode down into two parts. In this first part we spoke about the goal of airway management and ways we can maximise our success.

I really hope you enjoy the episode. Please do subscribe, leave us a quick review, and feel free to get in touch with any comments, opinions, or feedback.  Cheers! 

--

Silas

 

References

• Can an airway assessment score predict difficulty at intubation in the emergency department? (Reed, Dunn, and McKeown, 2005)
• Direct Laryngoscopy and Tracheal Intubation (Bannister and MacBeth, 1944)
• Anatomic Insights and Practice Changing Concepts (Levitan, 2012)
• The "Ear-Sternal Notch" Line-How Should You Lie? (Rahiman and Keane, 2017)
• The Difficult Airway Society Guidelines
• The Vortex Approach
• 'EVLI' Airway Incrementalization (Kovacs, 2018) #EMCrit
• Kovacs Kata to Optimize a Failing Laryngoscopy Attempt (Weingart, 2019) #EMCrit

 

Sound recordist

• Jack Neuman

Hosted on Acast. See acast.com/privacy for more information.

Hello everyone,

It's been a long time in the making but we have finally got round to starting The Prehospital Podcast! 

This prologue just gives a brief introduction to the podcast, and some information about how it will pan out in the future. 

Please get in touch with feedback, we're always keen to hear your thoughts and suggestions about episodes so far, and content you'd like us to include in the future. 

Don't forget to subscribe, it would be great to build a bit of an audience! 

--

Silas.

Hosted on Acast. See acast.com/privacy for more information.