Oliver Marshall

Flight Paramedic @ Netcare911. Calisthenics Enthusiast. Intrs: Emergency Med, Retrieval Med & Prehospital Sonography. #FOAMed. All views are my own.

[NETCARE 911 @Netcare911_sa]

Interested in a career in the Pre-hospital Emergency Medical Care Field?
Netcare Education Faculty of Emergency and Critical Care FECC Midrand campus invites you to an Open Day.

[Medit @Meditonline]

Brilliant! 11 unforgettable #ECG patterns suggestive of coronary occlusion. #FOAMed RT @EM_RESUS: #ECG reading is all about pattern recognition. If you rely on #STEMI Criteria, you'l miss many Coronary Occlusions. Be able to recognize ECG PATTERNS & I promise you will save lives

[Skyler Lentz @SkylerLentz]

Approach to shock

Is it a low SVR/ distributive shock/sepsis?
Vasopressors (norepi, epi)

Is it a cardiac output problem?
Inotropes (dobutamine, epi, norepi)

Is it both?
Pressors with B1/ a1 activity (norepi, epi)

+/- Volume in any patient w/ shock

#Foamcc #Foamed @UVM_EM

[#hello my name is Ross @ffolliet]

Top 10 presentation tips https://t.co/R82lJkmqK7

[Tamy Emma Pepin @TamyEmmaPepin]

Congratulations to Katie Bouman to whom we owe the first photograph of a black hole ever. Not seeing her name circulate nearly enough in the press.

Amazing work. And here’s to more women in science (getting their credit and being remembered in history) 💥🔥☄️

[NETCARE 911 @Netcare911_sa]

Helicopter Emergency Medical Services: Today Netcare 5, a specialised helicopter ambulance based at Virginia Airport in Durban KZN was activated for a boating incident in Sodwana Bay making this flight the 100th mission for the coastal region HEMS which includes Netcare 6.

[AirwayMan @JohnCSakles]

I was today years old when I learned that critically ill adult patients with hypoxemic respiratory failure (60%) who are low risk for aspiration (50% fasted>6hrs) become hypoxemic during RSI and should be mask ventilated 😉

https://t.co/nyftgXBzcN

[NEJM @NEJM]

#VisualAbstract: Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Read the full text abstract:

[Karim Brohi @karimbrohi]

There are two main reasons for running BP low in bleeding trauma patients: A. Dilutional coagulopathy. B. Worsening bleeding ("don't pop the clot")

(B) is important but (A) is really important.

[Karim Brohi @karimbrohi]

Conceptually, If you pour 1L crystalloid into 4L (remaining) blood volume, you've diluted that patient's clotting factors by 20%. If they bleed another litre and you add another litre of crystalloid, then they're running close to 50% of starting clotting factors already.

[Karim Brohi @karimbrohi]

Maintaining a patient at 60mmHg will lead to some degree of later organ dysfunction. This is not the same as dying in the next few minutes/hours from exsanguination.

In trauma, early deaths from exsanguination >>> deaths from organ dysfunction.

[Karim Brohi @karimbrohi]

The lower the BP, the longer the shock, the more severe the organ dysfunction.

Any discussion of permissive hypotension is really talking about minutes, maybe an hour or so.

The shorter the timeframe, the lower the transient tolerable BP.

[Oliver Marshall @OllieRedMedic]

https://t.co/1mlZamaCLX

[Lara Goldstein @drlaragoldstein]

Watch out for the HALT effects on your judgement and decision-making...
H ungry
A ngry
L ate
T ired

[Willem Stassen|badEM @willem_stassen]

#AfCEM18

[Jefferson Ultrasound @jeff_sono]

J-Club: Pre-Hospital Lung #POCUS for differentiating CHF and COPD is feasible, ⬆appropriate treatment, and may ⬇ED LOS.
https://t.co/VRHIlby56N

[AirwayMan @JohnCSakles]

What if I told you that the A in ABC stands for “oxygenate the lungs” and not “intubate the trachea”?

[Dr Helgi @doctorhelgi]

The fact that the trauma patient is pregnant frequently distracts us from our normal practice:
Give tranexamic acid, tetanus, antibiotics (if indicated)
Try to insert venous access above the diaphragm
If she needs a CT scan, do a CT scan.
#anes18

[Willem Stassen|badEM @willem_stassen]

A simple dispatch algorithm for #HEMS in South Africa; the South African HEMS Activation Screen. MUCH more research needed, but here is a first step. #FOAMEMS @AfJEM https://t.co/dc1gXykZ2x

[Oliver Marshall @OllieRedMedic]

@justint035 @craigwylie @TraumaSocietySA Interesting. Unsure of the origin of the research as it was during the talk. Will see what I can find.

[Oliver Marshall @OllieRedMedic]

Avoid thrombolysis in stroke mimics - although there is low complication rate #RCSAZA