@Elennaro IMHO finger-scalpel-bougie is the way to go. whoever is trained in this skill should be doing it. doesn't matter whether you're an EMT or a professor of surgery. it's a simple technique which I think anyone can learn (I've done it twice and I'm a nerdy medicine-trained flea)
hopefully folks reading this thread will realize how the article ignores many life-saving principles of managing upper airway obstruction ... if not, pls see these posts by Scott Weingart:
- surgical airway: https://t.co/301DkaBNtJ
- awake intubation:
https://t.co/b119IKj8MU
We then placed him on BIPAP right away running continuous high-dose combination aerosols right through the mask. It’s very important to nebulize BOTH Albuterol AND Ipratropium which together are more effective than Albuterol alone.
[9/x]
So here’s what we did. First, we sat him straight up to 90 degrees. This simple positioning maneuver accomplishes three main things: it minimizes atalectasis, optimizes FRC, and decreases the work of breathing.
[8/x]
There’s a natural reflex and momentum to want to intubate these patients right away. But here’s a message I want to get out:
INTUBATION IS THE LAST THING A CRASHING ASTHMATIC NEEDS.
[5/x]
Interesting talk on Crowding in the ED by IFEM president Dr Ducharme with this viewpoint: @EmergencyDocs motto of “Anyone, anything and anytime” has made us our own worst enemy where we are the answer for all other services and the stop gap for health system flaws
My EM colleague, friend, collaborator, an inspiration to us all, the spokeswoman of our time bringing #physiciancompassion to the forefront, Barbara Tatham died today.
These 4 mins of her speaking are the most important podcast minutes in EM Cases history.
https://t.co/ykkK9RYv4z
Incredible pressures on our emergency depts at height of summer !
Staff continue to work to maintain safety&care for patients on corridors in ED waiting forbeds
Part of NHS long Term Plan must ensure we have enough staff to care for inc numbers in ED& creating more bed capacity
Very pleased to have been elected the next @RCollEM President. Will be working from now so that when I take over formally from Taj in October I am ready to face the challenges of another NHS winter- campaigning for no corridor medicine.
Emergency department Compartment syndrome - EDCS
Where there are no beds to go, no ambulances left to take people home and a complete lack of space to see people in but patients continue to book in.
Pressure rises
Pain ensues
Peak incidence in *winter
Today we’re running the next diet of #EBEEMpartA simultaneously in five cities (Antalya 🇹🇷, Antwerp 🇧🇪, Florence 🇮🇹, Stockholm 🇸🇪 and Valetta 🇲🇹). We wish all candidates good luck! #EMERGEteam