PEM Review 013 – CANNULATION // NIGHT SHIFTS // FEBRILE CONVULSIONS // COMMUNICATION // ENT

PEMgeek3This week: anaesthetists share their trade secrets, ED doctors talk about coping with night shifts, and the IV salbutamol vs IV aminophylline debate is revisited (plus loads more):

salbutamol  1. WHEEZY DECISION?

Severe asthma: the IV salbutamol vs IV aminophylline debate is set to continue, with no completely solid evidence marking one out as superior to the other. Even within departments there can be a wide range of practice (how often does the decision on which drug to start boil down to ‘…let’s just check who’s on call…’?) This pragmatic article in @ADC_BMJ (#journalFOAM) compares the results of several RCTs but also looks at the pharmacology, side effects and practical considerations such as ease of prescription, fluid compatibility and monitoring required ( Detailed table ) –  which are all important factors when time is of the essence.

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2. NIGHT SHIFTS

Love or hate them, night shifts are an unavoidable part of working in emergency medicine. ERcast have a discussion in this podcast about some of the best ways to cope, before, during and after the shift… and some things which really don’t help (listen from 20mins 45 sec).

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securing-cannula  3. LITTLE PRICKS

Ever wondered how anaesthetists somehow manage to find that vein that has eluded everyone else? Some pros share their secrets: new paediatric anaesthesia blog songsorstories.com has an absolute GOLDMINE of tips for cannulation this week. Looking forward to more content from these guys.

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15-fever  4. FEBRILE FITS

It’s a real skill to be able to reassure parents and give them the confidence to go home with their child when they’ve just seen a febrile seizure in action (even if said child is now completely back to normal and running round the ED with a huge grin on their face). Watch Brad Sobelewski of @PEMtweets in this video  as he demonstrates how he talks to parents after their child has suffered a febrile seizure – some excellent pointers on how to explain what has happened, and what to expect in the future.

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hoover  5. SUCK IT UP

A neat trick of the trade – ear foreign body removal with the help of a flexible suction catheter. Thanks @ALiEMteam 🙂

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the-internet-vs-research-paper 6. FALLIBLE FOAMed

Since you’ve found your way to this site I assume you’re as pro FOAMed as I am (hello, welcome). However, many people recently (in both pro- and anti- FOAMed camps) have been concerned that one negative aspect of the movement is the way that results/’findings’ of poorly performed research can rapidly disseminate if people don’t read the source material and critique it themselves before sharing. We’re all responsible for this!

Here’s a four minute video from @sketchyebm which gives a simple structure for reviewing papers – next time before hitting retweet on something that’s going viral, go and read the original article and draw your own conclusions first 😉

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stroke  7. STROKE

Paediatric stroke is rare (9/100,000 incidence), but over the course of a career in EM you’re likely to see it at some point. This week on @emdocsdotnet, a case of a 17 month old boy presenting with a MCA stroke – causes, diagnosis and treatment are discussed (so far there is little evidence for thrombolysis in children)…

FOAMed love,

PEMgeek3

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