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, Simon Finf

Peripheral vasopressors and preshospital LMA vs ET Tube in Cardiac Arrest

Jun 22nd, 2016 8m 59s

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

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

Jun 22nd, 2016 21m 41s

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 Intens

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

Jun 22nd, 2016 16m 58s

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.

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

Jun 22nd, 2016 19m 24s

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 morbidity and

Vasopressors & Inotropes in the ED

Jun 22nd, 2016 16m 14s

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 is hypotensive f

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

Jun 22nd, 2016 13m 27s

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) demonstra

Thrombolysis for presumed MI in cardiac arrest

Jun 22nd, 2016 11m 6s

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 chest pain, looked flush

Assessing fluid status; USS and the IVC?

Jun 22nd, 2016 11m 29s

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 i

Central Venous Pressure and fluid responsiveness

Jun 22nd, 2016 7m 34s

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

Framingham Risk Factors in the ED; from the RCFN

Jun 22nd, 2016 12m 34s

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

HIV testing in the ED

Jun 22nd, 2016 6m 35s

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

A shocking pause

Jun 22nd, 2016 8m

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

Lactate and lactate clearance

Jun 22nd, 2016 12m 4s

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?

One year of EBM

Jun 22nd, 2016 10m 34s

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

Blood and Sepsis; the TRISS trial

Jun 22nd, 2016 6m 9s

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

Video laryngoscopy; can you see the cords?

Jun 22nd, 2016 4m 48s

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.

The ARISE trial

Jun 22nd, 2016 10m 31s

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

Diagnostics in EM from the RCFN podcast

Jun 22nd, 2016 16m 5s

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.

Point of care ultrasound in the ED; the POCUS trial

Jun 22nd, 2016 9m 36s

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 presentati

Upper GI bleed; what's your transfusion threshold?

Jun 22nd, 2016 10m 44s

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.

Collapse ? cause; the San Francisco Syncope Rule

Apr 16th, 2016 12m 43s

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

The HECTOR Project

Apr 16th, 2016 16m 1s

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