EMS / HEMS / prehospital EM Folks..Any protocol for noradrenaline infusion (without an infusion pump) in the prehospital setting? @cliffreid.bsky.social @ebmgonewild.bsky.social @sjtrem.bsky.social @stemlyns.bsky.social @emmanchester.bsky.social

Dr. George Willis on DKA Myths at #IncrEMentum2025: 🪦DKA Criteria is not set in stone 🧪Check B-Hydroxy-Butyrate Levels 💉Dont assume its insulin noncompliance 🦑Consider SQuID Protocol for mild to mod DKA #FOAMed #MedEd #MedSky @thesgem.bsky.social @cliffreid.bsky.social @emmanchester.bsky.social

@thesgem.bsky.social & Salim Rezaie on Induction Agents at #IncrEMentuM2025: 🫁Asthmatic requiring intubation = Ketamine 🧠Increased ICP, consider Propofol vs Etomidate 🦠Septic Shock = Ketamine vs Etomidate. Avoid Propofol #FOAMed #MedEd #MedSky @drfreeze.bsky.social @emmanchester.bsky.social

Dr.Reuben Strayer on Airway in Trauma at #Incrementum2025: 🧑‍🦯Dont blindly follow ATLS 🩸Yankuer suctions SUCKS badly (consider Ducanto catheter) 🔪Scalpel -Finger-Bougie = Be prepared #FOAMed #MedEd #MedSky @emswami.bsky.social @emmanchester.bsky.social @drfreeze.bsky.social @davidcarr333.bsky.social

Simon Carley @emmanchester.bsky.social did a nice breakdown of the issues with how the paper was widely misinterpreted, and does in fact shows a mortality benefit from prehospital TXA. (also, hi Simon!) www.stemlynsblog.org/the-patch-tr...

There is increasingly evidence that diastolic blood pressure (DBP) is a crucial resuscitation target in trauma and cardiac care. Based on a great article by Dan and Rich we look at how optimizing DBP may improve survival rates in emergency medicine.

Podcast – Monthly Round Up December 2024 – Chest trauma, IO access, AI and more This month’s St Emlyn’s podcast wraps up Season 11 with a review of key emergency medicine topics. We cover new evidence on chest trauma management, intraosseous access safety, pediatric imaging updates, AI in…

This blog post provides concise summaries of recent critical care trials, including HEMOTION, PREOXI, BLING III, CLASSIC, EVIDENCE, VICTOR, and PARAMEDIC-3. Each trial is examined for its key findings, strengths, limitations, and practical implications for clinical practice. The post aims to inform

London Trauma Conference 2024: Key Insights Day 2 of the London Trauma Conference delivered impactful discussions on trauma care innovations, including advanced resuscitation strategies, rib fracture management, and prehospital interventions. Highlights

Explore the variability in maintaining PHEA for trauma patients. With insights into drug protocols, administration methods, and governance. #FOAMed @stemlyns

The latest St Emlyn's podcast - an interview with Matt Hooper recorded at the London Trauma Conference about compassionate resuscitation and some of the lessons we can learn in Emergency Medicine from the world of palliative care.

The latest St Emlyn's podcast - Emergency medicine demands constant practice, yet many clinicians experience skills fade due to lack of exposure. Nathalie Pattyn explores how this decline occurs, why it’s a systemic issue rather than an individual failure, and what changes are needed to maintain com

I thought this was a good article to remind us to read more than a title, tweet or abstract: Good work from authors, but what about the underpinning data?

This article explores the impact of physician-led interprofessional pre-hospital teams on survival and mortality outcomes for critically ill and injured patients. The article suggests a benefit, but how robust is that finding?

Our latest monthly update podcast from St Emlyn's blog, with lots on developing a learning culture, chest drain size in haemothorax, arterial lines in cardiac arrest, and much more. Listen whevere you get your podcasts and please like and subscribe.

The latest St Emlyn's podcast - an episode about the Ten Second Triage tool recorded ay Tactical Trauma 24.

Prehospital setting: The weight is an estimate The dose is somewhere between 0,25 and 1 mg/kg depending on how unwell the patient looks. And its a personal choice.

How are you dosing ketamine for RSI in critically unwell patients? LBW ABW IBW And is that personal choice or protocol?

Benefits of physician-paramedic for prehospital critical care demonstrated in this neat study www.youtube.com/watch?app=de... In geographically vast Australia it takes time for teams to arrive to rural/remote incidents We need rural responder networks to support ambulance in rural Oz

How does pre-hospital emergency anaesthesia (PHEA) delivered by Helicopter Emergency Medical Services (HEMS) impact trauma care timelines compared to emergency department RSI (EDRSI). This retrospective study explores time efficiency, injury severity, and

Let’s review the Sub30 trial. The first uk study of ECPR in PHEM and lots of challenges. Should we adopt it more widely? www.stemlynsblog.org/sub30study/

when admitting a hypothermic patient, check a TSH and random serum cortisol don’t need a new blood draw (just add it on to the last blood draw sitting in the lab) don’t waste a ton of neurons on this, just check it like a reflex arc. in ~1/50 cases you’ll look like a diagnostic genius 🤣 #EMIMCC

Intraosseous (IO) access is a great tool in emergency care, but what about the risks? In this Danish retrospective cohort study of over 5,000 patients they found fewer than five cases of osteomyelitis, no osteonecrosis or compartment syndrome.

Review of the ELECT2 Trial (EarLy Exercise in blunt Chest wall Trauma) by @emmanchester.bsky.social for @stemlyns.bsky.social #FOAMed #MedSky #EMedSky www.stemlynsblog.org/early-exerci...

What a nice coincidence: My first post to share my first blog post for @stemlyns.bsky.social - looking back at the fantastic @eusem.bsky.social congress in October. #EuSEM #Copenhagen

If you had #FOMO about missing the London Trauma Conference held earlier this month, don't worry - I've got you covered with my take on Day 1 here (via @stemlyns.bsky.social) www.stemlynsblog.org/talking-trau...

This retrospective study explores the link between intra-arrest arterial blood pressure (IBP) and return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA). A DBP threshold of 35 mmHg was identified as optimal.

GLP-1A toxicity: What do emergency clinicians need to know about drugs like Ozempic® and Wegovy®? #FOAMed @stemlyns

Greg Yates reviews this paper for @stemlyns.bsky.social; GLP-1A toxicity: What do emergency clinicians need to know about drugs like Ozempic® and Wegovy®? #FOAMed #MedSky #EMedSky www.stemlynsblog.org/glp-1a-toxic...

Podcast – Bad Behaviour in Teams with Liz Crowe at Tactical Trauma 2024 In this podcast, Liz Crowe discusses the effect bad behaviour has on teams and ultimately patient safety.

Toxic alcohol poisoning: What do we know about fomepizole, methanol and ethylene glycol? Uncover the truth about alcohol poisoning. Find out how toxic alcohols can be ingested accidentally or intentionally and the serious consequences they can have with a focus on Emergency medicine management.…

Podcast – Reflections from the London Trauma Conference 2024: Insights and Inspiration A podcast with some of the highlights from the London Trauma Conference 2024

Uncover the ethical dimensions of AI in emergency care. Understand the potential benefits, pitfalls, and unanswered questions for the use of AI in emergency care, from trust and reliability to regulation, and the importance of a human touch. #FOAMed

Great work from @richardbody.bsky.social on AI in EM It’s defo here and the next few years are going to be fascinating as it embeds into daily practice

Great post on toxic alcohol ingestion from Greg and the @stemlyns.bsky.social team Greg started this months ago, but recent events have reminded us of the importance of the topic. www.stemlynsblog.org/toxic-alcoho...

Learn about the possible utility of ECMO in trauma in this podcast with Chris Bishop at Tactical Trauma 2024

Explore key takeaways from the DAS 2024 meeting, including airway management in obstetrics, ethics of training, challenges in critical care, and international practices. Insights tailored for emergency and anaesthesia professionals. #FOAMed @stemlyns

One of the most important posts @emmanchester.bsky.social has ever written for @stemlyns.bsky.social - how to ask a question at conferences #FOAMed #MedSky www.stemlynsblog.org/captain-ques...

Great post on toxic alcohol ingestion from Greg and the @stemlyns.bsky.social team Greg started this months ago, but recent events have reminded us of the importance of the topic. www.stemlynsblog.org/toxic-alcoho...

A HUGE thank you to Wayne Shaw, Managing Director of The Window Company in Stretford, for their incredibly generous donation of £500 to the North West Pre-hospital Critical Care Charity! Your support means the world to us & helps ensure we can continue delivering life-saving care in our communities

More excellent podcasting with Liz Crowe and the @stemlyns.bsky.social team

Our #Criticalcare vehicle is out tonight across the patch supporting the North West Ambulance Service. Our crew tonight is Critical Care Paramedic @oggie272.bsky.social, Doctor @cgraydoc.bsky.social and Trustee Dane. We wish them a safe shift. #Merseyside #Lancashire #Manchester and #Cheshire.

Looks like we need a decent DBP to get ROSC. About 35mmHg, and if you don't measure it, how do you know?? Read more...

Small vs large chest drains for haemothorax. How low can we go? (A - prob smaller than you think). #FOAMed @stemlyns.bsky.social www.stemlynsblog.org/jc-small-ver...

Creating a learning culture in the ED. How to build psych safety, curiosity ands grass roots learning cultures. @stemlyns #AfCEM24 #FOAMed @stemlyns stemlynsblog.org/building-a-l... #AfCEM24