Bilateral fixed dilated pupils? Operate if extradural!

Almost two-thirds of patients with extradural haematoma and bilateral fixed dilated pupils survived after surgery, with over half having a good outcome   Neurosurgeon, HEMS doctor, and all round good egg Mark Wilson was on the RAGE podcast recently and mentioned favourable outcomes from neurosurgery in patients with extradural (=epidural) haematomas who present with bilateral […]

Early femur fixation recommended

The Eastern Association for the Surgery of Trauma recommends early (<24 hours) open reduction and internal fracture fixation in trauma patients with open or closed femur fractures. They acknowledge the strength of the evidence is low, but suggests a trend toward lower risk of infection, mortality, and venous thromboembolic disease. They conclude: “the desirable effects […]

SMACC Chicago – don’t miss the boat!

If you’ve attended a SMACC conference or heard anything about them, you will be aware that it is the most exciting, inspiring, interesting, and educational critical care conference ever. It is a non-profit venture dedicated to getting the best educators, clinicians, and researchers in intensive care, emergency medicine, prehospital/retrieval medicine and anaesthesia to share their […]

Left Ventricular Assist Device for Cardiac Arrest?

An interesting case report by Dr Heidlebaugh and colleagues from the Department of Emergency Medicine at the William Beaumont Hospital describes a 72 year old marathon runner who arrested during cardiac catheterisation. It suggests a possible novel alternative to ECMO for cardiac arrest. The patient became bradycardic then asystolic during catheterisation of his right coronary […]

ARISE study: EGDT no better than standard care

The second of three major trials assessing early goal directed therapy (EGDT) in sepsis – the Australasian ARISE Trial – has been published. ARISE tested the hypothesis that EGDT, as compared with usual care, would decrease 90-day all-cause mortality among patients presenting to the emergency department with early septic shock in diverse health care settings. […]

ARISE study: EGDT no better than standard care

The second of three major trials assessing early goal directed therapy (EGDT) in sepsis – the Australasian ARISE Trial – has been published. ARISE tested the hypothesis that EGDT, as compared with usual care, would decrease 90-day all-cause mortality among patients presenting to the emergency department with early septic shock in diverse health care settings. […]