Cliff Reid – Advice to a young resuscitationist


Dr Cliff Reid of Greater Sydney HEMS is probably one of the finest exponents of not only resuscitative science but also in transmitting ideas via talks/presentations. This plenary from SMACC Chicago last year gives us important insights into:

  • overconfidence
  • following up
  • changing oneself and systems when thigns go wrong
  • other specialists and using their skill and experience
  • risks and rewards of being in this field

He has his own channel here for other inspiring talks on resuscitation.

Webucation 29/5/16

Webucation this month comes from the realms of paedatric surgery, urology and even on some tele-medicine. Remember to visit and credit the original posters.


  • Sepsis-3 - This is need to know classification for all who deal with this disease
The last link is a must read for those in our speciality. For it is said many a time that the 2 things that we deal with mostly in our career are related to vascular problems and sepsis. So be good at them.

Another win for U/S

Here's a good one from JournalWatch. Its encouraging to see some myth-busting and new standard setting coming into the mainstream.
Original study lives here.


No Need for Chest X-Ray After Ultrasound-Guided Right Internal Jugular Lines?


Very few complications were picked up by routine chest x-ray at a large academic hospital system.

For decades, dogma has been that chest x-ray should be performed to confirm placement of all internal jugular (IJ) central lines, despite evidence that ultrasound can significantly reduce complication rates. These authors retrospectively assessed detection of complications by routine chest x-rays obtained after ultrasound-guided placement of right IJ central lines in adults at an academic tertiary hospital system.
During 2014, a total of 1322 right IJ central lines were placed with ultrasound guidance in emergency departments, intensive care units, and general wards. Overall, 97% of attempts were successful. Chest x-ray detected 1 (0.1%) pneumothorax, 13 (1.0%) misplaced catheters that required repositioning, and no arterial placements.

COMMENT

For ultrasound-guided, right IJ lines, these findings suggest that routine chest x-ray may eventually be replaced by ultrasound to assess for placement complications. The findings also demonstrate that resuscitation should not be delayed by waiting for the confirmatory x-ray. The case is closed when it comes to the requirement for using ultrasound for IJ line placement. If you aren't using it, be prepared for the difficult conversation explaining why.

Tupac on nurses

Having learnt some hard lessons when I was fresh and having been on the treatment side of medicine, I can attest to the truth of the following video. This is a never ending shout out to the nurses who embody the spirit of healing.
Testify Zdogg...