Cutting Edge Intra-Arrest Care

The RAGE team owe a lot to Mr EMCrit Scott Weingart. Together with Rob Orman of ERCast, he was instrumental in helping us get the technical aspects of podcasting in order as we found our podcasting feet.

Here is Weingart in action at smaccGOLD. His talk on ‘Cutting Edge Intra-Arrest Care’ is unequivocally essential listening for anyone who follows the RAGE podcast.

It is controversial.

He calls for resuscitationists to go beyond ACLS and function on the bleeding edge of critical care.

Critics will argue that early adoption is intensely dangerous. I am sure that some of the things Scott talks about will prove to be false in the fullness of time (I just can’t see vasopressin-epi-steroids being validated by bigger multi-center trials, for instance).  Nevertheless, this is a masterful talk by a master resuscitationist.

If you resuscitate, you must listen to this talk!

This is the audio: (direct download mp3 here):

These are the slides:

This is the video:

Cricoid: To Press or Not to Press?

Just in case you still thought cricoid pressure was a good idea, listen to the RAGE team’s newest member John Hinds at smaccGOLD. Hinds is an anaesthetist, intensivist and a motorcycle-riding prehospital resuscitationist based in Northern Ireland. In this debate he will tell you about ‘cricolol’.

What?

John parodies cricoid pressure by encouraging us to imagine that this procedure is a drug… Yep, might as well use it as a suppository.

Would you give it?

RAGE listeners have already heard Scott Weingart in RAGE: smaccGOLD edition call this the ‘most brilliant cutting away at the knees of an opponent…”

Listen to the talk below (John starts about halfway through at 12min 55sec if you’re impatient).

Here are the slides to flick through as you listen:

Or why not go straight to the video:

BTW, big ups to Brent May for valiantly putting forward the case for cricoid pressure… An unenviable task.

Learn more here:

Otherwise check out John’s references:

  1. Sellick BA. Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. Lancet 1961;2:404-6.
  2. Koziol CA, Cuddeford JD, Moos DD. Assessing the force generated with application of cricoid pressure. AORN journal 2000;72:1018-28, 30.
  3. Smith KJ, Dobranowski J, Yip G, Dauphin A, Choi PT. Cricoid pressure displaces the esophagus: an observational study using magnetic resonance imaging. Anesthesiology 2003;99:60-4.
  4. Hartsilver EL, Vanner RG. Airway obstruction with cricoid pressure. Anaesthesia 2000;55:208-11.
  5. Allman KG. The effect of cricoid pressure application on airway patency. Journal of clinical anesthesia 1995;7:197-9.
  6. Levitan RM, Kinkle WC, Levin WJ, Everett WW. Laryngeal view during laryngoscopy: a randomized trial comparing cricoid pressure, backward-upward-rightward pressure, and bimanual laryngoscopy. Annals of emergency medicine 2006;47:548-55.
  7. Garrard A, Campbell AE, Turley A, Hall JE. The effect of mechanically-induced cricoid force on lower oesophageal sphincter pressure in anaesthetised patients. Anaesthesia 2004;59:435-9.
  8. Chassard D, Tournadre JP, Berrada KR, Bouletreau P. Cricoid pressure decreases lower oesophageal sphincter tone in anaesthetized pigs. Canadian journal of anaesthesia = Journal canadien d’anesthesie 1996;43:414-7.
  9. Heath KJ, Palmer M, Fletcher SJ. Fracture of the cricoid cartilage after Sellick’s manoeuvre. British journal of anaesthesia 1996;76:877-8.
  10. Ralph SJ, Wareham CA. Rupture of the oesophagus during cricoid pressure. Anaesthesia 1991;46:40-1.

The Art and Science of Fluid Responsiveness

Unavoidable delays mean you’ll have to wait a bit longer for RAGE Session 4… But it is in the works, we promise!

In the meantime check out this masterful smaccGOLD presentation by the RAGE team’s very own Haney Mallemat: ‘The Art and Science of Fluid Responsiveness’.

Here is the audio (download the mp3 directly here):

Here is the video:

Learn more about related topics via the LITFL CCC:

To listen to all the smaccGOLD talks as they are released subscribe to the SMACC podcast on iTunes.

What a great job!

Indispensable RAGE team member Cliff Reid was a keynote speaker at the ACEM Annual Scientific Meeting in 2013.

He was tasked with delivering a talk titled ‘What a great job!’

… and, of course, he well and truly delivered.

httpv://vimeo.com/93460243

Hopefully this tides you over until the next RAGE session and inspires you as much as it inspires us.

Special thanks to ACEM for allowing the audio to be released as FOAM on the RAGE Podcast.

RAGE on…

Thanks again for listening to the RAGE!