Web musings this week come from the worlds of critical care, paediatrics, orthopaedics and even the dermatologists! A lot of the below has risk management and error reduction pearls included. So visit and support the content creators as always.
- Pneumonia detection - difficult x-rays in children, but not impossible
- Splinting upper/lower - EM in 5 gives a great rundown about casting limbs
- Is it Nec Fasc? - ALiEM relate a fascinating case, with a bit of risk management thrown in
- Variability of different BVMs - this article was a surprise to me. Click to be surprised as well.
- Is this distracting? - Ryan Radecki breaks down another myth. This time about c-spine clearance.
- What is a wide mediastinum? - The trauma pro answers this much asked question
- Vent settings in asthma - what to do AFTER the intubation
The last link is a good reminder to trainees and professionals alike on the subtler aspects of holistic critical care. Additionally we would like to remind our readers of an old adage:
"If you are intubating an asthmatic, you have failed him/her medically"
It's not a judgement but rather to remind you that there are tons of things that you can do prior to mechanically ventilating an asthmatic (most of the time). So make sure you have thought of the following prior to attempting this very high risk procedure:
- Broncho-dilator maximisation
- Continuous nebs
- IV infusions of beta agonists
- Theophylline (old school I admit)
- Non invasive ventilation and nebs via that route (anecdotally works great in our XP)
Emcit has the best crashing asthmatic talk over here.