Sedation is becoming an ever more significant part of our work in the Emergency Department. At the end of May 2016 the Royal College of Emergency Medicine Published the RCEM Sedation Audit of 2015-2016 that covered more than 8,000 ED sedations throughout the UK (involving more than 190 ED's).
There are some pearls to take out of this great piece of work in which there would seem to be some significant scope to improve. The document not only benchmarks our practice but helps give us a feel for the risks involved.
Have a listen and check out the resources mentioned via the hyperlinks below, most importantly make sure you have a look at the document itself.
Carbon Monoxide poisoning is definitely one of those differentials that you consider when the patients books into ED with '?carbon monoxide poisoning'...... but how much do we really think about it in a patient that hasn't been sent down to the ED with this specific thought in mind?
Rob Fenwick talks us through the key points of Carbon Monoxide poisoning and some recent evidence on the topic which will probably make us consider the possibility a bit more frequently! This podcast was based around the post Rob wrote for Jonathan Downham's superb Critical Care Practitioner podcast. Go and have a look at the post for a lot more information on the topic.
For June we have a look at papers covering CT head imaging in delayed trauma presentations, risk stratifying TIAs, early administration of fluids in severe sepsis and most importantly the utility of a biro in a surgical airway.......
Make sure you go and have a look at the papers yourself to see what the evidence means to you.
Validation of ABCD2 scores ascertained by referring clinicians: a retrospective transient ischaemic attack clinic cohort study. Dutta D. Emerg Med J. 2016 Apr 7. pii: emermed-2015-205519. doi: 10.1136/emermed-2015-205519. [Epub ahead of print]
Association of Fluid Resuscitation Initiation Within 30 Minutes of Severe Sepsis and Septic Shock Recognition With Reduced Mortality and Length of Stay. Leisman D. Ann Emerg Med. 2016 Apr 14. pii: S0196-0644(16)00148-7. doi: 10.1016/j.annemergmed.2016.02.044. [Epub ahead of print]
CT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study. Marincowitz C. Emerg Med J. 2016 Apr 13. pii: emermed-2015-205370. doi: 10.1136/emermed-2015-205370. [Epub ahead of print]