As the years tick by our healthcare systems work harder and harder to ensure that acute coronary syndromes are picked up as they present to our Emergency Departments, the evolution of high sensitivity troponins and their application have been key to this.
The utility of a test however is dependant upon it's application to the appropriate patient. In a heavily burdened system it can at times seem sensible to front load tests and 'add on a troponin' before we are even sure the history is consistent with a possible acute coronary syndrome. But is this a safe approach for our patients and what are the potential consequences?
In this podcast we run through a recent paper from the US on the topic. Whilst not the highest level of evidence and also looking at a system not entirely generalisable to the UK, it does highlight the aforementioned concerns and is a useful reminder to consider our approach to testing in patients with chest pain.
We are certainly not berating the use of troponin, we just think the paper serves a great reminder that testing must be appropriately applied.
Enjoy, and as ever we'd love to hear your feedback!
So my talk at the ICS SOA 2016 conference on whether ED should be allowed to intubate certainly provoked some discussion, which was fortunate as it was the purpose of the talk!
If you haven't listened to it yet, stop listening to this and have a listen to the talk here first.
In this quick debrief between Rob and myself we have a think about the feedback and where to go from here.
We'd love to hear any feedback in the comments section at the webpage at www.TheResusRoom.co.uk
RSI delivered by EM clinicians is common place throughout the globe, in the UK however it still seems a contentious topic, with recent data showing only 20% of ED RSIs being performed by EM clinicians.
I was lucky enough to be asked to talk at the ICS SoA 2016 conference on the topic of EM doctors carrying out RSI's in the UK and this podcast is a copy of that talk.
I hope it provides some context both to UK practitioners and also to those from other countries, who may not understand what the big deal is all about.
Welcome to December's Papers of the month where we'll be looking at the papers recently published that have caught our eye.
First up, what happens when clinicians override clinical decision rules for PE? Are we better than the the rules?
Next we have a look at a review article that runs through the back ground literature on subsegmental PE's, their diagnosis and management.
And finally we have a look at a paper that helps to benchmark ED airway management with regards first pass success rate.
Our sponsors ADPRAC are giving away another £30 iTunes voucher to spend on education/entertainment to support your work life balance! All you need to do is click the link on our home page through to the ADPRAC website and answer the question relating to the podcast, good luck!
References & Further Reading