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The Resus Room

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Now displaying: Page 1
Feb 1, 2017

Welcome back to Papers of the Month. February holds a diverse number of topics on some really interesting areas of practice.

We kick off with a snap shot systematic review from the Annals of Emergency Medicine on the effect of Amiodarone or Lignocaine on the outcome from refractory VF or VT arrests, are drugs losing more favour yet again in cardiac arrest.

Next up is a pilot study following the surgical theme of minimal intervention for appendicitis, can antibiotics safely be used in a particular cohort of patients to prevent the need for surgery? And moreover could this be even safer than the traditional surgical cure?

Last up we cover a paper looking at the survival from traumatic cardiac arrest and consider the bias that may occur by reporting those resuscitation attempts that are of limited duration in with the whole cohort; are we painting a overly negative picture of the prognosis of traumatic cardiac arrest?

As ever we would highly encourage you to go and read the papers yourselves, these are only our takes on the literature and we would love to hear your thoughts below.

Enjoy

Simon & Rob

References & Further Reading

In Patients With Cardiac Arrest, Does Amiodarone or Lidocaine Increase Meaningful Survival? Hunter BR. Ann Emerg Med

Antibiotics-First Versus Surgery for Appendicitis: A US Pilot Randomized Controlled Trial AllowingOutpatient Antibiotic Management. Talan DA. Ann Emerg Med. 2016 Dec

Resuscitation attempts and duration in traumatic out-of-hospital cardiac arrest. Beck B. Resuscitation 2017 Feb

1 Comments
  • over seven years ago
    Iliya Englin
    I would love to have some solid evidence to back up medical mx of appendicitis, working in a remote area. A lot of people have been doing it under the counter for some time, under the guise of time pressures in theatre, but they don't always get away with it.

    I am quite certain that good antibiotics can resolve an infection in the appendiceal wall if given early. No problem there.

    I would want to know, however, that the appendix is empty - if it contains a faecalith, however, I would be wary of it resolving without steel.

    Next question. Every surgeon has removed an appendix covered in scars from previous episodes. So are these medically managed patients set up to have another emergency? A year is not that long a follow-up. I tell patients with cholelithiasis not to travel overseas or into the desert until they have the chop - would medical mx of appendicitis create a similar population at risk?
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