Ken Spearpoint and I talk about Crew resource management as it relates to the cardiac arrest scenario. I love talking with Ken as he is so knowledgeable and puts his points across so well. i found it really interesting to chat with him about this. I have broken it down into two parts as we both had so much to say, so the second part will be podcast 027 next time.
One of my work colleagues, sent me a tweet a few days ago about an arrest he had been involved in.
There were some problems with the airway and the difficulty encountered with the moving target as CPR is ongoing. I suggested that someone should be holding the head whilst my colleague attempted to tube the patient, and this brought up the subject of Crisis Resource Management (CRM).
This got me looking at this issue as it relates to the emergency situation and I have found a number of useful resources. I have found a few definitions of what this means but I think this one includes most issues:
Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock.
Read More
We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion.Although these patients look fluid overloaded, they are effectively hypovolaemic. Start with small aliquots of balanced crystalloid, avoiding 0.9% saline. In hepatorenal syndrome or tense ascites, 20% albumin is
Read More
In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priorities at the bedside. Listeners are
Read More