CREAD 003- CRitical Evaluation, Appraisal and Discussion

 September 24

by Jonathan Downham

CREAD (1)_optWelcome to the third edition of CREAD- CRitical Evaluation, Appraisal and Discussion.

This very much takes its inspiration from the work of the team over at Life in The Fast Lane which provides regular round ups of some of the many resources available via the internet which makes our learning easier.

We are attempting something similar here, but the difference is that the contributors are from specialties other than medicine. So we have paramedics, nurses, and physios to name just a few. They are all experienced in their fields, regular internet learners and Twitter users. Some have written articles and some have pointed out some of the resources they have come across on their internet travels.

This will be a bi-monthly effort initially. If it becomes popular and the hard working contributors can find the time then I hope it will become more regular.

I do want to emphasize that it is the work of the contributors that makes it work…..I am just the coordinator.

If you do feel you want to make a contribution in the future please get in touch with me via Twitter @ccpractitioner.


Extra Corporeal Carbon Dioxide Removal

Gavin Denton gets us off to a great start in this issue. He has written a very thorough review of some of the issues surrounding Extra Corporeal Carbon Dioxide Removal. It is a longer than normal post, but please go and read it….I think it is excellent.

Gastric Residual Volumes

Heather Baid points out that we may be stopping the practice of routine checking of gastric residual volumes here….

Just Say Sepsis

Nicki Credland has highlighted some of the key themes from the Just Say Sepsis document released at the end of last year. This short summary can be found here…..

Ventilating through Supra Glottic Airways

James DuCanto points us to an article about the use of a supra glottic airway when ventilating patients.

Article with Dr Benumof as coauthor. He’s the biggest guy in US Anesthesia airway management.

He concludes that the air-Q beats the LMA Excel and Unique for grade of visualization and intubation success using anesthesia residents as the endoscopists with flexible bronchoscopes.

One of my hesitations on the use of the i-gel is that I cannot get it to flatten out to get through a narrow oropharyngeal passage like I can with the air-Q.  This was a significant factor in an airway I did for an intensivist during a code last week–lady wasn’t quite fully dead yet, had her teeth clamped shut, and the code team could not ventilate her with a mask (and they lacked the ability to place an oral airway). I pried open her mouth with a Yankauer suction and inserted an air-Q through a tremendously limited space, and it was successful in establishing the needed airway on the first pass.  No way I would have had the intraoral space to get an iGel in the mouth in that patient, and questionable if it would have rounded the base of tongue adequately either.

Men in Nursing

Tom Hreben mulls over why men come into nursing….do you agree with him??



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