Papers of June 2021

This month we’ve got three papers that have challenged our practice both from an in-hospital and pre-hospital perspective.

Firstly we consider a paper that looks at admission saturations for patients with exacerbations of COPD and compare this to the BTS guidance on oxygen therapy, regarding altering oxygen saturations for those proven not to be hypercapnoeic. Should we be aiming for 88-92% or 94-98%?

Next we look at a paper from the team at KSS looking at dispatch to older trauma victims and consider whether current triggers for HEMS dispatch are set at the appropriate level to catch those in this cohort that may benefit from critical care interventions.

Lastly we look at a paper evaluating the QRS width in PEA cardiac arrests and consider firstly whether a broad QRS complex is predictive of hyperkalaemia and secondly whether we would treat patients based off this finding?

Once again we’d love to hear any thoughts or feedback either on the website or via twitter @TheResusRoom.

Enjoy!

Simon and Rob

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References & Further Reading

Oxygen therapy and inpatient mortality in COPD exacerbation. Carlos Echevarria. Emerg Med J. 2021

NEWS-2

Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger? J E Griggs. Scand J Trauma Resusc Emerg Med. 2021

Association between wide QRS pulseless electrical activity and hyperkalemia in cardiac arrest patients. Young-Min Kim. Am J Emerg Med. 2021

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