February 2019; papers of the month

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 1 February 2019

⏱️ 30 minutes

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Summary

Ketamine and trauma are the topics for this months papers.

The three papers we cover are really important for all of us involved in the care of critically unwell patients. Hypotensive resuscitation in the context of trauma has been an evolving area of practice in the treatment of our acute trauma victims. A paper published in SJTREM this month meta-analyses the data that exists out there on the topic and looks to give us an idea of the benefits and potential risks associated with such an approach, the paper is available here and is well worth a full read.

Morphine has been a mainstay of the treatment of acute severe pain in the Emergency Department for decades, but as the popularity of ketamine grows we take a look at another meta-analysis, this time comparing the efficacy of ketamine versus morphine in this setting and group of patients.

And lastly, if you have ever had a patient become severely agitated with ketamine sedation, you'll be keen to avoid that happening again! The last paper we look at is a randomised control trial looking at the potential benefits of using either midazolam or haloperidol to achieve that.

We hope you find the podcast useful, as ever please go and take a look at the papers yourself and we'd love to hear any thought or comments you have either rat the bottom of the page, or via twitter @TheResusRoom.

Enjoy!

Simon & Rob

References

Risks and benefits of hypotensive resuscitation in patientswith traumatic hemorrhagic shock: a meta-analysis. Owattanapanich N. Scand J Trauma Resusc Emerg Med.2018

A Systematic Review and Meta-analysisof Ketamine as an Alternativeto Opioids for Acute Pain in the Emergency Department. Karlow N. Acad Emerg Med.2018

Premedication With Midazolamor Haloperidolt o Prevent Recovery Agitation in Adults Undergoing Procedural Sedation With Ketamine: A Randomized Double Blind Clinical Trial. Akhlaghi N. Ann Emerg Med.2019

St Emlyns; JC: Should we premedicate for ketamine sedation?

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.9	Five, four, three, two, one, fire.
0:13.3	So hi, and welcome back to the Recess Room podcast. I'm Simon Lang.
0:18.1	And I'm Rob Fenwickwick And we're rattling through 2019
0:21.2	And this is February's papers of the month
0:23.5	It is indeed
0:24.3	We've got three papers as ever for you
0:26.5	We've got hemorrhagic shock
0:27.8	And we've got a couple on ketamine
0:29.8	Interesting
0:31.0	And if you're not a big fan of ketamine
0:32.9	Don't worry because it is relevant to opioid analgesia
0:36.4	So it's relevant to all of you That might be giving IV morphine for patients in acute pain.
0:42.0	Before we get into the podcast, a big thanks to APRAC for supporting the show.
0:46.5	They're an advanced clinical practitioner group who are looking for emergency nurse practitioners and ECPs that can work in minor illness and injury streams that work in
0:55.1	the Cambridgeshire and Lincolnshire areas and also for ACPs in the London area. So big thanks
1:01.3	to them. Without further ado, let's get on with the podcast. So first up then, hypotensive
1:09.6	resuscitation. So we've just had our roadside to recess on shock.
1:14.4	This probably follows on pretty well from that, although we didn't talk about trauma in that.
1:18.6	So if you haven't listened to that, go and have a listen to it first, but let's carry on with this paper.
1:24.1	So the lead author was Nathida Owatanapenich. It's published in S.J. Trem and the title of the paper
1:30.2	risks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock and meta-analysis.
	...

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