June 2019; papers of the month

The Resus Room

Simon Laing

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

4.8 • 678 Ratings

🗓️ 1 June 2019

⏱️ 33 minutes

🔗️ Recording | iTunes | RSS

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Summary

Status Epilepticus in children, lying and standing blood pressures in syncope or presyncope and decompressing paediatric tension pneumothoraces.

You'll no doubt have seen and heard about the two papers published this month in the Lancet, both Consept and Eclipse look at the use of keppra vs phenytoin as a second line anti convulsant therapy for children in status epilepticus. We take a look at both papers, and have a think about what this means for practice.

There has been a large amount of focus on the optimal position for needle decompression of tension pneumothoraces in adults, but an open access paper from SJTREM looks at the best position in children, take a look at the paper here.

Finally, should all patients with a presentation of syncope/presyncope be getting a lying and standing blood pressure, or is it an ineffective test?

Make sure you take a look at the papers yourself, remembering that the paper from SJTREM on paediatric pneumothoraces is totally open access.

We'd love to hear your thoughts and comments.

Enjoy!

Simon & Rob

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:13.0	So hi and welcome back to the Recess Room podcast. I'm Simon Lang. And I'm Rob Fenwick.
0:19.6	And this is June 2019's Papers of the Month.
0:23.9	Oh yes, it is.
0:24.8	We've got not three papers this month, but I think we might have four.
0:28.3	Is that right?
0:29.2	It is a stonkingly big episode.
0:32.1	33% gratis.
0:34.1	There you go.
0:34.7	No problems.
0:36.5	Yeah, we've got some big topics, haven't we? So we're covering needle decompression of pediatric pneumothoroses. We're having a look at two big papers on second line anti-convulsants in status epilepticus. And then we're finishing off with everyone's favorite testing in the emergency department, or correction,
0:54.8	it's not a urine dip, orthostatic testing, so testing lying and standing blood pressures
1:00.4	in ED, should we be doing it?
1:03.0	Wow, there you go. That's some topics for you. Let's get cracking.
1:07.0	It certainly is. Before we get into the podcast, a huge thanks to S.J. Trem, the Scandinavian Journal of Trauma, Resuscitation, Emergency Medicine, but we've collaborated with and are supporting the podcast and enabling this to be a free open access venture. Have a look at their journal. All of their articles are open access online, so any papers that we talk about, you can have a direct look at on their website.
1:29.5	So without further ado, let's go on to paper number one.
1:35.0	So paper number one this month is titled chest wall thickness and depth to vital structures in
1:41.1	pediatric patients, implications for pre-hospital needle decompression of tension
1:46.2	pneumothorax. So, Simon, as I'm sure you're aware, there's been some changes with regard
1:51.8	to the evidence for the optimum location for needle decompression for tension pneumothorax in adults.
1:57.9	However, where is the best place to do this in children? Well, with the thinner chest walls,
2:03.2	is there more risk of injury to the underlying vital structures? Well, this is a paper that might
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