RAGE Session Two

The wait is over, RAGE Session Two is here!

RAGE Session Two is 80 min 19 sec long and includes:

• Introduction, including some bad news… (starts 00:00 min)
• ‘What’s bubbling up?’ (starts 00:58 min) — shout outs and interesting discoveries from the world of FOAM and elsewhere featuring codeine in kids, post-intubation sedation, adenosine versus verapamil for SVT and how to do a good vagal manoeuvre, the ETM Twitter fiasco, the FOAMcc Google Plus Community and smaccGOLD.
• the RAGE team discussing a case of submassive pulmonary embolism and the role of thrombolysis (starts 22:14 min)
• the RAGE team’s discussion on ‘Humans in the resus room: ‘when your back-up gets your back up’’ (starts 51:50 min)
• ‘A blast from the past’ on WW2 hero and chain-smoking legend Edgar Patz, the only man to complete an entire Masters degree unconscious! (starts 73:00 min)
• ‘Wise Words’ featuring the art of observation, the immortal John Hunter and the infinitely wise Sir William Osler (starts 77.55 min)

Show notes for RAGE Session Two:

What’s bubbling up?

• 6 PEM papers that could change your practice – #1 – codeine (DFTB)
• Binks: Practice Changing Articles in PEM (Free Emergency Medicine Talks)
• Podcast 115 – A New Paradigm for Post-Intubation Pain, Agitation, and Delirium (EMCrit)
• I Hate Adenosine (Prehospital Wisdom)
• Valsalva maneuver by pressing on the abdomen (ALIEM)
• Walker S, Cutting P. Impact of a modified Valsalva manoeuvre in the termination of paroxysmal supraventricular tachycardia. Emerg Med J. 2010 Apr;27(4):287-91. doi: 10.1136/emj.2009.073866. PubMed PMID: 20385681.
• Best of 2013 – Eight is Enough & Social Media Update (EMCrit)
• Airways in the ED and on Twitter (LITFL)
• FOAMcc Google Plus Community (join in, it’s free)
• smaccGOLD

Submassive Pulmonary Embolus and Thrombolysis

FOAM:

• Submassive Pulmonary Embolus and Thrombolysis (LITFL CCC)
• Thrombolysis in submassive PE – still equipoise? (Resus.ME) — summary of the AHA guidelines
• MOPETT – Half-Dose tPA for PE (EMLON)
• EMCrit Wee – The Mopett Trial (EMCrit)
• Podcast 51: Fibrinolysis in Pulmonary Embolism (EMCrit)
• The case for thrombolysis in PE: PEITHO, ULTIMA, and TOPCOAT with Dr Stavros Konstantinides, ULTrasound Accelerated ThrombolysIs of PulMonAry Embolism (ULTIMA), Tenecteplase or Placebo: Cardiopulmonary Outcomes At Three Months (TOPCOAT), MOPETT: Is half-dose thrombolysis feasible for moderate PE? andUltrasound plus fibrinolysis reduce right heart dysfunction in pulmonary-embolism patients (Clot Blog on Medscape)

Journal articles:

• Dresden S,et al. Right ventricular dilatation on bedside echocardiography performed by emergency physicians AIDS in the diagnosis of pulmonary embolism. Ann Emerg Med. 2014 Jan;63(1):16-24. doi: 10.1016/j.annemergmed.2013.08.016. Epub 2013 Sep 27. PMID: 24075286.
• Kline JA, Steuerwald MT, Marchick MR, Hernandez-Nino J, Rose GA. Prospective evaluation of right ventricular function and functional status 6 months after acute submassive pulmonary embolism: frequency of persistent or subsequent elevation in estimated pulmonary artery pressure. Chest. 2009 Nov;136(5):1202-10. doi: 10.1378/chest.08-2988. Epub 2009 Jun 19. PubMed PMID: 19542256; PMCID: PMC2818852.
• Howard LS. Thrombolytic therapy for submassive pulmonary embolus? PRO viewpoint. Thorax. 2014 Feb;69(2):103-5. doi: 10.1136/thoraxjnl-2013-203413. Epub 2013 Apr 26. PMID: 23624534.
• Konstantinides S, Geibel A, Heusel G, Heinrich F, Kasper W; Management Strategies and Prognosis of Pulmonary Embolism-3 Trial (MAPPET-3) Investigators. Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism. N Engl J Med. 2002 Oct 10;347(15):1143-50. PubMed PMID: 12374874.
  
• Sharifi M, et al; “MOPETT” Investigators. Moderate pulmonary embolism treated with thrombolysis (from the “MOPETT” Trial). Am J Cardiol. 2013 Jan 15;111(2):273-7. doi: 10.1016/j.amjcard.2012.09.027. Epub 2012 Oct 24. PMID: 23102885.
• Simpson AJ. Thrombolysis for acute submassive pulmonary embolism: CON viewpoint. Thorax. 2014 Feb;69(2):105-7. doi: 10.1136/thoraxjnl-2013-204193. Epub 2013 Sep 17. PMID: 24046127.

Humans in the Resus Room: ‘When your Back-Up gets your Back Up’

• Making Things Happen (Resus.ME)
• The Resus Room Life Guard (Resus.ME)
• Communication in a Crisis (LITFL CCC)
• Crisis Resource Management (CRM) (LITFL CCC)

Blast from the Past

• Hero who put himself through hell (jameslefanu.com)

Words of Wisdom

• Do you know John Hunter (LITFL)
• Smith, Bell and the Art of Observation (LITFL)
• Lessons from Osler 003 — Learn the art of observation (LITFL)