The Procedures Course Podcast
The Procedures Course Podcast
Alfred STAR Program
Learn more about life, limb and heroic critical care procedures in the emergency department & retrieval environment
Retrieval Amputation
Prehospital limb amputation is an uncommonly performed procedure whereby amputation of an entrapped limb is required to facilitate the safe extrication of a patient in a life-threatening situation.
Jun 24, 2017
Resuscitative Hysterotomy - Peri-Mortem C-Section
Resuscitative hysterotomy is the emergent delivery of a foetus from a mother in cardiac arrest to improve the outcomes of both the mother and foetus. Questions covered include: * Is the 4 minute rule really valid? * What are the technical steps in performing the procedure?
Apr 16, 2017
Pericardial Decompression - Resuscitative Thoracotomy
Most fatalities from blunt or penetrating cardiac injuries occur prior to hospital arrival. The main reversible pathology is acute cardiac tamponade, which may be present without external signs of injury, abnormal clinical signs, or ECG abnormalities. The cause of the tamponade is usually a laceration to a low-pressure cardiac cavity. In recent years the widespread use of ultrasound in the initial assessment of severely injured patients has facilitated the early diagnosis of cardiac tamponade and associated cardiac injuries.
Mar 8, 2017
Escharotomy involves incision of inelastic burned tissue (eschar) that can impair perfusion of the extremities, as well as restrict chest wall movement and ventilation. Indications: * Limb hypoperfusion * Ventilation restriction Limb Hypoperfusion Can occur with circumferential AND non-circumferential burns.
Feb 25, 2017
Temporary Trans-venous Pacing
Temporary transvenous cardiac pacing involves insertion of a pacing wire (catheter based electrode) into the right ventricle to allow electrical stimulation of the myocardium. Transvenous pacing is usually attempted in the emergency department after less invasive treatments have been unsuccessful.
Feb 23, 2017
Resuscitative Vascular Access
The anatomical properties of the subclavian vein provide a number of benefits for its use in central venous access, especially during trauma resuscitation. The subclavian vein is a large diameter central vein without valves which, as a result of its soft tissue attachments, remains patulous and undisplaced even in the hypovolaemic patient.
Feb 22, 2017
Pleural Decompression & Drainage
Pleural decompression with subsequent tube thoracostomy is one of the most commonly performed life-saving procedures for traumatic chest injuries. Thoracic injuries are primarily responsible for 25% of all trauma deaths and contribute to a further 25% of deaths. However, over 85% of patients with thoracic trauma do not require thoracic surgery.
Feb 17, 2017
Surgical Airway
An emergency surgical airway may be a life-saving procedure in situations where other airway management techniques have failed or are contraindicated. Whilst the incidence of the can’t intubate, can’t oxygenate (CICO) scenario is low, with estimates ranging from 1/50,000 intubations in the operating theatre to 1/100 intubations in the Emergency Department, being able to gain access to the airway via the anterior neck is an essential rescue option.
Feb 11, 2017