RESPIRATORY

Asthma

Asthma Foundation Handbook – Managing acute asthma (Adults and Children)

RCH Guidelines

LITFL – EBM Asthma 

Asthma Severity Assessment:

Asthma Severity Assessment - Children 6yo to Adults Asthma Severity Assessment Children 0-5

Crashing Asthmatic

EM Tutorials

Deranged Physiology

EM Updates

20111021Vent_ObstructiveDzTable 8. Post-Intubation Troubleshooting Emergency medical Practice

PNEUMONIA

LIFTL Community Acquired Pneumonia

Pneumonia

LITFL – Nosocomial Pneumonia

RCH Guidelines

Therapeutic Guidelines – Empirical Rx

  • Mild: Amoxicillin or Doxycycline
  • Mod: Benzylpenicillin + Atypical cover: Doxy or Azithromycin (Tropical = Ceftriaxone + Gentamicin)
  • Severe: Ceftriaxone + Azithromycin.  (Consider Vancomycin if covering Staph, Tazocin if concern about G-ve, Tropical Merepenem or Tazocin and Azithromycin)
CURB 65 – Pneumonia Severity Score

Pneumothorax

British Thoracic Society Guidelines

Cochrane review

Aspiration vs Chest tube (2007)

Conservative vs Interventional (2014)

LIFTL

RCH Guidelines

BTS – Air Travel Recomendations (2011) (Also Good Summary EMRAP (Need subscription))

  •  Patients with a closed pneumothorax should not travel on commercial flights (with the exception of the very rare case of a loculated or chronic localised air collection which has been very carefully evaluated) (C).
  • Patients who have had a pneumothorax must have a chest x- ray to confirm resolution before flight. Many would regard it as prudent for a further 7 days to elapse before embarking upon flight (C).
  • In the case of a traumatic pneumothorax, the delay after full radiographic resolution should ideally be 2 weeks (D).
  • A definitive surgical intervention undertaken via thoracotomy is likely to be entirely successful and patients should be allowed to fly once they have recovered from surgery. (D) A similar intervention undertaken by video- assisted thoracoscopic surgery is also expected to have a high success rate but is not definitive; these patients should be aware of a slight risk of recurrence (B).
  •  Patients having other forms of pleurodesis and those not undergoing pleurodesis after a pneumothorax are unlikely to have further episodes precipitated by flight, but spontaneous recurrence could have important consequences in the absence of prompt medical care. The risk of recurrence is higher in those with coexisting lung disease and does not fall significantly for at least 1year. Those not undergoing definitive surgery may therefore wish to consider alternative forms of transport (D).

Chest Drains:
Pigtail Insertion

LITFL

NEJM

Thoracocentesis NEJM

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s