Papers of February 2019

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 & Further Reading

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

A Systematic Review and Meta-analysis of Ketamine as an Alternative to Opioids for Acute Pain in the Emergency DepartmentKarlow N. Acad Emerg Med. 2018

Premedication With Midazolam or Haloperidol to Prevent Recovery Agitation in Adults UndergoingProcedural Sedation With Ketamine: A Randomized Double-Blind Clinical Trial. Akhlaghi N. Ann Emerg Med. 2019 

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

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