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Cliff Reid Profile picture
@cliffreid
Mar 15, 2019 • 3 tweets • 2 min read • Read on X
So who's coming to #EMSWolfpackFightclub at #SMACC on 26 March? Would be good to have an idea of numbers
@HumanFact0rz are you in?
@jrparamed are we welcoming novices? Would be good to offer a taster

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More from @cliffreid

Cliff Reid Profile picture
Nov 23, 2023
WTF is a ‘difficult airway’?

A 🧵

1/14
I avoid the term ‘difficult airway’ altogether

How we describe a situation can have a psychological framing effect that can affect our performance

2/
Mindset, confidence, and therefore performance are likely to be worse if you expect the airway to be ‘difficult’ rather than prepare for it to be ‘potentially challenging’

3/
Read 14 tweets
Cliff Reid Profile picture
Nov 20, 2023
Let's review an intubation together - a 🧵
A previously well patient in her 60's presents with a first seizure & post-ictal coma
A nasopharyngeal airway has been placed for airway patency
She weighs 100kg
She receives 70mg propofol /100mg rocuronium after checklist completion, pre-ox & application of nasal cannula O2
This video shows what a nasopharygeal airway looks like, and how far it can go down

It was removed during laryngoscopy- not sure why. Consider leaving it in in case you need it to support facemask ventilation if laryngoscopy is unsuccessful
Read 11 tweets
Cliff Reid Profile picture
Sep 15, 2023
Stopping someone from bleeding to death requires many keys steps

Our team uses this cognitive aid

Page 1 covers general measures to guide vascular access, haemostatic resuscitation, reversal of anticoagulation, and optimising of clotting

1/10 Image
Page 2 gives specific guidance on managing the location of haemorrhage, eg. epistaxis, haematemesis, etc

2/10 Image
We use this to ensure things aren't forgotten, such as maintaining normocalcaemia and normothermia, and that doses are at our fingertips, eg. for prothrombin complex concentrate or terlipressin

3/10 Image
Read 10 tweets
Cliff Reid Profile picture
Jul 21, 2023
Very short🧵on AF in hospital 1/5

Atrial fibrillation in hospital often starts from interplay between underlying risk factors (substrate) & acute triggers Image
The 3 A's of acute management are

1. Acute trigger identification & management

2. AF rate/rhythm control

3. Anticoagulation - BUT:...

2/5 Image
...the risk/benefit assessment for anticoagulation must take into account the acute presentation

The approach that's used in chronic AF does not necessarily apply

For example, AF in common in critically ill patients, such as those with sepsis

3/5
Read 5 tweets
Cliff Reid Profile picture
Dec 1, 2022
The iGel is a great supraglottic airway device

But like other supraglottic airway devices (SAD) it's not foolproof

Here's how to maximise your success with the iGel - a thread 🧵
Adequately positioned SADs produce a good seal and no leak
Ideally the iGel cuff should sit snugly over the larynx
Read 22 tweets
Cliff Reid Profile picture
Nov 27, 2022
Three #cardiology cases with diagnostic ECGs in our resus room today and some learning points for emergency clinicians

#ecg #ekg
1. Sudden onset palpitations

ECG shows regular narrow complex tachycardia with rate around 140
We suspected this was atrial flutter
Rather than subject a patient to the horror of iv adenosine (which only reveals flutter - it can’t convert it), we moved the ECG limb leads around to get a ‘Lewis lead’ which better shows atrial activity

(See litfl.com/lewis-lead-s5-… )
Read 13 tweets

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