David Anderson ASM
@expensivecare.bsky.social
Medical Director - Ambulance Victoria; Intensivist - Alfred Health; Adj Assoc Prof - Monash Paramedicine. 🏴🇳🇿🇨🇦🇦🇺🏳️🌈 #medsky #foamed #emsky #paramedicsky
It isn’t often that you need to provide a risky treatment before you’ve even assessed the patient, but that’s what prehospital clinicians sometimes need to do when caring for patients with acute behavioural disturbance.
@jamesoz1.bsky.social & I talk sedation safety on Clinical Conversations.
@jamesoz1.bsky.social & I talk sedation safety on Clinical Conversations.
🚑 New Episode of Clinical Conversations🎙️
Pre-hospital sedation carries serious ethical and clinical risks. In this episode of Clinical Conversations, @expensivecare.bsky.social and I explore why it’s risky and how to make it safer.
#Paramedicine #PreHospitalCare #EmergencyMedicine #Sedation #EMS
Pre-hospital sedation carries serious ethical and clinical risks. In this episode of Clinical Conversations, @expensivecare.bsky.social and I explore why it’s risky and how to make it safer.
#Paramedicine #PreHospitalCare #EmergencyMedicine #Sedation #EMS
Sedation safety for acute behavioural disturbance
Clinical Conversations · Episode
open.spotify.com
March 18, 2025 at 9:13 AM
It isn’t often that you need to provide a risky treatment before you’ve even assessed the patient, but that’s what prehospital clinicians sometimes need to do when caring for patients with acute behavioural disturbance.
@jamesoz1.bsky.social & I talk sedation safety on Clinical Conversations.
@jamesoz1.bsky.social & I talk sedation safety on Clinical Conversations.
Reposted by David Anderson ASM
ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review
CCR Journal Watch
https://criticalcarereviews.com/latest-evidence/journal-watch
Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe
CCR Journal Watch
https://criticalcarereviews.com/latest-evidence/journal-watch
Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe
January 26, 2025 at 9:34 PM
ECG Patterns of Occlusion Myocardial Infarction: A Narrative Review
CCR Journal Watch
https://criticalcarereviews.com/latest-evidence/journal-watch
Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe
CCR Journal Watch
https://criticalcarereviews.com/latest-evidence/journal-watch
Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://criticalcarereviews.com/newsletters/subscribe
Reposted by David Anderson ASM
More medical inspired art: coronary arteries as subway map.
November 26, 2024 at 4:41 PM
More medical inspired art: coronary arteries as subway map.
So humbled and proud to have been awarded an Ambulance Service Medal is this year’s Australia Day honours list.
Thanks to those who nominated me and to the friends and colleagues I’ve worked with over the ups and downs of 25+ years in prehospital care ☺️.
🎖️🤓🚑
Thanks to those who nominated me and to the friends and colleagues I’ve worked with over the ups and downs of 25+ years in prehospital care ☺️.
🎖️🤓🚑
January 26, 2025 at 2:29 AM
So humbled and proud to have been awarded an Ambulance Service Medal is this year’s Australia Day honours list.
Thanks to those who nominated me and to the friends and colleagues I’ve worked with over the ups and downs of 25+ years in prehospital care ☺️.
🎖️🤓🚑
Thanks to those who nominated me and to the friends and colleagues I’ve worked with over the ups and downs of 25+ years in prehospital care ☺️.
🎖️🤓🚑
I’ve learned so much from @jamesoz1.bsky.social chatting all things pain with @billlord.bsky.social in this series, and we’ve saved the best for last.
An exacerbation of chronic pain is a common reason to call an ambulance. What can we do as paramedics and as an EMS system?
Let’s find out!
An exacerbation of chronic pain is a common reason to call an ambulance. What can we do as paramedics and as an EMS system?
Let’s find out!
🎙️ New Podcast Alert
The final episode in our pain management series with @expensivecare.bsky.social and @billlord.bsky.social is now live.
🔥 Topics:
Pain care performance measures 📊
Chronic pain challenges
Opioid myths & realities 💊
👉 Tune in: open.spotify.com/episode/5MMs...
The final episode in our pain management series with @expensivecare.bsky.social and @billlord.bsky.social is now live.
🔥 Topics:
Pain care performance measures 📊
Chronic pain challenges
Opioid myths & realities 💊
👉 Tune in: open.spotify.com/episode/5MMs...
Pain (Part 3) - Systems issues and special circumstances
Clinical Conversations · Episode
open.spotify.com
January 24, 2025 at 9:11 AM
I’ve learned so much from @jamesoz1.bsky.social chatting all things pain with @billlord.bsky.social in this series, and we’ve saved the best for last.
An exacerbation of chronic pain is a common reason to call an ambulance. What can we do as paramedics and as an EMS system?
Let’s find out!
An exacerbation of chronic pain is a common reason to call an ambulance. What can we do as paramedics and as an EMS system?
Let’s find out!
Reposted by David Anderson ASM
This article rings true everywhere. It might be more pressing in the UK, as other countries willingly accept their senior staff with better pay and/or work hours, but it's still a factor in rural areas of the US and Australia.
And certainly worth a read.
And certainly worth a read.
My latest @bmj.com on why an experienced workforce is necessary for safety and productivity www.bmj.com/content/387/...
“Rookie factor”: why healthcare workforce policy needs to embrace experience
What price experience? I have been working across several safety critical industries for years and in terms of the approaches that these industries take to workforce issues there are some stark differ...
www.bmj.com
January 4, 2025 at 10:35 PM
This article rings true everywhere. It might be more pressing in the UK, as other countries willingly accept their senior staff with better pay and/or work hours, but it's still a factor in rural areas of the US and Australia.
And certainly worth a read.
And certainly worth a read.
Reposted by David Anderson ASM
Word of the Day is one I keep posting at the end of the year, hoping its time will come.
‘Respair’, from the 16th century, is fresh hope, and a recovery from despair.
Here’s to a few drops of respair in 2025.
‘Respair’, from the 16th century, is fresh hope, and a recovery from despair.
Here’s to a few drops of respair in 2025.
December 31, 2024 at 7:12 PM
Word of the Day is one I keep posting at the end of the year, hoping its time will come.
‘Respair’, from the 16th century, is fresh hope, and a recovery from despair.
Here’s to a few drops of respair in 2025.
‘Respair’, from the 16th century, is fresh hope, and a recovery from despair.
Here’s to a few drops of respair in 2025.
Morphine or fentanyl? Does splinting really reduce pain? Is ketamine the ideal prehospital analgesic? Is there a role for paramedic administered NSAIDs? What about nerve blocks?
Find out the answer to these and more on part 2 of James’ interview with Bill Lord.
🚑💊🤕
Find out the answer to these and more on part 2 of James’ interview with Bill Lord.
🚑💊🤕
Pain relief is important, so what can we actually do to help? In Part 2 of my conversation with @billlord.bsky.social and
@expensivecare.bsky.social, we look at best practice in the care of people with pain.
@expensivecare.bsky.social, we look at best practice in the care of people with pain.
Pain (Part 2) - Management
Clinical Conversations · Episode
open.spotify.com
December 18, 2024 at 6:26 AM
Morphine or fentanyl? Does splinting really reduce pain? Is ketamine the ideal prehospital analgesic? Is there a role for paramedic administered NSAIDs? What about nerve blocks?
Find out the answer to these and more on part 2 of James’ interview with Bill Lord.
🚑💊🤕
Find out the answer to these and more on part 2 of James’ interview with Bill Lord.
🚑💊🤕
Wonderful feedback on our new book. 🤓
The perfect gift for the discerning paramedic in your life! 😃
The perfect gift for the discerning paramedic in your life! 😃
Critical Care Paramedicine "creates an immersive experience" by placing you in the centre of the action. Whether you're studying, a working paramedic or an aspiring #criticalcareparamedic, this book will deepen your understanding and knowledge.🚑
bit.ly/CriticalCare... @expensivecare.bsky.social
bit.ly/CriticalCare... @expensivecare.bsky.social
December 13, 2024 at 10:29 PM
Wonderful feedback on our new book. 🤓
The perfect gift for the discerning paramedic in your life! 😃
The perfect gift for the discerning paramedic in your life! 😃
Reposted by David Anderson ASM
Presented at #CCRDownUnder:
In the SAHARA trial involving patients with subarachnoid hemorrhage and anemia, liberal transfusion of red cells did not result in a lower risk of an unfavorable neurologic outcome than a more restrictive strategy. nej.md/4ilTVdO
In the SAHARA trial involving patients with subarachnoid hemorrhage and anemia, liberal transfusion of red cells did not result in a lower risk of an unfavorable neurologic outcome than a more restrictive strategy. nej.md/4ilTVdO
December 10, 2024 at 12:39 PM
Presented at #CCRDownUnder:
In the SAHARA trial involving patients with subarachnoid hemorrhage and anemia, liberal transfusion of red cells did not result in a lower risk of an unfavorable neurologic outcome than a more restrictive strategy. nej.md/4ilTVdO
In the SAHARA trial involving patients with subarachnoid hemorrhage and anemia, liberal transfusion of red cells did not result in a lower risk of an unfavorable neurologic outcome than a more restrictive strategy. nej.md/4ilTVdO
Reposted by David Anderson ASM
Early Restrictive vs Liberal Oxygen for Trauma Patients: The #TRAUMOX2 Randomized Clinical Trial | JAMA - Just published! #ccrdownunder jamanetwork.com/journals/jam...
Early Restrictive vs Liberal Oxygen for Trauma Patients
This randomized controlled trial investigates whether an early 8-hour restrictive oxygen strategy compared with a liberal oxygen strategy lowers the incidence of death and/or major respiratory complic...
jamanetwork.com
December 10, 2024 at 10:23 PM
Early Restrictive vs Liberal Oxygen for Trauma Patients: The #TRAUMOX2 Randomized Clinical Trial | JAMA - Just published! #ccrdownunder jamanetwork.com/journals/jam...
Reposted by David Anderson ASM
We have seen a number of trials with non-significant findings at #CCRdownunder. There is often debate then about what next? This paper by Pocock & Stone is a useful discussion piece to inform this type of discussion
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
The Primary Outcome Fails — What Next? | NEJM
When the primary outcome of a clinical trial fails to reach its prespecified end point, can any clinically meaningful information still be derived from it? This review article addresses that question.
www.nejm.org
December 10, 2024 at 11:20 PM
We have seen a number of trials with non-significant findings at #CCRdownunder. There is often debate then about what next? This paper by Pocock & Stone is a useful discussion piece to inform this type of discussion
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
Reposted by David Anderson ASM
Published in JAMA with #CCRdownunder:
In critically ill adults with suspected sepsis, antibiotic regimens were safely reduced when guided by measurement of procalcitonin but not by C-reactive protein. @criticalcarereviews.com
ja.ma/3BovM5v
In critically ill adults with suspected sepsis, antibiotic regimens were safely reduced when guided by measurement of procalcitonin but not by C-reactive protein. @criticalcarereviews.com
ja.ma/3BovM5v
December 9, 2024 at 10:20 PM
Published in JAMA with #CCRdownunder:
In critically ill adults with suspected sepsis, antibiotic regimens were safely reduced when guided by measurement of procalcitonin but not by C-reactive protein. @criticalcarereviews.com
ja.ma/3BovM5v
In critically ill adults with suspected sepsis, antibiotic regimens were safely reduced when guided by measurement of procalcitonin but not by C-reactive protein. @criticalcarereviews.com
ja.ma/3BovM5v
Reposted by David Anderson ASM
ADAPT-SEPSIS: “Care guided by measurement of PCT reduces antibiotic duration safely compared with standard care, but CRP does not. All-cause mortality for CRP was inconclusive.” #ccrdownunder
December 9, 2024 at 10:22 PM
ADAPT-SEPSIS: “Care guided by measurement of PCT reduces antibiotic duration safely compared with standard care, but CRP does not. All-cause mortality for CRP was inconclusive.” #ccrdownunder
Reposted by David Anderson ASM
Today it’s Lung #POCUSf="/hashtag/POCUS" class="hover:underline text-blue-600 dark:text-sky-400 no-card-link">#POCUS for you!
It is:
Easy to perform
Accurate
Sensitive
Repeatable
Negates irradiation or transport elsewhere!
#FOAMed #POCUS #FOAMcc #foamus @icmteaching @ICUltrasonica
Where do we scan then?? Linear/curvilinear or phased probe positions shown👍👇
It is:
Easy to perform
Accurate
Sensitive
Repeatable
Negates irradiation or transport elsewhere!
#FOAMed #POCUS #FOAMcc #foamus @icmteaching @ICUltrasonica
Where do we scan then?? Linear/curvilinear or phased probe positions shown👍👇
November 18, 2024 at 11:49 PM
Today it’s Lung #POCUSf="/hashtag/POCUS" class="hover:underline text-blue-600 dark:text-sky-400 no-card-link">#POCUS for you!
It is:
Easy to perform
Accurate
Sensitive
Repeatable
Negates irradiation or transport elsewhere!
#FOAMed #POCUS #FOAMcc #foamus @icmteaching @ICUltrasonica
Where do we scan then?? Linear/curvilinear or phased probe positions shown👍👇
It is:
Easy to perform
Accurate
Sensitive
Repeatable
Negates irradiation or transport elsewhere!
#FOAMed #POCUS #FOAMcc #foamus @icmteaching @ICUltrasonica
Where do we scan then?? Linear/curvilinear or phased probe positions shown👍👇
Reposted by David Anderson ASM
During #WW1, Marie Curie created a vehicle that contained a hospital bed, generator, X-ray machine & photographic darkroom equipment. These “petite Curies" (below) could be driven right up to the Front. Curie trained 150 women as radiology technicians. #histmed #skystorians #histsci
December 2, 2024 at 11:31 PM
During #WW1, Marie Curie created a vehicle that contained a hospital bed, generator, X-ray machine & photographic darkroom equipment. These “petite Curies" (below) could be driven right up to the Front. Curie trained 150 women as radiology technicians. #histmed #skystorians #histsci
Reposted by David Anderson ASM
I almost didn’t write this blog in *2015* about how contrast nephropathy isn’t real, because I thought it was already pretty obvious at that point (https://emcrit.org/pulmcrit/do-ct-scans-cause-contrast-nephropathy/)
nearly a decade later, we’re still struggling with knowledge translation 🙈
nearly a decade later, we’re still struggling with knowledge translation 🙈
'Conclusion
Based upon the available literature, the use of IV contrast for CT imaging does not appear to be associated with an increased risk of #AKI' acute kidney injury, IV contrast dye for imaging probably dsnt harm kidneys. #angiogram
#emimcc #cardiosky
www.jem-journal.com/article/S073...
Based upon the available literature, the use of IV contrast for CT imaging does not appear to be associated with an increased risk of #AKI' acute kidney injury, IV contrast dye for imaging probably dsnt harm kidneys. #angiogram
#emimcc #cardiosky
www.jem-journal.com/article/S073...
Is Intravenous Contrast Associated with Increased Risk of Acute Kidney Injury?
Computed tomography (CT) is a common imaging modality used in the Emergency Department.
Intravenous (IV) contrast can assist with visualization of pathology, particularly
for inflammatory conditions a...
www.jem-journal.com
December 2, 2024 at 11:49 PM
I almost didn’t write this blog in *2015* about how contrast nephropathy isn’t real, because I thought it was already pretty obvious at that point (https://emcrit.org/pulmcrit/do-ct-scans-cause-contrast-nephropathy/)
nearly a decade later, we’re still struggling with knowledge translation 🙈
nearly a decade later, we’re still struggling with knowledge translation 🙈
Reposted by David Anderson ASM
this is so brutal it hurts, but it’s true 😳
December 1, 2024 at 2:51 AM
this is so brutal it hurts, but it’s true 😳
So sad that I wasn’t able to be there for the official celebration of our new critical care paramedicine book. I was looking forward to my biscuit 😋.
Great to finally see it on the shelves though!
Great to finally see it on the shelves though!
Kate and Josie are excited to be attending the Air Ambulance UK National Conference today. They'll be holding a book celebration for our newly published title Critical Care Paramedicine, so make sure to say hi and grab one of our yummy biscuits!
November 30, 2024 at 9:53 PM
So sad that I wasn’t able to be there for the official celebration of our new critical care paramedicine book. I was looking forward to my biscuit 😋.
Great to finally see it on the shelves though!
Great to finally see it on the shelves though!
Reposted by David Anderson ASM
A liberal transfusion strategy compared with a restrictive strategy resulted in a lower rate of unfavorable neurological outcome among patients with acute brain injury.
ja.ma/3V5z1p9
ja.ma/3V5z1p9
November 25, 2024 at 2:26 AM
A liberal transfusion strategy compared with a restrictive strategy resulted in a lower rate of unfavorable neurological outcome among patients with acute brain injury.
ja.ma/3V5z1p9
ja.ma/3V5z1p9
Reposted by David Anderson ASM
Lot's of answers approximating what I think is best:
1. Are you in the Vortex? (can you ventilate?)
2. Have you ever been in the Green Zone (able to ventilate). If so, try to go back and do that.
3. Have you had a best effort at any lifeline? (define what can be abandoned/what's left to try).
1. Are you in the Vortex? (can you ventilate?)
2. Have you ever been in the Green Zone (able to ventilate). If so, try to go back and do that.
3. Have you had a best effort at any lifeline? (define what can be abandoned/what's left to try).
Was discussing this yesterday while teaching #VortexApproach. We ask participants to consider the 1st 3 questions they should ask when arriving at something they recognise as an airway crisis. Thoughts?
(specific qtns to get oriented to the airway issue beyond “who’s in charge”, etc)
(specific qtns to get oriented to the airway issue beyond “who’s in charge”, etc)
What is a common thread in medical tragedies?
Rescuers fail to cut through the ‘mind lock’; they follow the primary caregiver down the wrong, fatal, path.
If we are going to train our way out of this problem, we need to train the rescuers.
#AnSky #HFESky #MedSky
https://buff.ly/3COBTjM
Rescuers fail to cut through the ‘mind lock’; they follow the primary caregiver down the wrong, fatal, path.
If we are going to train our way out of this problem, we need to train the rescuers.
#AnSky #HFESky #MedSky
https://buff.ly/3COBTjM
November 23, 2024 at 8:07 AM
Lot's of answers approximating what I think is best:
1. Are you in the Vortex? (can you ventilate?)
2. Have you ever been in the Green Zone (able to ventilate). If so, try to go back and do that.
3. Have you had a best effort at any lifeline? (define what can be abandoned/what's left to try).
1. Are you in the Vortex? (can you ventilate?)
2. Have you ever been in the Green Zone (able to ventilate). If so, try to go back and do that.
3. Have you had a best effort at any lifeline? (define what can be abandoned/what's left to try).
Reposted by David Anderson ASM
November 22, 2024 at 3:53 PM
I used to post visitors to my garden to the other place. Here’s my first Bluesky garden friend. I think a juvenile male Australian king parrot. Very friendly 🤓🦜
November 23, 2024 at 8:02 AM
I used to post visitors to my garden to the other place. Here’s my first Bluesky garden friend. I think a juvenile male Australian king parrot. Very friendly 🤓🦜
Reposted by David Anderson ASM
Being a 'good rescuer' is:
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM
November 22, 2024 at 12:10 PM
Being a 'good rescuer' is:
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM
• counterintuitive eg the advice to stand back & analyse rather than pile in & do something
• counter-cultural eg using checklists rather than relying on memory
Specific rescuer training would reinforce these skills.
#AnSky #MedSky #HFESky
https://buff.ly/3COBTjM