Boring basics beat the brave

The biggest problem with studying for this damn quiz (apart from wasting time blogging of course) is that there are now SO MANY fantastic resources out there. This has several problems – the interesting stuff does not necessarily nail you the marks, and being TOO up to date in cutting edge ED stuff may actually piss the examiners off. I had a mock question marked the other day and got into strife in the marking because one of my points about the use of NIV with a sedating/dissociating dose of ketamine for pre-oxygenating respiratory failure patients (i.e. Scott Weingart’s DSI concept) was considered to be too risky to put in an exam answer because it is not “accepted practice.” That may be so, but I have now used this approach several times with some considerable success, and it definitely alleviates the palpable fear that comes with intubating that agitated, hypoxic, peri-arrest, respiratory failure patient. Plus, it is in the literature, AND it stands up to theoretical scrutiny! The evidence may never come in anything other than case series, but the concept has definitely changed my practice.

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About dreapadoir

Emergency Physician, author of http://underneathEM.com Emergency Medicine blog, photographer at http://www.dreapadoir.com
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2 Responses to Boring basics beat the brave

  1. patrick says:

    Absolutely Domhnall, Absolutely – I would have put the same down myself 😉

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