Cliff Reid | The University of Sydney (original) (raw)
Papers by Cliff Reid
Bmj British Medical Journal, Jun 20, 1998
Archives of Disease in Childhood
A short cut review was carried out to establish whether the addition of oral corticosteroids to a... more A short cut review was carried out to establish whether the addition of oral corticosteroids to antihistamines leads to a more rapid resolution of urticaria. Thirty nine papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
Emergency Medicine Journal
A short cut review was carried out to establish whether the addition of oral corticosteroids to a... more A short cut review was carried out to establish whether the addition of oral corticosteroids to antihistamines leads to a more rapid resolution of urticaria. Thirty nine papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
Emergency Medicine Australasia, 2015
In critical care medicine, US views of the inferior vena cava (IVC) and its change with respirati... more In critical care medicine, US views of the inferior vena cava (IVC) and its change with respiration are used to estimate the intravascular volume status of unwell patients and, in particular, to answer the question: 'Is this patient likely to be fluid responsive?' Most commonly in the literature, the subxiphisternal (SX) window in the longitudinal plane is utilised. To date, no study has specifically assessed interrater agreement in estimating IVC diameter between emergency medicine specialists (experts) and trainees (learners). To determine the interrater agreement between an expert (senior emergency specialist with US qualifications) and learner (emergency medicine trainee) when measuring IVC diameter (IVCD) and IVC collapsibility index (IVCCI) in the SX longitudinal US window in healthy volunteers. Healthy volunteers (ED staff) were scanned in the supine position using a sector (cardiac) probe of a portable US machine, in the SX longitudinal position. The maximum and minimum diameters of the IVC were measured in each of these positions and the IVCCI calculated. Results were analysed using Bland-Altman plots. In the longitudinal SX window, the operators' measurements of maximum IVCD differed by an average of 1.9 mm (95% limits of agreement -9.4 mm to +5.5 mm) and their measurement of IVCCI differed by an average of 4% (95% limits of agreement -30% to 38%). The wide 95% limits of agreement demonstrate a poor interrater agreement between the IVC US measurements obtained by expert and learner users in the assessment of fluid status. These ranges are greater than clinically acceptable.
Anaesthesia and intensive care, 2012
Resuscitation, 2002
Pacing is a well recognised treatment in asystolic arrest with residual p wave activity. This can... more Pacing is a well recognised treatment in asystolic arrest with residual p wave activity. This can be achieved by transvenous, transthoracic, or manual external (cardiac percussion) pacing techniques. We report a case of ventricular asystole in which all three pacing modalities were applied, and demonstrate their relative effectiveness with invasive haemodynamic monitoring data. Stroke volumes were comparable with all three methods. Manual external pacing is an effective holding measure when cardiac output is compromised due to bradycardia or asystole with residual p wave activity before more definitive pacing techniques are instituted.
Annals of Emergency Medicine, 2014
Prehospital Emergency Care, 2011
Objective. This article reviews the logistics and safety of extracorporeal membrane oxygenation (... more Objective. This article reviews the logistics and safety of extracorporeal membrane oxygenation (ECMO) medical retrieval in New South Wales, Australia. Methods. We describe the logistics involved in ECMO road and rotary-wing retrieval by a multidisciplinary team during the H1N1 influenza epidemic in winter 2009 (i.e., June 1 to August 31, 2009). Basic patient demographics and key retrieval time lines were analyzed. Results. There were 17 patients retrieved on ECMO, with their ages ranging from 22 to 55 years. The median weight was 110 kg. Four critical events were recorded during retrieval, with no adverse outcomes. The retrieval distance varied from 20.8 to 430 km. There were delays in times from retrieval booking to both retrieval tasking and retrieval team departure in 88% of retrievals. The most common reasons cited were "patient not ready," 23.5% (4/17); "vehicle not available," 23.5% (4/17); and "complex retrieval," 41.2% (7/17). The median time (hours:minutes) from booking with the medical retrieval unit (MRU) to tasking was 4:35 (interquartile range [IQR] 3:27-6:15). The median time lag from tasking to departure was 1:00 (IQR 00:10-2:20). The median stabilization time was 1:30 (IQR 1:20-1:55). The median retrieval duration was 7:35 (IQR 5:50-10:15). Conclusion. The process of development of ECMO retrieval was enabled by the preexistence of a high-volume experienced medical retrieval service. Although ECMO retrieval is not a new concept, we describe an entire process for ECMO retrieval that we believe will benefit other retrieval service providers. The increased workload of ECMO retrieval during the swine flu pandemic has led to refinement in the system and process for the future.
Injury, 2011
Re: Engel DC, Mikocka-Walus A, Cameron PA, Maegele M. "Pre-hospital and in-hospital paramete... more Re: Engel DC, Mikocka-Walus A, Cameron PA, Maegele M. "Pre-hospital and in-hospital parameters and outcomes in patients with traumatic brain injury: A comparison between German and Australian trauma registries" [Injury 2010;41(9):901-6]. ... Burns B, Reid C, Habig K, Pearce A, ...
European Journal of Emergency Medicine, 2011
... Resuscitation issues in pregnancy: a comprehensive study guide. Emergency medicine. 20046th e... more ... Resuscitation issues in pregnancy: a comprehensive study guide. Emergency medicine. 20046th ed Columbus, USA McGraw-Hill:9499. Cited Here... 4. Scott JR, Porter TFGibbs RS, Karlan BY, Haney AF, Nygaard I. Caesarean delivery. Danforth's obstetrics and gynaecology. ...
European Journal of Emergency Medicine, 2013
The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in th... more The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in the haemodynamically unstable patient and serve as a bridge to treatment options such as coronary artery bypass grafting and cardiac transplantation. Transfer of IABP-dependent patients for upgrade of clinical care is increasingly common and safe. In Australia, percutaneous coronary intervention centres can be located outside cardiothoracic surgical centres. This study reviews IABP medical retrieval by a doctor/paramedic team after implementation of a standardized protocol. This was a retrospective case series review, using descriptive statistics. Greater Sydney Area Helicopter Emergency Service carried out 22 cases from 1 May 2007 to 31 December 2009. Median age was 62 years [interquartile range (IQR) 51-83], 67% were male. In all, 63% of patients were retrieved on inotropic support, 29% overall received invasive ventilation. Highest frequency indications were myocardial infarction, cardiogenic shock and bridge to coronary artery bypass grafts. There were complications during 18% of all retrievals and no adverse outcomes. Of the patients, 67% (14/21) were retrieved by road and 33% (7/21) by helicopter (longest distance 500 km). Median stabilization time by a retrieval team was 1 h 15 min (IQR 50 min to 3 h 30 min). Median mission time was 4 h 55 min (IQR 3 h 50 min to 8 h 54 min). Our system offers a safe method of IABP medical retrieval. The doctor and paramedic combination complements strengths in logistics and critical care. This serves as a guide to other systems looking to put in place a similar model of care.
European Journal of Emergency Medicine, 2013
Emergency Medicine Journal, 2013
Introduction Fresh frozen cadavers are effective training models for airway management. We hypoth... more Introduction Fresh frozen cadavers are effective training models for airway management. We hypothesised that residual carbon dioxide (CO 2 ) in cadaveric lung would be detectable using standard clinical monitoring systems, facilitating detection of tracheal tube placement and further enhancing the fidelity of clinical simulation using a cadaveric model. Methods The tracheas of two fresh frozen unembalmed cadavers were intubated via direct laryngoscopy. Each tracheal tube was connected to a self-inflating bag and a sidestream CO 2 detector. The capnograph display was observed and recorded in highdefinition video. The cadavers were hand-ventilated with room air until the capnometer reached zero or the waveform approached baseline. Results A clear capnographic waveform was produced in both cadavers on the first postintubation expiration, simulating the appearances found in the clinical setting. In cadaver one, a consistent capnographic waveform was produced lasting over 100 s. Maximal end-tidal CO 2 was 8.5 kPa (65 mm Hg). In cadaver two, a consistent capnographic waveform was produced lasting over 50 s. Maximal end-tidal CO 2 was 5.9 kPa (45 mm Hg). Conclusions We believe this to be the first work to describe and quantify detectable end-tidal capnography in human cadavers. We have demonstrated that tracheal intubation of fresh frozen cadavers can be confirmed by life-like waveform capnography. This requires further validation in a larger sample size.
Emergency Medicine Journal, 1999
Accident and emergency medicine or emergency medicine? EDITOR,-AS trainees in emergency medicine,... more Accident and emergency medicine or emergency medicine? EDITOR,-AS trainees in emergency medicine, we welcome Laurence Rocke's suggestion to re-open the debate on the name of our specialty.' We would support the dropping of the clumsy "accident and" prefix for the following reasons: it is a mouthful to say; it is redundant since most accidental injuries can be considered emergencies, if not by the physician then at least by the patient; and it carries with it historical connotations of being an orthopaedic subspecialty, reinforcing the attitudes that many other specialists unfortunately continue to hold towards us.
Emergency Medicine Journal, 2012
Background Every day throughout the UK, ambulance services seek medical assistance in providing c... more Background Every day throughout the UK, ambulance services seek medical assistance in providing critically ill or injured patients with pre-hospital care.
Emergency Medicine Journal, 2013
The Greater Sydney Area Helicopter Emergency Medical Service provides physicians for undertaking ... more The Greater Sydney Area Helicopter Emergency Medical Service provides physicians for undertaking prehospital and inter-hospital critical care. We quantified the obstetric caseload of our service with respect to primary diagnosis and interventions in order to provide targeted physician training. Retrieval records over a 4-year period were searched to identify keywords associated with pregnancy or obstetric complications. The data collected related to gestation, diagnosis, nature of transfer and interventions. Of 66 pregnant or postpartum cases, 38 were transported by road and 28 by air. 33 had obstetric-related conditions, and 33 had non-obstetric medical conditions. 61 patients required mechanical ventilation, 23 of whom were intubated by the retrieval physicians prior to transport. 33 patients required vasoactive circulatory support, and arterial and/or central venous access was established in 48 and 30 patients, respectively. The only obstetric interventions provided by retrieval physicians were intravenous tocolytic therapy (two cases) and one case of resuscitative hysterotomy (peri-mortem caesarean section). A half of all peri-partum patients in our critical care transport service are retrieved for non-obstetric diagnoses. Obstetric interventions by retrieval physicians are rare, but resuscitative hysterotomy may be required. Most interventions are general critical care procedures. Exhaustive training in obstetric emergencies may not reflect the learning needs of retrieval physicians in services such as ours. Educational resources should prioritise general critical care of the pregnant woman rather than specific obstetric procedures. We have used these findings to construct a targeted obstetric module as part of our retrieval physician training programme.
Bmj British Medical Journal, Jun 20, 1998
Archives of Disease in Childhood
A short cut review was carried out to establish whether the addition of oral corticosteroids to a... more A short cut review was carried out to establish whether the addition of oral corticosteroids to antihistamines leads to a more rapid resolution of urticaria. Thirty nine papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
Emergency Medicine Journal
A short cut review was carried out to establish whether the addition of oral corticosteroids to a... more A short cut review was carried out to establish whether the addition of oral corticosteroids to antihistamines leads to a more rapid resolution of urticaria. Thirty nine papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.
Emergency Medicine Australasia, 2015
In critical care medicine, US views of the inferior vena cava (IVC) and its change with respirati... more In critical care medicine, US views of the inferior vena cava (IVC) and its change with respiration are used to estimate the intravascular volume status of unwell patients and, in particular, to answer the question: 'Is this patient likely to be fluid responsive?' Most commonly in the literature, the subxiphisternal (SX) window in the longitudinal plane is utilised. To date, no study has specifically assessed interrater agreement in estimating IVC diameter between emergency medicine specialists (experts) and trainees (learners). To determine the interrater agreement between an expert (senior emergency specialist with US qualifications) and learner (emergency medicine trainee) when measuring IVC diameter (IVCD) and IVC collapsibility index (IVCCI) in the SX longitudinal US window in healthy volunteers. Healthy volunteers (ED staff) were scanned in the supine position using a sector (cardiac) probe of a portable US machine, in the SX longitudinal position. The maximum and minimum diameters of the IVC were measured in each of these positions and the IVCCI calculated. Results were analysed using Bland-Altman plots. In the longitudinal SX window, the operators' measurements of maximum IVCD differed by an average of 1.9 mm (95% limits of agreement -9.4 mm to +5.5 mm) and their measurement of IVCCI differed by an average of 4% (95% limits of agreement -30% to 38%). The wide 95% limits of agreement demonstrate a poor interrater agreement between the IVC US measurements obtained by expert and learner users in the assessment of fluid status. These ranges are greater than clinically acceptable.
Anaesthesia and intensive care, 2012
Resuscitation, 2002
Pacing is a well recognised treatment in asystolic arrest with residual p wave activity. This can... more Pacing is a well recognised treatment in asystolic arrest with residual p wave activity. This can be achieved by transvenous, transthoracic, or manual external (cardiac percussion) pacing techniques. We report a case of ventricular asystole in which all three pacing modalities were applied, and demonstrate their relative effectiveness with invasive haemodynamic monitoring data. Stroke volumes were comparable with all three methods. Manual external pacing is an effective holding measure when cardiac output is compromised due to bradycardia or asystole with residual p wave activity before more definitive pacing techniques are instituted.
Annals of Emergency Medicine, 2014
Prehospital Emergency Care, 2011
Objective. This article reviews the logistics and safety of extracorporeal membrane oxygenation (... more Objective. This article reviews the logistics and safety of extracorporeal membrane oxygenation (ECMO) medical retrieval in New South Wales, Australia. Methods. We describe the logistics involved in ECMO road and rotary-wing retrieval by a multidisciplinary team during the H1N1 influenza epidemic in winter 2009 (i.e., June 1 to August 31, 2009). Basic patient demographics and key retrieval time lines were analyzed. Results. There were 17 patients retrieved on ECMO, with their ages ranging from 22 to 55 years. The median weight was 110 kg. Four critical events were recorded during retrieval, with no adverse outcomes. The retrieval distance varied from 20.8 to 430 km. There were delays in times from retrieval booking to both retrieval tasking and retrieval team departure in 88% of retrievals. The most common reasons cited were "patient not ready," 23.5% (4/17); "vehicle not available," 23.5% (4/17); and "complex retrieval," 41.2% (7/17). The median time (hours:minutes) from booking with the medical retrieval unit (MRU) to tasking was 4:35 (interquartile range [IQR] 3:27-6:15). The median time lag from tasking to departure was 1:00 (IQR 00:10-2:20). The median stabilization time was 1:30 (IQR 1:20-1:55). The median retrieval duration was 7:35 (IQR 5:50-10:15). Conclusion. The process of development of ECMO retrieval was enabled by the preexistence of a high-volume experienced medical retrieval service. Although ECMO retrieval is not a new concept, we describe an entire process for ECMO retrieval that we believe will benefit other retrieval service providers. The increased workload of ECMO retrieval during the swine flu pandemic has led to refinement in the system and process for the future.
Injury, 2011
Re: Engel DC, Mikocka-Walus A, Cameron PA, Maegele M. "Pre-hospital and in-hospital paramete... more Re: Engel DC, Mikocka-Walus A, Cameron PA, Maegele M. "Pre-hospital and in-hospital parameters and outcomes in patients with traumatic brain injury: A comparison between German and Australian trauma registries" [Injury 2010;41(9):901-6]. ... Burns B, Reid C, Habig K, Pearce A, ...
European Journal of Emergency Medicine, 2011
... Resuscitation issues in pregnancy: a comprehensive study guide. Emergency medicine. 20046th e... more ... Resuscitation issues in pregnancy: a comprehensive study guide. Emergency medicine. 20046th ed Columbus, USA McGraw-Hill:9499. Cited Here... 4. Scott JR, Porter TFGibbs RS, Karlan BY, Haney AF, Nygaard I. Caesarean delivery. Danforth's obstetrics and gynaecology. ...
European Journal of Emergency Medicine, 2013
The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in th... more The intra-aortic balloon pump (IABP) was first introduced in 1968 to augment cardiac output in the haemodynamically unstable patient and serve as a bridge to treatment options such as coronary artery bypass grafting and cardiac transplantation. Transfer of IABP-dependent patients for upgrade of clinical care is increasingly common and safe. In Australia, percutaneous coronary intervention centres can be located outside cardiothoracic surgical centres. This study reviews IABP medical retrieval by a doctor/paramedic team after implementation of a standardized protocol. This was a retrospective case series review, using descriptive statistics. Greater Sydney Area Helicopter Emergency Service carried out 22 cases from 1 May 2007 to 31 December 2009. Median age was 62 years [interquartile range (IQR) 51-83], 67% were male. In all, 63% of patients were retrieved on inotropic support, 29% overall received invasive ventilation. Highest frequency indications were myocardial infarction, cardiogenic shock and bridge to coronary artery bypass grafts. There were complications during 18% of all retrievals and no adverse outcomes. Of the patients, 67% (14/21) were retrieved by road and 33% (7/21) by helicopter (longest distance 500 km). Median stabilization time by a retrieval team was 1 h 15 min (IQR 50 min to 3 h 30 min). Median mission time was 4 h 55 min (IQR 3 h 50 min to 8 h 54 min). Our system offers a safe method of IABP medical retrieval. The doctor and paramedic combination complements strengths in logistics and critical care. This serves as a guide to other systems looking to put in place a similar model of care.
European Journal of Emergency Medicine, 2013
Emergency Medicine Journal, 2013
Introduction Fresh frozen cadavers are effective training models for airway management. We hypoth... more Introduction Fresh frozen cadavers are effective training models for airway management. We hypothesised that residual carbon dioxide (CO 2 ) in cadaveric lung would be detectable using standard clinical monitoring systems, facilitating detection of tracheal tube placement and further enhancing the fidelity of clinical simulation using a cadaveric model. Methods The tracheas of two fresh frozen unembalmed cadavers were intubated via direct laryngoscopy. Each tracheal tube was connected to a self-inflating bag and a sidestream CO 2 detector. The capnograph display was observed and recorded in highdefinition video. The cadavers were hand-ventilated with room air until the capnometer reached zero or the waveform approached baseline. Results A clear capnographic waveform was produced in both cadavers on the first postintubation expiration, simulating the appearances found in the clinical setting. In cadaver one, a consistent capnographic waveform was produced lasting over 100 s. Maximal end-tidal CO 2 was 8.5 kPa (65 mm Hg). In cadaver two, a consistent capnographic waveform was produced lasting over 50 s. Maximal end-tidal CO 2 was 5.9 kPa (45 mm Hg). Conclusions We believe this to be the first work to describe and quantify detectable end-tidal capnography in human cadavers. We have demonstrated that tracheal intubation of fresh frozen cadavers can be confirmed by life-like waveform capnography. This requires further validation in a larger sample size.
Emergency Medicine Journal, 1999
Accident and emergency medicine or emergency medicine? EDITOR,-AS trainees in emergency medicine,... more Accident and emergency medicine or emergency medicine? EDITOR,-AS trainees in emergency medicine, we welcome Laurence Rocke's suggestion to re-open the debate on the name of our specialty.' We would support the dropping of the clumsy "accident and" prefix for the following reasons: it is a mouthful to say; it is redundant since most accidental injuries can be considered emergencies, if not by the physician then at least by the patient; and it carries with it historical connotations of being an orthopaedic subspecialty, reinforcing the attitudes that many other specialists unfortunately continue to hold towards us.
Emergency Medicine Journal, 2012
Background Every day throughout the UK, ambulance services seek medical assistance in providing c... more Background Every day throughout the UK, ambulance services seek medical assistance in providing critically ill or injured patients with pre-hospital care.
Emergency Medicine Journal, 2013
The Greater Sydney Area Helicopter Emergency Medical Service provides physicians for undertaking ... more The Greater Sydney Area Helicopter Emergency Medical Service provides physicians for undertaking prehospital and inter-hospital critical care. We quantified the obstetric caseload of our service with respect to primary diagnosis and interventions in order to provide targeted physician training. Retrieval records over a 4-year period were searched to identify keywords associated with pregnancy or obstetric complications. The data collected related to gestation, diagnosis, nature of transfer and interventions. Of 66 pregnant or postpartum cases, 38 were transported by road and 28 by air. 33 had obstetric-related conditions, and 33 had non-obstetric medical conditions. 61 patients required mechanical ventilation, 23 of whom were intubated by the retrieval physicians prior to transport. 33 patients required vasoactive circulatory support, and arterial and/or central venous access was established in 48 and 30 patients, respectively. The only obstetric interventions provided by retrieval physicians were intravenous tocolytic therapy (two cases) and one case of resuscitative hysterotomy (peri-mortem caesarean section). A half of all peri-partum patients in our critical care transport service are retrieved for non-obstetric diagnoses. Obstetric interventions by retrieval physicians are rare, but resuscitative hysterotomy may be required. Most interventions are general critical care procedures. Exhaustive training in obstetric emergencies may not reflect the learning needs of retrieval physicians in services such as ours. Educational resources should prioritise general critical care of the pregnant woman rather than specific obstetric procedures. We have used these findings to construct a targeted obstetric module as part of our retrieval physician training programme.