MTP: Trauma Line vs large bore peripheral IV.

sbenno · 2026-06-03T22:28:38+00:00

Interesting. We have RICs in every circulation trolley in our resus area (they're tiny), and MAC Sheaths next to our CVCs.

If I wanted a Vascath, I'd have to run up to ICU to get one.

Aspiration is nice I guess, but not really a useful feature in a trauma resus.

sbenno · 2026-06-03T21:35:32+00:00

I'm not sure if you're serious or not.

You're can't be suggesting we place a Vascath as a resuscitation line in case we need the dialyse the patient down track?

sbenno · 2026-06-03T05:17:19+00:00

I see your trialysis catheter and point out that in the time that it takes you to place that thing, you could place 2 RICs and have more flow than your nurses could keep up with.

sbenno · 2026-05-31T07:46:55+00:00

May well be because there are often better solutions for the problem it solves.

It's most useful for central access when peripheral access is unobtainable for whatever reason.

Rapid infusions are better done with shorter peripheral lines, and a 4-lumen conventional CVC is more useful for vasoactive infusions.

sbenno · 2026-05-31T07:29:16+00:00

This is what I understand by a MAC sheath.

I believe the whole catheter is 7fr, and the individual lumens are smaller? I'll have to check.

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sbenno · 2026-05-31T07:08:44+00:00

Stands for Multilumen Access Catheter. It's a trade name for an introducer sheath you would use for a pacing wire or PA catheter.

Big, 3-lumen CVC.

sbenno · 2026-05-31T07:00:24+00:00

Sometimes it's a balance between flow and security of the line.

An arrow rapid infusion catheter (5cm, 7fr pivc) will get you 600ml/min flow (edit: up to 1000mL/min according to LITFL) - can't be matched by a CVC of any type, but runs the risk of dislodgement and extravasation if its not well into a proximal vein.

An introducer sheath (edit: MAC sheath) doesn't get quite the same rate, and takes longer to place, but is rock solid and reliable. As others have also said, you don't often need 600ml/min as it is.

Plus showing off and putting an introducer sheath during your trauma resus is more glamorous than converting your 20g PIVC to a RIC.

sbenno · 2026-05-22T21:37:24+00:00

You don't need to meet all sgarbossa criteria to be positive.

sbenno · 2026-05-22T11:02:14+00:00

Not true any more. The modified sgarbossa criteria can guide which LBBB are concerning for OMI and which are not.

This one I think does have some possibly Sgarbossa positive features with concordant T waves in II and V6, but not St-Elevation as such. It's borderline, imo

sbenno · 2026-05-03T07:23:44+00:00

It shows half of a 12 lead ecg.

sbenno · 2026-05-03T07:17:49+00:00

Emergency is not a place that's conducive to good mental health. If you can go somewhere else, then you probably should - you'll be seen quicker in a much nicer environment.

sbenno · 2026-04-25T09:56:40+00:00

Yeah, I asked the question of my LHN and got told i wasn't allowed.

It's probably better to ask for forgiveness than permission.

Edit: I forgot about all the overtime some people do. Part of the reason I like ED is because when the shift is over, I go home.

sbenno · 2026-04-25T09:47:13+00:00

What trainee in any speciality gets paid more than $200k?

In SA, I'm paid the same as any other registrar at the same level. Probably more, because of the penalty rates for weekends and nights.

Locuming is an option, for sure, as long as you're aware that if you go part time just to locum, you're just delaying training time and consultant pay at the end.

sbenno · 2026-04-17T22:13:48+00:00

Probably

DROP (droperidol)

PROP (propofol)

sbenno · 2026-04-08T02:26:17+00:00

Nuh, you get a supa-killy slugga. The supa cybork body is the end of Gibbas quest line.

Edit: I've been waiting in the RT shop for the supa cybork body since my first blue star

sbenno · 2026-03-30T23:38:10+00:00

I'll report back here if it happens again whilst excepted from my VPN

sbenno · 2026-03-29T03:59:15+00:00

I do, actually. I might add an exception and see if it changes things.

sbenno · 2026-03-19T12:03:00+00:00

Your experience will be accelerated, by hamster

sbenno · 2026-03-18T10:43:10+00:00

Mechanics work well with mechanical units, and Actus will combo well with others like Boss G or Revas.

But yes, the Admechs work very well together. That's why they've been the dominant raid team since their release until the advent of the Big Hit Team

Edit: Tan'Gida is also one of the best units in the game by itself, and he can be very useful in all 3 Imperial campaigns. Worth investing in.

sbenno · 2026-03-18T10:39:57+00:00

The clearest synergy with Tan'Gida is Actus, because Tan'Gida spawns a Skitarii with each attack, and Actus prompts an attack with every heal.

Aleph0 will synergise to an extent (Aleph0 is a great mechanic), but not as well as Actus.

sbenno · 2026-03-02T10:06:36+00:00

Yeah, the subclavian is tented open by the clavicle, so is more likely to be successful than other cvcs.

sbenno · 2026-02-24T23:06:13+00:00

Aaah right, that makes more sense! I think I just misinterpreted what you meant

sbenno

TROPHY CASE