Staff Publication

Mastering Arterial Blood Gases in Emergency Medicine: A practical Guide (2025)

Posted on by

Type of publication:

Book

Author(s):

*Nwaneri, Chukwuemeka

Abstract:

Navigate Critical Decisions with Confidence
In the high-stakes environment of the emergency department, rapid, accurate diagnosis is paramount. The Arterial Blood Gas (ABG) is an indispensable diagnostic tool, yet its complex interpretation often leaves clinicians feeling overwhelmed.
"Mastering Arterial Blood Gases in Emergency Medicine: A Practical Guide" is your definitive resource for transforming intimidating numbers into clear, actionable insights at the bedside.
Authored by an experienced emergency clinician, this book is specifically designed to equip emergency physicians, clinicians, residents, advanced practice providers, and critical care nurses with the unwavering confidence to interpret ABGs accurately and efficiently.

What You'll Discover Inside:
* The Unrivalled 6-Step Systematic Algorithm: Learn a proven, step-by-step approach to ABG interpretation that simplifies complex analysis, ensuring consistent and reliable results even under pressure.
* Practical, ED-Focused Scenarios: Bridge the gap between theory and practice with dedicated chapters on common emergency presentations, including:
* Respiratory Emergencies: COPD exacerbations, acute asthma, pneumonia, ARDS, PE, opioid overdose, and neuromuscular weakness.
* Metabolic Mayhem: Diabetic Ketoacidosis (DKA), lactic acidosis, renal failure, salicylate poisoning, toxic alcohol ingestions, severe diarrhea, and electrolyte imbalances from vomiting or diuretics.
* Other Critical Conditions: Cardiac arrest, severe trauma (hemorrhagic shock), carbon monoxide and cyanide poisoning, and early sepsis.
* Demystifying Complex Concepts: Gain clarity on the Anion Gap, Delta-Delta Gap, and the nuances of mixed acid-base disorders, transforming potential pitfalls into diagnostic triumphs.
* Oxygenation & Ventilation Mastery: Understand the critical relationship between PaO2, SaO2, and the A-a gradient to precisely assess and manage your patient's oxygenation status.
* Beyond the Numbers: Learn to integrate ABG results seamlessly with the full clinical picture, treating the patient, not just the ABG. Explore the limitations of ABGs and the strategic use of Venous Blood Gases (VBGs).
* The Future of Diagnostics: Peer into the exciting advancements in Point-of-Care (POC) testing, non-invasive monitoring, and the transformative potential of AI in ABG interpretation.
Whether you're a seasoned practitioner seeking to refine your skills or a new clinician building foundational knowledge, this practical guide cuts through the complexity, empowering you to make faster, more informed decisions that directly impact patient outcomes.
Master the ABG. Master the Emergency.

ISBN: 979-8293926329

Clinical and Functional Outcomes Following Intra-articular Platelet-Rich Plasma Injection for Knee Osteoarthritis: A Prospective Cohort Study (2025)

Posted on by

Type of publication:

Journal article

Author(s):

*Murugesan, Thivagar; Mohankumar, Mahesh; Guna Surya, Pedapati Ssk Vijaya.

Citation:

Cureus. 17(10):e95297, 2025 Oct.

Abstract:

Background and objective Knee osteoarthritis (OA), a common degenerative joint disease, often leads to chronic pain and disability, particularly in middle-aged individuals. With growing interest in regenerative therapies, platelet-rich plasma (PRP) has emerged as a potential biological treatment due to its anti-inflammatory and reparative properties. This study aimed to evaluate the clinical and functional outcomes following intra-articular PRP injections in patients with early-stage knee OA. Methodology A prospective clinical trial was conducted at a tertiary care center involving 113 patients diagnosed with Kellgren-Lawrence grade 1 or 2 knee osteoarthritis. Each participant received a single intra-articular PRP injection and was followed for 24 weeks. Pain and functional outcomes were assessed using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)-CRD at baseline, and at six, 12, and 24 weeks post-injection. Results At every follow-up, both VAS and WOMAC scores demonstrated significant reductions (p < 0.001). Patients with grade 1 OA showed greater improvement compared to those with grade 2 at all time points. While VAS scores decreased from 5.87 to 2.85, the
average WOMAC score fell from 32.81 at baseline to 24.89 after 24 weeks. Better results were strongly connected with younger age and lower radiographic grade. Conclusions Our results align with existing research supporting the effectiveness of PRP in managing early osteoarthritis. The treatment showed consistent symptom relief, particularly in younger patients and those with lower radiographic grades. Over a six-month period, intra-articular PRP injections offered significant pain reduction and functional improvement in early-stage knee OA, establishing it as a safe and effective therapy.

DOI: 10.7759/cureus.95297

Link to full-text [open access - no password required]

A Multicomponent Intervention to Improve Maternal Infection Outcomes (2025)

Posted on by

Type of publication:

Journal article

Author(s):

Lissauer, David; Gadama, Luis; Waitt, Catriona; Whyte, Sonia; Burnside, Girvan; Anilkumar, Aiswarya; Makuluni, Regina; Okwaro, Peace; Yang, Liu; Waitt, Peter; Musopole, Owen; Bilesi, Rosemary; Maseko, Bertha; Lwasa, Joel; Mugahi, Richard; Olaro, Charles; Lamorde, Mohammed; Makuta, Mirriam; Kachiwaya, Chimwemwe; Mkandawire, Tionge; Malunga, Adrian; Chitsulo, Nyadani; Abitimo, Prisca; Ayabo, Tabitha; Weeks, Andrew; Martin, James; Hemming, Karla; Gallos, Ioannis; Monk, Edward J M; Riches, Jennifer; Chapuma, Chikondi; Nanyondo S, Judith; Lorencatto, Fabiana; Monahan, Mark; Allegranzi, Benedetta; Dunlop, Catherine; Atkins, Lou; Rosala-Hallas, Anna; Roberts, Tracy; Gamble, Carrol; Malata, Address; Desmond, Nicola; Kommwa, Edward; Merriel, Abi; *Parry-Smith, William; Smith, Rebecca; Ndumu, Ivy; Williams, Eleanor; Faque, Bob; Banda, Gertrude; Nyondo-Mipando, Alinane L; Twimukye, Adelline; Chater, Tim; Diplas, Aristotelis; Brizuela, Vanessa; Souza, Joao Paulo; Rylance, Jamie; Cheshire, James; Hawker, Lydia; Coomarasamy, Arri; Bonet, Mercedes.

Citation:

New England Journal of Medicine.  2025 Nov 19.

Abstract:

BACKGROUND: Maternal infection and sepsis are major causes of maternal death and severe illness worldwide, particularly in low- and middle-income countries. Inconsistent implementation of evidence-based recommendations for infection prevention and management and delays in detection and treatment of maternal sepsis contribute to the number of preventable deaths.

METHODS: We conducted a cluster-randomized trial to assess a multicomponent intervention, the Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) program. This program was designed to support health care providers in achieving three goals: adherence to World Health Organization (WHO) hand-hygiene standards; adoption of evidence-based practices for maternal infection prevention and management; and early detection of sepsis and use of the FAST-M (fluids, antibiotics, source control, transfer if required, and monitoring) treatment bundle. Usual care was provided in the control group, along with dissemination of guidelines. The primary outcome was a composite of infection-related maternal death, infection-related near-miss event (events in which women survived a life-threatening complication), or severe infection-related illness (deep surgical-site, deep perineal, or body-cavity infection) among women who were pregnant or had recently been pregnant.

RESULTS: We randomly assigned 59 health facilities (where 431,394 women gave birth during the trial) in Malawi and Uganda to the intervention group (30 clusters) or the usual-care group (29 clusters). A primary-outcome event occurred in 1.4% of the patients in the intervention group and in 1.9% of those in the usual-care group (risk ratio, 0.68; 95% confidence interval, 0.55 to 0.83; P<0.001). This effect was generally consistent between countries and among facilities of difference sizes and was sustained over time.

CONCLUSIONS: Implementation of the APT-Sepsis program led to a significantly lower risk of a composite of infection-related maternal death, infection-related near-miss event, or severe infection-related illness than usual care. (Funded by the Joint Global Health Trials scheme and others; APT-Sepsis ISRCTN number, ISRCTN42347014.).

DOI: 10.1056/nejmoa2512698

Systemic Arterial Air Embolism Following Computed Tomography (CT)-Guided Percutaneous Lung Biopsy: Case Series and review of underlying risk factors, treatment and preventive strategies (2025)

Posted on by

Type of publication:

Journal article

Author(s):

*Adamu, Maimuna; *Skillicorn, Chris; *Stone, Timothy; Moudgil, Harmesh; *Abayaratne, Chulangani.

Citation:

Clinical Medicine. 100530, 2025 Nov 17.

Abstract:

BACKGROUND: Systemic arterial air embolism is an uncommon but potentially fatal complication of CT-guided transthoracic lung biopsy. Although rare, it carries significant morbidity due to cerebral and coronary ischemia.

CASE PRESENTATION: We report two cases of systemic arterial air embolism occurring during CT-guided percutaneous lung biopsies. Both patients developed acute neurological deficits immediately following the procedure, attributed to cerebral air embolism. Imaging confirmed the presence of intracranial air in subarachnoid spaces. Neurological symptoms improved with supportive management, including oxygen administration and positioning. Histopathology in both cases revealed pulmonary adenocarcinoma.

CONCLUSION: These cases highlight the importance of prompt recognition and appropriate management of systemic air embolism. Risk mitigation strategies include careful patient positioning, minimization of intrapulmonary pressure gradients, and maintenance of needle occlusion. Although rare, this complication must be anticipated by interventionalists and managed promptly to avoid permanent neurological damage.

DOI:

Link to full-text [no password required]

Quality improvement programme for 2 week wait Gynaecology suspected cancer referrals (2025)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Claire Carr

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

To improve the triage system for patients on the faster diagnosis pathway for suspected gynaecological cancers by 1st October 2025 as evidenced by more people being seen within the 28 days target.

Link to PDF poster

Bridging the Confidence Gap: A Quality Improvement Initiative for Surgical Training in Resident Doctors (2025)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Lauren Morris, *Rosie Wilson

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

To address limitations and gaps in learning to formally enhance basic surgical skills teaching for resident doctors at SaTH by the 31st October 2025 as evidence by training feedback.

Link to PDF poster

Optimising Temperature Monitoring in HOT Gallbladder Theatre (Anaesthetics QIP) (2025)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Krishna Iyer *Eric Perkin

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

To improve 30-minute temperature monitoring compliance during HOT Gallbladder lists and ensure consistent, guideline-based documentation by the 31st October 2025

Link to PDF poster

Improving Documentation on Paediatric Inpatient Drug Charts (2025)

Posted on by

Type of publication:

Service improvement case study

Author(s):

*Dima Abdelhafiz, *Caitlyn Randles

Citation:

SaTH Improvement Hub, November 2025

SMART Aim:

I will improve the accuracy and completeness of weight documentation on paediatric drug cards by 30/09/25 as evidenced by a two cycle quality improvement project which shows an improvement in clear and accurate weight documentation on paediatric drug charts.

Link to PDF poster