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Updated: 2017-07-23T23:02:00+00:00

 



LITFL Review 290

2017-07-23T23:02:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 290th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum […] LITFL Review 290Marjorie Lazoff, MDLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 290th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Portsmouth ICU just updated their free quality and safety materials with a ton of local protocols and checklists. Have a look! [SO]  The Best of #FOAMed Emergency Medicine Excellent review of recent literature on apneic oxygenation for intubation by our own Salim Rezaie on REBEL EM. [AS] The Best of #FOAMcc Critical Care I review a recent study on IVC collapsibility for fluid responsiveness for the Bottom Line this week. Opinions welcome!  [SO] The Alfred ICU held a recent Advanced mechanical ventilation conference. The tweets have been collated and “storified”. Thanks, Chris! [SO] A second Alfred ICU podcast is posted, this time on Training for Stress. [SO] Jonny Wilkinson reflects on Early Goal Directed Therapy. Does it really kill? [SO] The Best of #FOAMres Resuscitation John-Emile Kenny goes through the physiology of IVC collapse and explains why using a simplistic approach to IVC collapse is dangerous in the setting of complex physiology. [SR] More on IVC from Rory Spiegel as he reviews a recent paper looking at the accuracy of IVC collapsibility. [SO] The Best of #FOAMus Ultrasound While we all agree that POCUS is great for determining the presence of a PTX, there are false positives–as James Rippey discusses this week elsewhere on LITFL. [AS] The Best of #FOANed Nursing A clear and concise overview of post-operative delirium from rehabilitation Clinical Nurse Specialist, Sally Moyle. [JS] The Best of Medical Education and Social Media Simon Carley writes a very thought provoking blog post on whether educational supervisors should also have an annual review of competence, just as we do for trainees. [SR] News from the Fast Lane Check out what’s new amongst the 1,650+ pages of the Critical Care Compendium in CCC Update 014 [CN] Reference Sources and Reading List Emergency Medicine and Critical Care blog/podcast list LITFL Global Blogroll FOAMEM RSS feed syndication for global FOAM #FOAMed – #FOAMcc – #FOAMres #FOAMped – #FOAMtox – #FOAMus – #FOAMim – #FOANed Brought to you by: Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute) Chris Connolly [CC] (RCEMFOAMed, FOAMShED) Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Jesse Spurr [JS] (Injectable Orange, Simulcast, The Teaching Institute) Marjorie Lazoff [ML] (TandemHealth) Mat Goebel [MG] Salim Rezaie [SR] (REBEL EM, The Teaching Institute) Segun Olusanya [SO] (JICSCast, The Bottom Line) Last update: Jul 24, 2017 @ 7:02 am LITFL Review 290Marjorie Lazoff, MD [...]



Smarter Homes for All | British Gas

2017-07-21T14:46:00+00:00

LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog

Welcome to the 290th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum […]

LITFL Review 290
Marjorie Lazoff, MD




The Procedures Course

2017-07-21T09:18:00+00:00

LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog

The Procedures Course is a 'hands on' cadaver based course designed to help you achieve mastery at life-limb-and-sight saving procedures.

The Procedures Course
Chris Nickson

LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog

This week I participated as a learner in The Procedures Course. The course is run as a collaboration between The Alfred Trauma Unit, Alfred Emergency & Trauma Centre, National Trauma Research Institute and Monash University. It is a cadaver-based ‘hands on’ procedures course designed to enable emergency and critical care physicians to develop the mastery necessary to perform life-sight-and-limb-saving procedures when the time comes.

I’ve been involved in many courses as a participant, facilitator, and convenor. This course ranks among the very best. The pacing of the course is spot on, participant-to-cadaver and participant-to-faculty ratios were excellent, sub-specialty experts were on hand for Q&A sessions, and the extensive online resources accompanying the course were top notch. The resources include high-quality procedure videos, concise yet thorough treatments of the procedures covered, and an excellent audio podcast.

The best thing about this course is the procedures themselves. You get to work through them on real human anatomy at your own pace, with the opportunity to freely discuss all aspects of each procedure with expert colleagues. For some procedures, like lateral canthotomy and cantholysis, there simply is no adequate ‘mannikin’ substitute for the real thing. Procedures covered include:

  • orbital decompression (lateral cantholysis and canthotomy)
  • emergency craniotomy (burr holes)
  • emergency surgical airway
  • transvenous pacing
  • resuscitative vascular access (IO, RICC lines, and Mac lines)
  • pleural decompression and drainage
  • resuscitative thoracotomy
  • escharotomy
  • pre-hospital limb amputation
  • emergency hysterotomy

The good news is that you can take advantage of the Procedures podcast even if you haven’t enrolled in the course. I highly recommend it.

Upcoming course dates will be announced on TheProceduresCourse.com website soon — a little bird tells me the next course will be in Melbourne in November 2017.

Disclaimer: I have no conflict of interest. I am an employee of Alfred Health (in the Intensive Care Unit, which is not affiliated with this course) and I have an adjunct position with Monash University (with no involvement in the course).

The Procedures Course
Chris Nickson

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Funtabulously Frivolous Friday Five 198

2017-07-21T00:28:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Be challenged with some good old fashioned medical trivia FFFF...introducing Funtabulously Frivolous Friday Five 198 Funtabulously Frivolous Friday Five 198Neil LongLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 198. Question 1 The BBC ran an article on sexist adverts. Drug companies were not immune to providing sexist ads as well. What was the substance advertised below with the title “You can’t set her free. But you can help her feel less anxious.”? + Reveal the Funtabulous Answer Oxazepam [Reference] BBC article for less medical sexist adverts. Question 2 What is the curve below and why do the Italian’s call it “legge del cuore”? + Reveal the Funtabulous Answer Commonly this is called the Frank Starling Curve However, neither Frank nor Starling were the first to describe the relationship between the end-diastolic volume and the regulation of cardiac output. The first formulation of the law was theorized by the Italian physiologist Dario Maestrini, who on December 13, 1914, started the first of 19 experiments that led him to formulate the “legge del cuore” – law of the heart [Reference] See BSCC for Primary tutorial on the Frank Starling Curve. Question 3 What is steinstrasse and who gets it? + Reveal the funtabulous answer! The German word for “stone street” Describing a possible complication of extracorporeal shock wave lithotripsy for urinary tract calculi, wherein a column of stone fragments form that blocks the ureter. [Reference] Question 4 What is the Miller-Abbott tube? + Reveal the funtabulous answer! A long (3 m) double-channel intestinal tube, developed in 1934 by William Osler Abbott and Thomas Grier Miller. It is made up of two tubes, one for inflating the balloon when in the duodenum and one for the passage of water. When inserted, barium can be passed through them, and this, alongside radiography, can provide diagnostic information regarding a lesion. A mercury-filled bag has been used with these tubes to assist with decompression of an obstructed intestine, although there is one recorded case of this rupturing and causing death by mercury poisoning. [Reference] Question 5 What is the cause of marchiafava-bignami syndrome and why would Hannibal be prone to getting it? + Reveal the Funtabulous Answer It is a progressive neurological disease of alcoholism, characterized by corpus callous demyelination and necrosis, and subsequent atrophy. It was first described in 1903 by the Italian pathologists Amico Bignami and Ettore Marchiafava in an Italian Chianti drinker. Who knows, one too many Chianti’s and Hannibal may have developed a necrotic corpus callosum. Clinically he may have had a sudden onset of stupor or coma, or seizures. Alternatively he could have acute, subacute, or chronic onset of dementia and/or gait problems. Spasticity often complicates the gait disorder. Psychiatric disturbances, incontinence, hemiparesis, aphasia, dysarthria, apraxia, and signs of interhemispheric disconnection are also observed. Certainly all of this would have hampered his killing spree. Last update: Jul 21, 2017 @ 8:28 am Funtabulously Frivolous Friday Five 198Neil Long [...]



Jellybean 068 with Frank Gaillard of Radiopedia Fame

2017-07-20T07:30:00+00:00

LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog

Frank Gaillard, the creator of Radiopedia. Radiopedia is a very big thing but it started out as a way to avoid studying, surely something we can all relate to...

Jellybean 068 with Frank Gaillard of Radiopedia Fame
Doug Lynch

LITFL • Life in the Fast Lane Medical Blog
LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog

Matt McPartlin (aka @RollCageMedic) interviews Frank Gaillard, the Frank Gaillard, the one who created Radiopedia. Radiopedia is a very big thing but it started out as a way to avoid studying, surely something we can all relate to…

Frank Gaillard started Radiopedia as an exercise in pre-exam procrastination. It has become an educational juggernaut in freely available radiological education. Pre-dating the formalisation and explosion in FOAMed resources, Radiopedia embodies what FOAMed is all about.

Despite its success, Frank is a humble guy and an altruist at heart. Listening to him recount the origins and evolution of Radiopedia and peek into the near future of where it might go, you’d be forgiven for drawing comparisons with entities such as the Khan Academy. One important lesson to the sustained success of Radiopedia has been the way that Frank has managed to bring good people on board, people that love what they are doing, people that in turn inspire the creators. It’s a team. It’s quite a big team and that’s before you consider the extended community. It’s a beautiful thing.

The website has plans to expand into interesting new areas including self assessment tools and trying to fill gaps that people like Frank can see in training systems all over the world.

So no more teasing radiologists about lurking in dark rooms and maintaining an aloof distance from patients (well, maybe just a little bit). Turn on, tune in and rad out.

Links

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Last update: Jul 20, 2017 @ 3:30 pm

Jellybean 068 with Frank Gaillard of Radiopedia Fame
Doug Lynch

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Mastering Intensive Care 010 with Imogen Mitchell

2017-07-18T11:12:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Episode 10 of Mastering Intensive Care features Prof Imogen Mitchell, an intensivist focused on communication and clinical decision-making. Mastering Intensive Care 010 with Imogen MitchellAndrew DaviesLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Imogen Mitchell – An intensivist and Dean of Medicine focused on communication and clinical decision-making Do you seek the relative at the bedside’s help by asking them their opinion on whether their loved one is getting better or not? Do you even have families at the bedside on your ward round? Do you listen as much as you can in your end of life discussions? Professor Imogen Mitchell, a senior intensivist and Dean of Medicine from Canberra, Australia, sees talking to our patient’s families as one of the privileges of working in intensive care. She is a huge supporter of having families at the bedside for the clinical ward rounds and is a passionate believer in exposing our own vulnerability in family meetings, particularly by listening to the patient and their family’s stories first. Imogen has also consistently placed communication with the multi-disciplinary intensive care team at the forefront of great clinical care. Now as one of the senior women in Australasian Intensive Care, Imogen is also passionate about the gender inequity in intensive care training and also in consultant intensivist positions. She has felt the frustration of being a woman in intensive care when she has noticed behaviours that in retrospect she has wondered whether men would ever have been subjected to. Imogen also struggled to find the perfect mentor earlier in her career, perhaps because of the scarcity of female intensivists at the time. She now wants to make sure young female medical students and intensivists come to understand that intensive care can be an excellent career for both genders. Imogen is thoughtful, intelligent, compassionate and considerate. She has been a leader for most of her career, making her the ideal person to give us advice on leadership, communication, decision-making, the training of young doctors, and debriefing to manage stress. In this interview, Imogen starts with how she came to fancy intensive care over her initial desire to be a histopathologist, and ends with some great “life” tips for less experienced clinicians. This podcast was created to help and inspire intensive care clinicians to improve the care we give to our patients by providing interesting and thought-provoking conversations with highly respected and experienced clinicians. In each episode, Andrew Davies, an intensivist from Frankston Hospital in Melbourne, Australia, speaks with a guest for the purpose of hearing their perspectives on the habits and behaviours that they believe are the most important for improving the outcomes of our patients. Things like bringing our best selves to work each day, optimal communication, coping with stress and preventing burn out, working well in a team, and interacting with patient’s families and the many other health professionals we deal with on a daily basis. The podcast is less about the drugs, devices and procedures that can be administered and more about the habits, behaviours and philosophies that can help intensive care clinicians to master the craft of intensive care. Please send any comments through the Life In The Fast Lane website, facebook (masteringintensivecare), twitter (@andrewdavies66) or by simply emailing andrewATmasteringintensivecare.com. LITFL Clinical education resources Mastering Intensive Care Podcasts JellyBean Podcasts Clinical Cases LITFL weekly review Research and Reviews (R&R) in the FastL[...]



LITFL Review 289

2017-07-17T02:27:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 289th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the web LITFL Review 289Marjorie Lazoff, MDLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 289th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Our own Anand Swaminathan explains why the cognitive response to hypotension should not be to reach for a pressor but to treat the underlying condition in his post on occult causes of non-response to vasopressors. [SR]  The Best of #FOAMed Emergency Medicine Incredible podcast from EMCrit featuring Nadia Awad talking NOAC reversal. A must listen for Emergency providers and resuscitationists. [AS, SR] Fantastic talk from Essentials of EM and Amal Mattu on avoiding the clean kill in wide complex tachycardias. [AS] First10EM offers an excellent review of the recent literature on interventional stroke treatment and asks many of the critical questions in application. [AS] The Best of #FOAMcc Critical Care Is high flow nasal oxygen non-inferior to NIV in patients at high risk of re-intubation? David Slessor from the Bottom Line discusses a recent RCT on the topic. [SO] Aidan Burrell from the Alfred gives us a little lesson on VADs as part of the “Everything ECMO” series. [SO] INTENSIVE also have their inaugural podcast! Listen to David Tuxen discuss ventilation in asthma, and subscribe to the resource. [SO] Andrew Davies has yet another excellent podcast with a Master in Intensive Care- this time it’s Professor Imogen Mitchell from Canberra. [SO] The Best of #FOAMres Resuscitation John-Emile Kenny goes through the physiology of IVC collapse and explains why using a simplistic approach to IVC collapse is dangerous in the setting of complex physiology. [SR] More on IVC from Rory Spiegel as he reviews a recent paper looking at the accuracy of IVC collapsibility. [SO] News from the Fast Lane Check out what’s new amongst the 1,650+ pages of the Critical Care Compendium in CCC Update 014 [CN] Reference Sources and Reading List Emergency Medicine and Critical Care blog/podcast list LITFL Global Blogroll FOAMEM RSS feed syndication for global FOAM #FOAMed – #FOAMcc – #FOAMres #FOAMped – #FOAMtox – #FOAMus – #FOAMim – #FOANed Brought to you by: Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute) Chris Connolly [CC] (RCEMFOAMed, FOAMShED) Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Jesse Spurr [JS] (Injectable Orange, Simulcast, The Teaching Institute) Marjorie Lazoff [ML] (TandemHealth) Mat Goebel [MG] Salim Rezaie [SR] (REBEL EM, The Teaching Institute) Segun Olusanya [SO] (JICSCast, The Bottom Line) Last update: Jul 19, 2017 @ 1:32 pm LITFL Review 289Marjorie Lazoff, MD [...]



Pseudo lung point

2017-07-16T14:43:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog An anxious young man presents with left sided chest discomfort. After some internet research he is convinced he has a pneumothorax. What does this scan show? Pseudo lung pointJames RippeyLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog An anxious young man presents with left sided chest discomfort. After some internet research he is convinced he has a pneumothorax… What does this scan demonstrate? + Reveal Answer This image is taken on the left side adjacent to the pericardium. Despite initial appearances this is not a lung point, but the normal junction between sliding lung, and a pericardial fat pad. A common error in lung ultrasound is to misinterpret the normal junction between lung and either mediastinum or diaphragm, as a lung point. This video explains the difference between lung point and pseudo lung point. Related Resources Pneumothorax ECG A to Z by diagnosis –alphabetical diagnostic approach to the ECG ECG CLINICAL CASES — ECG’s placed in clinical context with a challenging Q&A approach Lung Point Case 2 Lung Point Case 3 Lung Point Case 4 Lung Point Case 5 LITFL Ultrasound Library ECG BASICS — Waves, Intervals, Segments and Clinical Interpretation ECG A to Z by diagnosis –alphabetical diagnostic approach to the ECG ECG CLINICAL CASES — ECG’s placed in clinical context with a challenging Q&A approach 100 ECG Quiz — Self-assessment tool for examination practice Last update: Jul 19, 2017 @ 1:41 pm Pseudo lung pointJames Rippey [...]



Funtabulously Frivolous Friday Five 197

2017-07-14T09:24:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Be challenged with some good old fashioned medical trivia FFFF...introducing Funtabulously Frivolous Friday Five 197 Funtabulously Frivolous Friday Five 197Neil LongLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 197. The week have a first-aid feel to the questions. Question 1 What organisation celebrates 140 years, 70 years before the NHS? + Reveal the Funtabulous Answer St John’s ambulance [Reference] See image of early sim wars competition: http://www.bbc.com/news/in-pictures-40555454 Question 2 Who solved the problem of the “cafe coronary” by feeding beagles large chunks of meat to test his manoeuvre? + Reveal the Funtabulous Answer Dr Henry Heimlich, American Surgeon and also inventor of the Heimlich flutter valve for chest drains.  In 1972, the New York Times reported that more than 3,000 people in the U.S. choked to death that year, making it the sixth most common cause of accidental death. Dr. Heimlich began by experimenting with beagle dogs and large chunks of meat. After several physical manoeuvres proved to be of no help, Heimlich was intrigued upon learning that by pressing upward on the dog’s diaphragm, the meat shot out. It was the flow of air “as in a small hurricane, not pressure that carried the object away.” He published his informal findings, an essay entitled “Pop Goes the Café Coronary,” in the June 1974 issue of Emergency Medicine. The method announced in this paper is now universally known as “the Heimlich Manoeuvre.” [Reference] He last practised this procedure on a fellow nursing home resident in 2016 aged 96 [Reference] Question 3 What is the most dangerous animal in Australia? + Reveal the funtabulous answer! The horse. According to the National Coronial Information System between July 2000 and November 2010 the horse was responsible for 77 deaths over this time period. The other animal kill rates are listed below: Cows = 33 Dogs = 27 Kangaroo = 18 Bees and sharks = 16 Snakes = 14 Crocodiles = 9 [Reference] Question 4 An elderly patient collapses in front of you on the street and you wonder the futility of starting CPR. While commencing CPR and humming “staying alive” you are reminded of the eldest person to complete an ironman. Who are they and how old were they when they completed their last ironman? + Reveal the funtabulous answer! Sister Madonna Buder (aka the Iron Nun – see video) Buder became the overall Ironman world record holder in age at age 82 by finishing the Subaru Ironman Canada on August 26, 2012, she completed the ironman in 16:32:00 minutes. [Reference] Question 5 Who first used a defibrillator successfully on a human? + Reveal the Funtabulous Answer Dr Claude Beck in 1947 Beck’s theory was that ventricular fibrillation often occurred in hearts which were fundamentally healthy, in his terms “Hearts that are too good to die”, and that there must be a way of saving them. Beck first used the technique successfully on a 14-year-old boy who was being operated on for a congenital chest defect. The boy’s chest was surgically opened, and manual cardiac massage was undertaken for 45 minutes until the arrival of the defibrillator. The use of procainamide and defibrillation successfully reverted the boy into a sinus rhythm. [Reference[...]



Jellybean 067 with Dr Hanna Kaade from Aleppo

2017-07-14T04:24:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Under Siege. Under fire. Undergraduate. The remarkable journey of Dr Hanna Kaade; from Aleppo to Berlin and from the Red Crescent to #dasSMACC. Jellybean 067 with Dr Hanna Kaade from AleppoDoug LynchLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Under Siege. Under fire. Undergraduate. The remarkable journey of Dr Hanna Kaade; from Aleppo to Berlin and from the Red Crescent to #dasSMACC. This is an ordinary tale. An accidental tale of everyday heroism. There are many tales like this. Every one worth telling, worth hearing, worth learning from. Hanna Kaade is a Syrian born and trained doctor. He completed his medical training in a town under siege, in a hospital under fire, in the centre of a civil war at the centre of a giant ugly geo-political maelstrom. We know about Aleppo. But we don’t know Aleppo like Hanna does. Hanna and I took some time to talk a little about what it was like to exist in such a conflict, to be a medical student delivering battle field trauma care in between basic medical training. From the mundane to the horrible, from studying under candles to working for the WHO. If you got a chance to get out, what would you do? If you had to start your medical training again what would you do? Hanna had to re-train in Germany. Germany has welcomed more Syrians than any country not bordering Syria. By UN estimates Germany has more registered Syrian refugees than every other country in Europe (not just the E.U.) and Canada and the USA and Australia combined. Now he is one of many, many doctors and nurses repeating his training and looking for a new start in Germany. Imagine how hard it will be for people like Hanna to get a start. When you hear him speak and when you see his smile you can believe that he will manage it. But it will be hard to get a break. Much harder than it was for most of us. There are many tales like this from Aleppo, from Syria, from Iraq, from every conflict zone. We are increasingly saturated with images of war but we cannot let these bombed homes, shattered lives or lost loved ones become anything other that the unique tragedy that they represent. We are speaking about some mothers son, some fathers daughter, someone like you and I. In different circumstances it could have been you or me, your sister, your child. Hanna’s story is one of hope, hope in the face of great adversity. Last update: Jul 14, 2017 @ 12:24 pm Jellybean 067 with Dr Hanna Kaade from AleppoDoug Lynch [...]



Research and Reviews in the Fastlane 189

2017-07-12T17:02:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 189th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians Research and Reviews in the Fastlane 189Jeremy FriedLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the  189th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature. This edition contains  4 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Justin Morgenstern and Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the full list of R&R contributors This Edition’s R&R Hall of Famer Emergency medicineLiu VX et al. The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med 2017. PMID: 28345952 While it makes sense that expeditious administration of antibiotics to patients with sepsis should result in better outcomes, a number of studies and meta-analyses haven’t shown a clear relationship between early (< 6 hours) and very early (< 1-2 hours). This multi-center, retrospective study demonstrates a clear association between time and mortality in sepsis, severe sepsis and septic shock. While the benefit is modest in sepsis and severe sepsis (absolute difference 0.3% and 0.4% respectively) the benefit is more robust in septic shock (1.8%). Regardless, flaws with registry data abound. Mervyn Singer offers and editorial on time and antibiotics that is an excellent companion piece. Recommended by: Anand Swaminathan The Best of the Rest ResuscitationStecker EC, et al. Health Insurance Expansion and Incidence of Out-of-Hospital Cardiac Arrest: A Pilot Study in a US Metropolitan Community. J Am Heart Assoc 2017. PMID: 28659263 This study compares emergency medical care statistics for an urban metropolitan community in Oregon before and after the implementation of the Affordable Care Act in the USA. With the incidence of cardiac arrest approximately 17 percent lower post ACA than before it certainly brings home the potential implications of repealing and replacing the ACA. Recommended by: Virginia Newcombe Emergency Medicinevan der Hulle T, et al; YEARS study group. Simplified diagnostic management of suspected pulmonary embolism (the YEARS study): a prospective, multicentre, cohort study. Lancet 2017. PMID: 28549662 The largest demonstration to date of the viability of 1000 ng/mL as the D-dimer cut-off for pulmonary embolism. Recommended by: RPR Further reading: Is the road to hell paved with D-dimers? (Emergency Medicine Literature of Note) Emergency MedicineKawano T, et al. H1-antihistamines reduce progression to anaphylaxis among emergency department patients with allergic reactions. Academic emergency medicine 2016. PMID: 27976492 The conclusions of this study state that “early H1a treatment in the ED or prehospital setting may decrease progression to anaphylaxis”. This would definitely be new information, but I am not sure it is actually what the data shows. This was a retrospective chart review (with excellent chart review methods) looking at 2376 patients[...]



LITFL Review 288

2017-07-09T23:34:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 288th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the web LITFL Review 288Marjorie Lazoff, MDLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 288th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Andrew Davies interviews the legendary John Myburgh as part of the “Mastering Intensive Care” series. An absolute must listen from elsewhere in LITFL. [SO] The Best of #FOAMed Emergency Medicine Our own Chris Nickson reposts Mike Cameron’s great tips for a new Emergency Physician that can sustain a long career. [AS] To NOAC or not to NOAC in non-valvular AF? CanadiEM has an excellent review comparing NOACs vs. warfarin for this indication. [AS] The Best of #FOAMcc Critical Care Alex Psirides’s awesome slide set from his SMACC talk on death and dying are available as FOAMed. Awesome! [SO] Josh Farkas makes a compelling argument against testing the gag reflex in awake patients. [SO] The Best of #FOAMres Resuscitation Paul Marik writes an impressive polemic, admonishing us to not use IVC Ultrasound as a guide to resuscitation in Sepsis. Especially interesting as Scott Weingart posts a reply straight away…[SO] Learn some tips on managing crashing pulmonary oedema combined with a rapid heart rate from Dr Smith’s ECG blog. [SO] The Best of Medical Education and Social Media Burnout is a hot topic in all fields of medicine. Listen to Iain Beardsell do an amazing interview with Liz Crowe this week on St. Emlyn’s. [AS] News from the Fast Lane Check out what’s new amongst the 1,650+ pages of the Critical Care Compendium in CCC Update 014 [CN] Reference Sources and Reading List Emergency Medicine and Critical Care blog/podcast list LITFL Global Blogroll FOAMEM RSS feed syndication for global FOAM #FOAMed – #FOAMcc – #FOAMres #FOAMped – #FOAMtox – #FOAMus – #FOAMim – #FOANed Brought to you by: Anand Swaminathan [AS] (EM:RAP, Core EM,REBEL EM and The Teaching Institute) Chris Connolly [CC] (RCEMFOAMed, FOAMShED) Chris Nickson [CN] ( iTeachEM, RAGE, INTENSIVE and SMACC) Jesse Spurr [JS] (Injectable Orange, Simulcast, The Teaching Institute) Marjorie Lazoff [ML] (TandemHealth) Mat Goebel [MG] Salim Rezaie [SR] (REBEL EM, The Teaching Institute) Segun Olusanya [SO] (JICSCast, The Bottom Line) Last update: Jul 10, 2017 @ 8:06 pm LITFL Review 288Marjorie Lazoff, MD [...]



Funtabulously Frivolous Friday Five 196

2017-07-06T22:00:00+00:00

LITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Be challenged with some good old fashioned medical trivia FFFF...introducing Funtabulously Frivolous Friday Five 196 Funtabulously Frivolous Friday Five 196Neil LongLITFL • Life in the Fast Lane Medical BlogLITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 196. Question 1 What happens if you swallow chewing gum? http://roalddahl.wikia.com/wiki/Violet_Beauregarde + Reveal the Funtabulous Answer Not a lot, most people pass the chewing gum uneventfully in the next couple of trips to the toilet. However, there have been case reports of chewing gum causing bezoars mixed with coins and one case report of a 4 yr old boy with a two year history of constipation. When the child finally underwent disimpaction a large mass of chewing gum was removed. On retrospective history the parents stated the child took between 5-7 pieces of chewing gum a day for good behaviour and commonly swallowed it. [Reference] Question 2 What are men more likely to be struck by when compared to women? + Reveal the Funtabulous Answer Lightning.  Men are 5x more likely to be struck by lightening in America Bonus fact: In Canada young men are 80% more likely to drown than the rest of the population. [Reference] Catatumbo lightning is an atmospheric phenomenon in Venezuela. It occurs only over the mouth of the Catatumbo River where it empties into Lake Maracaibo. It occurs during 260 nights a year, 10 hours per day and up to 280 times per hour. Question 3 In what season do children grow the fastest? https://en.wikipedia.org/wiki/Growth_chart + Reveal the funtabulous answer! Summer and slower in Winter “Melatonin is related to the glucocorticoid receptor (GR) pathway and there is a well-established link between the circadian cortisol cycle and growth rate. Therefore, the GR pathway modulation is a possible mechanism by which daylight could modulate growth response.” [Reference] Question 4 What causes a painful limb and acute pancreatitis in sugar cane harvesters in the West Indies? + Reveal the funtabulous answer! The sting of Tityus trinitatis a scorpion endemic in Trinidad Finally, a country where you don’t look stupid for suggesting scorpion bites in your differential. [Reference] Question 5 What is Schaltenbrand syndrome? + Reveal the Funtabulous Answer German neurologist Georg Schaltenbrand reported in 1938 and 1953 what he termed “aliquorrhea”, a condition marked by very low, unobtainable, or even negative CSF pressures. A few decades earlier, the same syndrome had been described in French literature as “hypotension of spinal fluid” and “ventricular collapse”. This is now recognised as spontaneous intracranial hypotension resulting from a small tear in the dura surrounding the brain or the spinal cord. It can occur with minor trauma such as bending over to pick up a toy, coughing, sneezing, twisting or sex. The headache is worse sitting up, CSF pressures are below normal and MRI with gadolinium is the test of choice. [Reference] Last update: Jul 7, 2017 @ 11:08 am Funtabulously Frivolous Friday Five 196Neil Long [...]















A festive message from British Gas

2016-12-14T07:59:00+00:00




Your British Gas Heating Adviser Visit

2016-11-21T16:07:00+00:00




























Latest Gas Safety News

2016-06-05T22:23:01+00:00

In the latest gas safety news, the has been a petition calling for TV warnings about carbon monoxide poisoning on the Isle of Wight, see article below.A petition calling for prime time TV warnings about carbon monoxide (CO) poisoning to save lives has been launched by Isle of Wight based campaigner, Stephanie Linda Trotter, OBE.The petition urges the Government to provide warnings against the dangers of the carbon monoxide poisoning. The deadly gas can be emitted from faulty cooking or heating appliances powered by any carbon based fuel (such as gas, coal, wood, oil, diesel, petrol etc.).Responsible for 50 deaths each year It states that less than 2% of CO in the air can kill in between one and three minutes and these deaths and injuries cost the taxpayer £178 million a year.In the UK, carbon monoxide poisoning is linked to around 50 deaths a year and more than 200 people go to hospital with suspected carbon monoxide poisoning.Read the full article here.Other news from around the country, another suspected carbon monoxide leak, read below.Dartmouth fire crews called to suspected carbon monoxide leakFIRE crews in Dartmouth were called on on Tuesday night after a suspected carbon monoxide leak at a property in the town.Crews donned breathing apparatus and using a gas detector to check the property in Lower Street. A fire service spokesman said: “Fortunately no gas was detected and the building was cleared of this danger and handed to a responsible person.”They added: “Carbon monoxide is a gas that is invisible, odourless and tasteless. It is recommended that if you have a room that burns a solid fuel (i.e wood or coal) then you should have a carbon monoxide detector installed, also as gas appliances can emit carbon monoxide it is also encouraged that you should have one fitted in a room that has a gas fires or gas appliances (boiler).”Read more at this link.You can find out more and see more carbon monoxide articles here.The article Latest Gas Safety News can be see at this siteIn the latest gas safety news, the has been a petition calling for TV warnings about carbon monoxide poisoning on the Isle of Wight, see article below.A petition calling for prime time TV warnings about carbon monoxide (CO) poisoning to save lives has been launched by Isle of Wight based campaigner, Stephanie Linda Trotter, OBE.The petition urges the Government to provide warnings against the dangers of the carbon monoxide poisoning. The deadly gas can be emitted from faulty cooking or heating appliances powered by any carbon based fuel (such as gas, coal, wood, oil, diesel, petrol etc.).Responsible for 50 deaths each year It states that less than 2% of CO in the air can kill in between one and three minutes and these deaths and injuries cost the taxpayer £178 million a year.In the UK, carbon monoxide poisoning is linked to around 50 deaths a year and more than 200 people go to hospital with suspected carbon monoxide poisoning.Read the full article here.Other news from around the country, another suspected carbon monoxide leak, read below.Dartmouth fire crews called to suspected carbon monoxide leakFIRE crews in Dartmouth were called on on Tuesday night after a suspected carbon monoxide leak at a prope[...]



Latest Gas Safety News | Gas Safety Information

2016-06-05T22:23:00+00:00

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Latest Gas Safety News

2016-06-05T22:10:00+00:00

In the latest gas safety news, the has been a petition calling for TV warnings about carbon monoxide poisoning on the Isle of Wight, see article below.   A petition calling for prime time TV warnings about carbon monoxide (CO) poisoning to save lives has been launched by Isle of […]

In the latest gas safety news, the has been a petition calling for TV warnings about carbon monoxide poisoning on the Isle of Wight, see article below.

 

A petition calling for prime time TV warnings about carbon monoxide (CO) poisoning to save lives has been launched by Isle of Wight based campaigner, Stephanie Linda Trotter, OBE.

The petition urges the Government to provide warnings against the dangers of the carbon monoxide poisoning. The deadly gas can be emitted from faulty cooking or heating appliances powered by any carbon based fuel (such as gas, coal, wood, oil, diesel, petrol etc.).

Responsible for 50 deaths each year
It states that less than 2% of CO in the air can kill in between one and three minutes and these deaths and injuries cost the taxpayer £178 million a year.

In the UK, carbon monoxide poisoning is linked to around 50 deaths a year and more than 200 people go to hospital with suspected carbon monoxide poisoning.

 

Read the full article here.

Other news from around the country, another suspected carbon monoxide leak, read below.

 

Dartmouth fire crews called to suspected carbon monoxide leak

FIRE crews in Dartmouth were called on on Tuesday night after a suspected carbon monoxide leak at a property in the town.

Crews donned breathing apparatus and using a gas detector to check the property in Lower Street.
A fire service spokesman said: “Fortunately no gas was detected and the building was cleared of this danger and handed to a responsible person.”

They added: “Carbon monoxide is a gas that is invisible, odourless and tasteless. It is recommended that if you have a room that burns a solid fuel (i.e wood or coal) then you should have a carbon monoxide detector installed, also as gas appliances can emit carbon monoxide it is also encouraged that you should have one fitted in a room that has a gas fires or gas appliances (boiler).”

Read more at this link.

You can find out more and see more carbon monoxide articles here.




Builder Health And Safety Offences Leads To Carbon Monoxide Tragedy | Gas Safety Information

2016-05-31T19:45:00+00:00

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Builder Health And Safety Offences Leads To Carbon Monoxide Tragedy

2016-05-31T19:44:00+00:00

Many times injuries and deaths from carbon monoxide poisoning could be avoided if we were to take action and install a carbon monoxide sensing device. However, there are times when our fate is not in our hands but those of professionals. Unfortunately in the article below, the professional in question took actions that resulted in the death of a man. In this instance, recognising the symptoms fast enough may help but sometimes the worst happens all too fast.A builder in his 60s has been given a suspended prison sentence after building work resulted in the death of a business owner in Wandsworth Road.Muhammad Javid Butt, 63, was found slumped against the wall of Taniya Dry Cleaners on October 5 2013.Officers were called to the scene, where they noticed a strong smell of gas inside.They left the drycleaners and Mr Butt, of Wensleydale Avenue, Ilford, to retrieve gas masks from their vehicle.London Fire Brigade crews were called to help move Mr Butt outside before paramedics attempted to resuscitate him.A post-mortem examination gave cause of death as carbon monoxide poisoning.Tests of the property showed that the carbon monoxide levels were 10 times greater than the minimum level required to be toxic to humans.Enquiries revealed the boiler’s external flume, used to ventilate fumes, had been cut back to about 5ft above the ceiling during building works undertaken by 6699 Limited.Builder with the firm Keith ‘Bruno’ Morris’, 66, of Ackland House, Beckenham, admitted to cutting the the pipe to make it safer for the builders to work around.The 66-year-old pleaded guilty at the Old Bailey on Friday, April 29 and was sentenced on Tuesday May 31 to eight months imprisonment, suspended for two years.He must carry out 200 hours of unpaid community work and pay £1,000 in costs.The company pleaded guilty to failure to plan, manage and monitor works, contrary to regulation 13(2) of the Construction (Design and Management) Regulations 207 and section 33(1)(c) of the Health and Safety at Work Act 1974.Sentencing for 6699 Limited will take place at the Old Bailey on Thursday, July 28.Read the original post here…Further news stories about carbon monoxide can be found at this feed.The original article can be viewed by clicking on this link[...]Many times injuries and deaths from carbon monoxide poisoning could be avoided if we were to take action and install a carbon monoxide sensing device. However, there are times when our fate is not in our hands but those of professionals. Unfortunately in the article below, the professional in question took actions that resulted in the death of a man. In this instance, recognising the symptoms fast enough may help but sometimes the worst happens all too fast.A builder in his 60s has been given a suspended prison sentence after building work resulted in the death of a business owner in Wandsworth Road.Muhammad Javid Butt, 63, was found slumped against the wall of Taniya Dry Cleaners on October 5 2013.Officers were called to the scene, where they noticed a strong smell of gas inside.They left the drycleaners and Mr Butt, of Wensleydale Avenue, Ilford, to[...]



Builder Health And Safety Offences Leads To Carbon Monoxide Tragedy

2016-05-31T19:29:00+00:00

Many times injuries and deaths from carbon monoxide poisoning could be avoided if we were to take action and install a carbon monoxide sensing device. However, there are times when our fate is not in our hands but those of professionals. Unfortunately in the article below, the professional in question […]

Many times injuries and deaths from carbon monoxide poisoning could be avoided if we were to take action and install a carbon monoxide sensing device. However, there are times when our fate is not in our hands but those of professionals. Unfortunately in the article below, the professional in question took actions that resulted in the death of a man. In this instance, recognising the symptoms fast enough may help but sometimes the worst happens all too fast.

 

A builder in his 60s has been given a suspended prison sentence after building work resulted in the death of a business owner in Wandsworth Road.

Muhammad Javid Butt, 63, was found slumped against the wall of Taniya Dry Cleaners on October 5 2013.

Officers were called to the scene, where they noticed a strong smell of gas inside.

They left the drycleaners and Mr Butt, of Wensleydale Avenue, Ilford, to retrieve gas masks from their vehicle.

London Fire Brigade crews were called to help move Mr Butt outside before paramedics attempted to resuscitate him.

A post-mortem examination gave cause of death as carbon monoxide poisoning.

Tests of the property showed that the carbon monoxide levels were 10 times greater than the minimum level required to be toxic to humans.

Enquiries revealed the boiler’s external flume, used to ventilate fumes, had been cut back to about 5ft above the ceiling during building works undertaken by 6699 Limited.

Builder with the firm Keith ‘Bruno’ Morris’, 66, of Ackland House, Beckenham, admitted to cutting the the pipe to make it safer for the builders to work around.

The 66-year-old pleaded guilty at the Old Bailey on Friday, April 29 and was sentenced on Tuesday May 31 to eight months imprisonment, suspended for two years.

He must carry out 200 hours of unpaid community work and pay £1,000 in costs.

The company pleaded guilty to failure to plan, manage and monitor works, contrary to regulation 13(2) of the Construction (Design and Management) Regulations 207 and section 33(1)(c) of the Health and Safety at Work Act 1974.

Sentencing for 6699 Limited will take place at the Old Bailey on Thursday, July 28.

 

Read the original post here

Further news stories about carbon monoxide can be found at this feed.




Outdoor Appliance Safety And Side Effects

2016-05-30T15:20:00+00:00

The dangers of carbon monoxide are everywhere and while some of us are more aware, other people still do not understand where the dangers can come from, as can be see in the article below. For further help click here.A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater.The incident has prompted health officials to warn against using outdoor appliances in enclosed areas.Western Australia’s chief health officer Tarun Weeramanthri said burning fuels or using unflued heaters in non-ventilated areas can cause poisoning, which can lead to serious tissue damage and death. A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater inside her home (stock image) A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater inside her home (stock image) Western Australia’s chief health officer Tarun Weeramanthri (pictured) said burning fuels or using unflued heaters in non-ventilated areas can cause poisoning, which can lead to serious tissue damage and death.‘Somebody who is intoxicated or sleeping can die from carbon monoxide poisoning without ever experiencing symptoms,’ Professor Weeramanthri said, according to Perth Now.‘Anybody who believes they might be experiencing carbon monoxide poisoning should go outside immediately and not return inside until they have recovered completely.‘Once in the fresh air, recovery is usually fast so if this does not happen it is important to call Health Direct on 1800 022 222 or the Poisons Information Centre on 13 11 26. CARBON MONOXIDE POISONING CASE STUDIESIn January 2011, a Queensland man died from suspected carbon monoxide poisoning caused by generator fumes while taking shelter from cyclone Yasi.In 2009, a 43-year-old Sydney man died from carbon monoxide poisoning after using an outdoor charcoal barbeque inside his home.During 2006–07, there were 365 public hospital cases for carbon monoxide poisonings recorded in Australia.In the US around 30 deaths and 450 injuries each year are related to accidental carbon monoxide poisoning. Source: ACCCThe odourless, colourless and highly poisonous gas is produced by any fuel-burning appliance. Early symptoms include dizziness, nausea and confusion.Carbon monoxide poisoning can cause heart disease and brain damage and is often deadly.Read the full article at the Daily MailAn interesting new development in further potential side effects of carbon monoxide poisoning. This time with a link to dementia as can be seen in the following article.A CHARITY said an ‘urgent investigation’ is needed to see if there is a between carbon monoxide poisoning could cause dementia in a bid help protect the elderly and vulnerable people.Carbon monoxide could be linked to dementiaCarbon monoxide is a colourless, odourless gas that can be toxic to humans and in large concentrations it is known to be a ‘stealth killer’.The Gas Safety Trust has discussed carbon monoxide as being one of factors which could be affecting peop[...]



Outdoor Appliance Safety And Side Effects | Gas Safety Information

2016-05-30T15:19:00+00:00

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Outdoor Appliance Safety And Side Effects

2016-05-30T15:05:00+00:00

The dangers of carbon monoxide are everywhere and while some of us are more aware, other people still do not understand where the dangers can come from, as can be see in the article below. For further help click here.   A Perth woman has suffered serious carbon monoxide poisoning […]The dangers of carbon monoxide are everywhere and while some of us are more aware, other people still do not understand where the dangers can come from, as can be see in the article below. For further help click here.   A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater. The incident has prompted health officials to warn against using outdoor appliances in enclosed areas. Western Australia’s chief health officer Tarun Weeramanthri said burning fuels or using unflued heaters in non-ventilated areas can cause poisoning, which can lead to serious tissue damage and death. A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater inside her home (stock image) A Perth woman has suffered serious carbon monoxide poisoning after using a charcoal barbecue as a heater inside her home (stock image) Western Australia’s chief health officer Tarun Weeramanthri (pictured) said burning fuels or using unflued heaters in non-ventilated areas can cause poisoning, which can lead to serious tissue damage and death. ‘Somebody who is intoxicated or sleeping can die from carbon monoxide poisoning without ever experiencing symptoms,’ Professor Weeramanthri said, according to Perth Now. ‘Anybody who believes they might be experiencing carbon monoxide poisoning should go outside immediately and not return inside until they have recovered completely. ‘Once in the fresh air, recovery is usually fast so if this does not happen it is important to call Health Direct on 1800 022 222 or the Poisons Information Centre on 13 11 26. CARBON MONOXIDE POISONING CASE STUDIES In January 2011, a Queensland man died from suspected carbon monoxide poisoning caused by generator fumes while taking shelter from cyclone Yasi. In 2009, a 43-year-old Sydney man died from carbon monoxide poisoning after using an outdoor charcoal barbeque inside his home. During 2006-07, there were 365 public hospital cases for carbon monoxide poisonings recorded in Australia. In the US around 30 deaths and 450 injuries each year are related to accidental carbon monoxide poisoning. Source: ACCC The odourless, colourless and highly poisonous gas is produced by any fuel-burning appliance. Early symptoms include dizziness, nausea and confusion. Carbon monoxide poisoning can cause heart disease and brain damage and is often deadly. Read the full article at the Daily Mail   An interesting new development in further potential side effects of carbon monoxide poisoning. This time with a link to dementia as can be seen in the following article. A CHARITY said an ‘urgent investigation’ is needed to see if there is a between carbon monoxide poisoning could cause dementia in a bid help protect the elderly and vulnerabl[...]



New Technologies In Carbon Monoxide Detection

2016-05-26T20:16:00+00:00

Here are some interesting updates in the detection of carbon monoxide gases in the air. Being so difficult to detect, it requires special sensors and any update in this technology can only assist us all further. Get to know your device.The detection of carbon monoxide (CO) in the air is a vital issue, as CO is a poisonous gas and an environmental pollutant. CO typically derives from the incomplete combustion of carbon-based fuels, such as cooking gas and gasoline; it has no odour, taste, or colour and hence it is difficult to detect. Scientists have been investigating sensors that can determine CO concentration, and a team from the Okinawa Institute of Science and Technology Graduate University (OIST), in tandem with the University of Toulouse, has found an innovative method to build such sensors.As a tool for CO detection, scientists use extremely small wires: copper oxide nanowires. Copper oxide nanowires chemically react with CO, creating an electrical signal that can be used to quantify CO concentration. These nanowires are so thin that it is possible to fit more than 1,000 of them in the average thickness of a human hair.Two issues have hampered the use of nanowires. “The first problem is the integration of nanowires into devices that are big enough to be handled and that can also be easily mass produced,” said Prof Mukhles Sowwan, director of the Nanoparticles by Design Unit at OIST. “The second issue is the ability to control the number and position of nanowires in such devices.” Both these difficulties might have been solved by Dr Stephan Steinhauer, postdoctoral scholar at OIST, together with Prof Sowwan, and researchers from the University of Toulouse. They recently published their research in the journal ACS Sensors.“To create copper oxide nanowires, you need to heat neighbouring copper microstructures. Starting from the microstructures, the nanowires grow and bridge the gap between the microstructures, forming an electrical connection between them,” Dr Steinhauer explained. “We integrated copper microstructures on a micro-hotplate, developed by the University of Toulouse. A micro-hotplate is a thin membrane that can heat up to several hundred Celsius degrees, but with very low power consumption.” Thanks to the micro-hotplate, researchers have a high degree of control over the quantity and position of the nanowires. Also, the micro-hotplate provides scientists with data on the electrical signal that goes through the nanowires.The final result is an exceptionally sensitive device, capable of detecting very low concentrations of CO. “Potentially, miniaturized CO sensors that integrate copper oxide nanowires with micro-hotplates are the first step towards the next generation of gas sensors,” Prof Sowwan commented. “In contrast to other techniques, our approach is cost effective and suitable for mass production.”This new method could also help scientists in better understanding the sensor lifetime. The performance of a sensor decreases overtime, and this is a[...]



New Technologies In Carbon Monoxide Detection

2016-05-26T20:00:00+00:00

Here are some interesting updates in the detection of carbon monoxide gases in the air. Being so difficult to detect, it requires special sensors and any update in this technology can only assist us all further. Get to know your device. The detection of carbon monoxide (CO) in the air […]Here are some interesting updates in the detection of carbon monoxide gases in the air. Being so difficult to detect, it requires special sensors and any update in this technology can only assist us all further. Get to know your device. The detection of carbon monoxide (CO) in the air is a vital issue, as CO is a poisonous gas and an environmental pollutant. CO typically derives from the incomplete combustion of carbon-based fuels, such as cooking gas and gasoline; it has no odour, taste, or colour and hence it is difficult to detect. Scientists have been investigating sensors that can determine CO concentration, and a team from the Okinawa Institute of Science and Technology Graduate University (OIST), in tandem with the University of Toulouse, has found an innovative method to build such sensors. As a tool for CO detection, scientists use extremely small wires: copper oxide nanowires. Copper oxide nanowires chemically react with CO, creating an electrical signal that can be used to quantify CO concentration. These nanowires are so thin that it is possible to fit more than 1,000 of them in the average thickness of a human hair. Two issues have hampered the use of nanowires. “The first problem is the integration of nanowires into devices that are big enough to be handled and that can also be easily mass produced,” said Prof Mukhles Sowwan, director of the Nanoparticles by Design Unit at OIST. “The second issue is the ability to control the number and position of nanowires in such devices.” Both these difficulties might have been solved by Dr Stephan Steinhauer, postdoctoral scholar at OIST, together with Prof Sowwan, and researchers from the University of Toulouse. They recently published their research in the journal ACS Sensors. “To create copper oxide nanowires, you need to heat neighbouring copper microstructures. Starting from the microstructures, the nanowires grow and bridge the gap between the microstructures, forming an electrical connection between them,” Dr Steinhauer explained. “We integrated copper microstructures on a micro-hotplate, developed by the University of Toulouse. A micro-hotplate is a thin membrane that can heat up to several hundred Celsius degrees, but with very low power consumption.” Thanks to the micro-hotplate, researchers have a high degree of control over the quantity and position of the nanowires. Also, the micro-hotplate provides scientists with data on the electrical signal that goes through the nanowires. The final result is an exceptionally sensitive device, capable of detecting very low concentrations of CO. “Potentially, miniaturized CO sensors that integrate copper oxide nanowires with micro-hotplates are the first step towards the next genera[...]



The importance of having a co detector | Gas Safety Information

2016-05-24T17:28:00+00:00

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The importance of having a co detector

2016-05-24T17:27:00+00:00

Having a carbon monoxide detector installed in the home is definitely a life saver. Here we have yet another news story about how this device can save lives. Please read and learn and connect on Facebook or Twitter.REXBURG, Idaho — It was a normal Sunday for Chris and Julia Marcum. They ate breakfast and spent some time playing with their young daughters before church.What they didn’t know was there was an invisible danger lurking in their home and it’s likely a small detector saved their lives.“At first I couldn’t really find what the noise was,” Chris Marcum tells EastIdahoNews.com. “We actually had recently purchased our carbon monoxide detector like a month and a half ago.”The detector was left forgotten in the Marcum’s furnace room until Sunday, May 15 when carbon monoxide levels became life threatening and the alarm started to sound.“My husband was like, ‘Everyone get out of the house,’” Julie Marcum says. “I got the baby up from her nap, grabbed the dog and my six-year-old was already outside crying. I think she thought our house was on fire.”The Madison County Fire Department responded to the house and found the furnace was leaking carbon monoxide.“It still feels kind of surreal — like we were actually in danger,” Chris says. “That day felt like just a normal day and there was nothing special about it. That’s how it would have felt even if we didn’t have it (the detector), I’m grateful that we did get the detector when we did.”Madison County assistant fire chief Mikel Walker says this situation is a reminder of how important it is that gas appliances are installed properly and maintained.“Make sure that your stuff is vented, your furnace is vented properly and your gas stove is vented if it has a chimney,” Walker says. “If your alarm goes off, open your windows, call the fire department, exit the house and protect yourself.”The Marcum’s two-year-old daughter did get sick from the carbon monoxide but she has recovered and is doing well now.The family says they’re grateful to be alive and hope those who don’t have smoke detectors will consider getting the life-saving tools.Original posted here -https://medium.com/media/83d9b1a843930a083e39bd128a3b923a/hrefGreat news for Barrie in Canada with the fire service having been given more than 100 CO alarms for distribution to help with the battle against carbon monoxide. Install your sensor as soon as possible(STAFF) — The Barrie Fire & Emergency Service received a special lifesaving delivery Friday morning.The service received a donation of more than 100 carbon monoxide detectors courtesy of the Insurance Bureau of Canada.Barrie MPP Ann Hoggarth was on hand, along with the bureau’s manager of government relations, Matt Hiraishi, to do the h[...]



The importance of having a co detector

2016-05-24T17:17:00+00:00

Having a carbon monoxide detector installed in the home is definitely a life saver. Here we have yet another news story about how this device can save lives. Please read and learn and connect on Facebook or Twitter.   REXBURG, Idaho — It was a normal Sunday for Chris and […]Having a carbon monoxide detector installed in the home is definitely a life saver. Here we have yet another news story about how this device can save lives. Please read and learn and connect on Facebook or Twitter.   REXBURG, Idaho — It was a normal Sunday for Chris and Julia Marcum. They ate breakfast and spent some time playing with their young daughters before church. What they didn’t know was there was an invisible danger lurking in their home and it’s likely a small detector saved their lives. “At first I couldn’t really find what the noise was,” Chris Marcum tells EastIdahoNews.com. “We actually had recently purchased our carbon monoxide detector like a month and a half ago.” The detector was left forgotten in the Marcum’s furnace room until Sunday, May 15 when carbon monoxide levels became life threatening and the alarm started to sound. “My husband was like, ‘Everyone get out of the house,’” Julie Marcum says. “I got the baby up from her nap, grabbed the dog and my six-year-old was already outside crying. I think she thought our house was on fire.” The Madison County Fire Department responded to the house and found the furnace was leaking carbon monoxide. “It still feels kind of surreal – like we were actually in danger,” Chris says. “That day felt like just a normal day and there was nothing special about it. That’s how it would have felt even if we didn’t have it (the detector), I’m grateful that we did get the detector when we did.” Madison County assistant fire chief Mikel Walker says this situation is a reminder of how important it is that gas appliances are installed properly and maintained. “Make sure that your stuff is vented, your furnace is vented properly and your gas stove is vented if it has a chimney,” Walker says. “If your alarm goes off, open your windows, call the fire department, exit the house and protect yourself.” The Marcum’s two-year-old daughter did get sick from the carbon monoxide but she has recovered and is doing well now. The family says they’re grateful to be alive and hope those who don’t have smoke detectors will consider getting the life-saving tools. Original posted here – Brand new carbon monoxide detector saves family Great news for Barrie in Canada with the fire service having been given more than 100 CO alarms for distribution to help with the battle against carbon monoxide. Install your sensor as soon as possible (STAFF) – The Barrie Fire & Emergency Service received a special lifesaving delivery Friday morning. [...]



Council putting lives at risk by dodging carbon monoxide detector rules critics argue

2016-05-22T14:53:01+00:00

For a while now, it has been law for landlords to fit carbon monoxide alarms in their rented properties, a long with smoke alarms. However, it looks like councils can get away with this. Although some are fitting CO detectors regardless, others are avoiding the expense, see the article below. Rss feed news here.A COUNCIL has been accused of dodging its own rules and risking tenants’ safety by failing to fit carbon monoxide detectors in its housing stock.During a cabinet meeting last month, Castle Point Council introduced Government legislation stating that private landlords need to fit detectors in properties with a solid fuel burning appliance.Landlords breaching the Smoke and Carbon Monoxide Alarm Regulations 2015 can be fined up to £5,000.A loophole means that council homes are exempt from the regulations.However, Basildon Council and South Essex Homes, which manages Southend Council’s housing stock, have both installed the detectors anyway.Rochford Housing Association, which bought Rochford Council’s housing supply in 2007, said it has also has fitted them to all properties.A Castle Point council spokesman told the Echo it is considering installing the detectors in light of the new legislation.She said: “The council housing stock does not come under the legislation which has recently been introduced for properties available in the private rental sector.“However, whilst we don’t currently have carbon monoxide detectors in our properties we are considering a programme of works to implement these within relevant properties.“In the meantime we have a very proactive programme of regular gas safety checks across all our properties where gas is installed, whereby the annual checks are now undertaken on a rolling ten month basis.”“We have also committed to an extensive programme of boiler replacements which commenced last year to bring all our boilers to a better standard.”Dave Blackwell, leader of the Canvey Independent Party, said he is disappointed the authority is “taking a chance with residents’ safety.”He has urged the council to act quickly to resolve the issue.Read the full article at the published source here…While we have some councils, perhaps, shirking their responsibilities in fitting co alarms, the Shropshire fire and rescue service have recently launched a campaign to raise the awareness of carbon monoxide poisoning, see below. Learn more at our Tumblr blog.Shropshire Fire and Rescue Service has launched a campaign aimed at raising awareness of carbon monoxide poisoning. Laura Kavanagh-Jones from SFRS’s Prevention team said: “Carbon Monoxide is a deadly gas that you can’t see, smell or taste.Too many people are dying or suffering needlessly from carbon monoxide poisoning. That’s why I am urging every resident in Shropshire to make sure they and their love[...]



Council putting lives at risk by dodging carbon monoxide detector rules, critics argue | Gas Safety Information

2016-05-22T14:53:00+00:00

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Council putting lives at risk by dodging carbon monoxide detector rules, critics argue

2016-05-22T14:18:00+00:00

For a while now, it has been law for landlords to fit carbon monoxide alarms in their rented properties, a long with smoke alarms. However, it looks like councils can get away with this. Although some are fitting CO detectors regardless, others are avoiding the expense, see the article below. […]For a while now, it has been law for landlords to fit carbon monoxide alarms in their rented properties, a long with smoke alarms. However, it looks like councils can get away with this. Although some are fitting CO detectors regardless, others are avoiding the expense, see the article below. Rss feed news here.   A COUNCIL has been accused of dodging its own rules and risking tenants’ safety by failing to fit carbon monoxide detectors in its housing stock. During a cabinet meeting last month, Castle Point Council introduced Government legislation stating that private landlords need to fit detectors in properties with a solid fuel burning appliance. Landlords breaching the Smoke and Carbon Monoxide Alarm Regulations 2015 can be fined up to £5,000. A loophole means that council homes are exempt from the regulations. However, Basildon Council and South Essex Homes, which manages Southend Council’s housing stock, have both installed the detectors anyway. Rochford Housing Association, which bought Rochford Council’s housing supply in 2007, said it has also has fitted them to all properties. A Castle Point council spokesman told the Echo it is considering installing the detectors in light of the new legislation. She said: “The council housing stock does not come under the legislation which has recently been introduced for properties available in the private rental sector. “However, whilst we don’t currently have carbon monoxide detectors in our properties we are considering a programme of works to implement these within relevant properties. “In the meantime we have a very proactive programme of regular gas safety checks across all our properties where gas is installed, whereby the annual checks are now undertaken on a rolling ten month basis.” “We have also committed to an extensive programme of boiler replacements which commenced last year to bring all our boilers to a better standard.” Dave Blackwell, leader of the Canvey Independent Party, said he is disappointed the authority is “taking a chance with residents’ safety.” He has urged the council to act quickly to resolve the issue.   Read the full article at the published source here…   While we have some councils, perhaps, shirking their responsibilities in fitting co alarms, the Shropshire fire and rescue service have recently launched a campaign to raise the awareness of carbon monoxide poisoning, see below. Learn more at our Tumblr blog.   Shropshire Fire and Rescue Service has launched a campaign aimed at rai[...]



How carbon monoxide detectors work

2016-05-20T19:30:01+00:00

This is a great article posted on the cnet.com website, giving details about how carbon monoxide detectors work. It also looks at why CO is so dangerous and breaks down what the alarms are doing when they detect CO gases in the environment . More CO blog posts available on Medium.How carbon monoxide detectors workCarbon monoxide is a killer. This colorless, odorless gas is a normal side product of the combustion of things such as the gas or oil that heats your house. Normally, this is only released in very small amounts and is dispersed into the atmosphere through a vent or chimney. However, if a heater is only partially burning fuel or there isn’t enough ventilation, it can quickly become a problem, because even small amounts can be fatal. That’s why laws were passed that required carbon monoxide detectors to be fitted to most homes, offices and other buildings. Let’s look at how these devices detect this stealthy killer.How carbon monoxide killsCarbon monoxide is a stealthy killer. An amount as low as 10 parts per million (ppm) can cause headaches, and 600 ppm levels can quickly lead to unconsciousness and, eventually, death. That’s how it kills most people: it puts them to sleep, then kills them while they sleep. The effect of low concentrations mounts over time, with even a very low concentration causing adverse effects if you are exposed for long enough. That’s because of the sneaky way it harms the body.Carbon monoxide blocks the ability of your blood to carry oxygen, replacing the spot that oxygen takes on the hemoglobin in your red blood cells. This iron-rich compound is how your blood carries oxygen around the body, and carbon monoxide bonds to hemoglobin much tighter than oxygen alone. Over time, as more and more hemoglobin is blocked from doing its job by carbon monoxide, your blood just can’t carry enough oxygen to keep your tissues going, especially the brain. They begin to fail, causing headaches, nausea, unconsciousness, and eventually, death.How carbon monoxide detectors workThere are several different ways to detect carbon monoxide, but most home carbon monoxide detectors use an electrochemical sensor. These rely on how the behavior of a chemical changes when carbon monoxide is around.Inside the carbon monoxide alarm is a small sensor with three electrodes on it. These three electrodes lead into a container of a chemical called the electrolyte. This container is gas permeable, meaning that gas from the atmosphere can pass freely into and out of it. A small voltage is applied between two of the electrodes (called the working and the reference electrodes). When carbon monoxide enters the sensor, it reacts with the oxygen also present in the atmosphere, releasing an electron and creating a small current between the electrodes. Some sensors use electrodes coated wi[...]



How carbon monoxide detectors work | Gas Safety Information

2016-05-20T19:30:00+00:00

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How carbon monoxide detectors work

2016-05-20T19:18:00+00:00

This is a great article posted on the cnet.com website, giving details about how carbon monoxide detectors work. It also looks at why CO is so dangerous and breaks down what the alarms are doing when they detect CO gases in the environment . More CO blog posts available on […]This is a great article posted on the cnet.com website, giving details about how carbon monoxide detectors work. It also looks at why CO is so dangerous and breaks down what the alarms are doing when they detect CO gases in the environment . More CO blog posts available on Medium.   How carbon monoxide detectors work Carbon monoxide is a killer. This colorless, odorless gas is a normal side product of the combustion of things such as the gas or oil that heats your house. Normally, this is only released in very small amounts and is dispersed into the atmosphere through a vent or chimney. However, if a heater is only partially burning fuel or there isn’t enough ventilation, it can quickly become a problem, because even small amounts can be fatal. That’s why laws were passed that required carbon monoxide detectors to be fitted to most homes, offices and other buildings. Let’s look at how these devices detect this stealthy killer. How carbon monoxide kills Carbon monoxide is a stealthy killer. An amount as low as 10 parts per million (ppm) can cause headaches, and 600 ppm levels can quickly lead to unconsciousness and, eventually, death. That’s how it kills most people: it puts them to sleep, then kills them while they sleep. The effect of low concentrations mounts over time, with even a very low concentration causing adverse effects if you are exposed for long enough. That’s because of the sneaky way it harms the body. Carbon monoxide blocks the ability of your blood to carry oxygen, replacing the spot that oxygen takes on the hemoglobin in your red blood cells. This iron-rich compound is how your blood carries oxygen around the body, and carbon monoxide bonds to hemoglobin much tighter than oxygen alone. Over time, as more and more hemoglobin is blocked from doing its job by carbon monoxide, your blood just can’t carry enough oxygen to keep your tissues going, especially the brain. They begin to fail, causing headaches, nausea, unconsciousness, and eventually, death. How carbon monoxide detectors work   There are several different ways to detect carbon monoxide, but most home carbon monoxide detectors use an electrochemical sensor. These rely on how the behavior of a chemical changes when carbon monoxide is around. Inside the carbon monoxide alarm is a small sensor with three electrodes on it. These three electrodes lead into a container of a chemical called the electrolyte. This container is gas permeable, meaning that gas from the atmosphere can pass freely into [...]



Father of teacher killed by carbon monoxide poisoning calls for national campaign

2016-05-18T19:30:01+00:00

A great concept that we wholly agree with. There is not enough awareness when it comes to carbon monoxide poisoning, especially when other things are on our mind like of the young woman in the story below. Moving abroad or just moving in general, as well as holidays can mean our guard is down when it comes to CO safety. It is important to remain aware at all times, read the article and get behind the campaign. Read our blog for more CO safety informationFather of teacher killed by carbon monoxide poisoning calls for national campaignA man whose daughter was killed by carbon monoxide poisoning has called for greater awareness among Brits abroad.Mark Dingley spoke at Westminster last week at an event convened by the All Party Parliamentary Carbon Monoxide Group (APPCOG).Mr Dingley’s daughter Francesca died in Chengdu, China, in February 2015 aged 22, having just moved to the country to start work as an English teacher.She was killed in her flat by carbon monoxide fumes from an incorrectly installed water heater.Mr Dingley urged for alarms to be seen as “essential” travel items and for the industry to do more to encourage the public to take detectors with them when they go abroad.He said: “People die needlessly from carbon monoxide simply because they know nothing about it.“Educating the general population is key, the government, travel industry and energy suppliers could all do far more to raise awareness.“We would like to see prominent and robust warnings in government travel advice, at airports and in ferry terminals, in railway and bus stations, in holiday brochures and on travel websites. Detectors should be available in the shops at airports and ferry terminals as well as in the travel sections of large retailers.”Mr Dingley called for a national advertising campaign, and said advice on government websites must be delivered more forcefully.On its website, the Foreign Office recommends those living in China should ensure their home contains a working carbon monoxide alarm.David Burrowes, MP for Enfield Southgate and APPCOG member, said: “I was pleased to bring the Dingley family’s tragic loss to the attention of Parliament so that vital lifesaving lessons are learned.“We are calling for action from the travel industry to make holiday and longer stay destinations safer, and for more awareness about the risks amongst the wider population, in order to empower people to protect themselves from the silent killer, both at home and abroad.Please read the full article here…All of us should be remaining aware, not just for ourselves but also for friends and family. You, or someone you know is probably going on holiday some time soon. Ensure they are awar[...]



Father of teacher killed by carbon monoxide poisoning calls for national campaign | Gas Safety Information

2016-05-18T19:30:00+00:00

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Father of teacher killed by carbon monoxide poisoning calls for national campaign

2016-05-18T19:24:00+00:00

A great concept that we wholly agree with. There is not enough awareness when it comes to carbon monoxide poisoning, especially when other things are on our mind like of the young woman in the story below. Moving abroad or just moving in general, as well as holidays can mean […]A great concept that we wholly agree with. There is not enough awareness when it comes to carbon monoxide poisoning, especially when other things are on our mind like of the young woman in the story below. Moving abroad or just moving in general, as well as holidays can mean our guard is down when it comes to CO safety. It is important to remain aware at all times, read the article and get behind the campaign. Read our blog for more CO safety information   Father of teacher killed by  carbon monoxide poisoning calls for national campaign A man whose daughter was killed by carbon monoxide poisoning has called for greater awareness among Brits abroad. Mark Dingley spoke at Westminster last week at an event convened by the All Party Parliamentary Carbon Monoxide Group (APPCOG). Mr Dingley’s daughter Francesca died in Chengdu, China, in February 2015 aged 22, having just moved to the country to start work as an English teacher. She was killed in her flat by carbon monoxide fumes from an incorrectly installed water heater. Mr Dingley urged for alarms to be seen as “essential” travel items and for the industry to do more to encourage the public to take detectors with them when they go abroad. He said: “People die needlessly from carbon monoxide simply because they know nothing about it. “Educating the general population is key, the government, travel industry and energy suppliers could all do far more to raise awareness. “We would like to see prominent and robust warnings in government travel advice, at airports and in ferry terminals, in railway and bus stations, in holiday brochures and on travel websites. Detectors should be available in the shops at airports and ferry terminals as well as in the travel sections of large retailers.” Mr Dingley called for a national advertising campaign, and said advice on government websites must be delivered more forcefully. On its website, the Foreign Office recommends those living in China should ensure their home contains a working carbon monoxide alarm. David Burrowes, MP for Enfield Southgate and APPCOG member, said: “I was pleased to bring the Dingley family’s tragic loss to the attention of Parliament so that vital lifesaving lessons are learned. “We are calling for action from the travel industry to make holiday and longer stay destinations safer, and for more awareness about the risks amongst the wider population, in [...]