Neuro Resus

Subarachnoid haemorrhage is one of the most time-critical and high-stakes emergencies in medicine. But in the real world, it rarely presents neatly. In this episode, Oli Flower is joined by two AI co-hosts — Simon (GPT-5.3) and Claude (Sonnet 4.6) — to work through the pre-hospital and emergency department management of SAH using a real-world scenario: a 42-year-old woman with a thunderclap headache, collapse, and reduced GCS. What follows is a mix of clinical reasoning, practical decision-making, and occasional AI overconfidence getting corrected in real time. What we cover: Airway decisions in SAH: Is GCS 8 an automatic intubation? Pre-hospital priorities and seizure management Blood pressure targets: physiology vs reality ED workflow: stabilise first or scan first? Hyperventilation and ICP: when it helps and when it harms Communicating with neurosurgery (and what actually matters) Nimodipine: what the evidence really says (and doesn't say) Why listen: This is not a guideline recitation. It's a practical, frontline discussion of how SAH actually presents and how decisions get made under pressure — including where the evidence is thin, debated, or misunderstood. Along the way: Dogma gets challenged Nuance matters And one AI model learns, the hard way, what happens when you misquote trials Key takeaways: SAH management is a balance between competing risks: perfusion vs rebleeding Early decisions in airway, blood pressure, and transport matter Much of what we do is still based on physiology and consensus, not definitive trials And yes — sometimes you're managing a brain with "buggered autoregulation" 🎧 If you work in emergency medicine, ICU, anaesthesia, or pre-hospital care, this episode will sharpen how you think about SAH from the moment the patient hits the floor to the CT scanner. 📍 ISAH 2026 — Sydney, 17–20 November Where these debates happen for real, with real humans.

Catherine Bell takes us through how to troubleshoot problems commonly encountered when looking after patients who have an external ventricular drain (EVD) in situ. Issues with using brain tissue oxygen monitors are also discussed. A highly practical session aimed at bedside clinicians. This presentation was delivered by Catherine Bell at CODA2022. Want more content about EVD? Visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.

Lizzy suffered a substantial aneurysmal subarachnoid haemorrhage that left her critically unwell, requiring a long stay in intensive care recovering from the consequences and complications of this devastating form of stroke. Now a couple of years after her haemorrhage, Lizzy has come so far. She and her husband Gordon describe their experiences, right from the day it all began and through those tumultuous first few weeks, to where she is today. This open and honest account gives us all invaluable insight into what it's like to go through the subarachnoid haemorrhage journey from a patient and family's perspective, hopefully helping us empathise more and deliver better patient-centred care. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.

Historically, when it came to brain injury, ketamine had a bad rap. Much of that dogma was dispelled in the last 20 years, and ketamine is now frequently used as an induction agent in acute brain injury, especially traumatic brain injury, partially due to the favorable effects on haemodynamics. However a new application of ketamine is now being explored - whether ketamine may be able to reduce secondary brain injury. In this talk Toby Jeffcote initially takes us through all the sedatives currently used in brain injury and the evidence to support their use. He then covers the history of ketamine use and the background to new research in use as a therapeutic agent. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.

Andrew Chow vs Andrew Udy This debate was set up to discuss the issues with categorising traumatic brain injury (TBI). The current system using GCS to divide patients into mild, moderate and severe has been criticised in recent times, with calls for a more nuanced approach. The debate was a just bit of fun but does highlight the key issues. Chowie didn't get to choose which side to argue for :) Andrew Chow, Intensivist with a neurosurgical background, argues that the current categorisation system for TBI works, and makes sense! He tackles us through the history of this system, and why it's important to differentiate different types of TBI. The arguments in favour of this categorisation include the consistency and benefits of a universal language, the implications for triage and management, and the fact that this system has been endorsed by all major organisations. Andrew Udy then argues that this classification is fundamentally flawed. He discusses the issues with the Glasgow Coma Scale, and therefore the follow-on issues in TBI classification, including all the confounders to the GCS, the issues with timing of the score as well as GCS not taking baseline function or specifics subtypes of TBI into account. He makes the argument that biomarkers may better categorise the diffuse entity we call TBI. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.

Tania Farrar is a neurologist and epileptologist with expertise in continuous EEG (cEEG) and status epilepticus (SE). This talk covers what a seizure is, what status is, including focal and generalised status epilepticus. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.

Shree Basu is a Paediatric Intensivist in Sydney. She discusses how Paediatric stroke presents, what neuroimaging is required and what interventions are available, including thrombolysis and the role of endovascular thrombectomy. The blood pressure targets in ICU are discussed; while there isn't strong evidence to support these targets, it does make sense and is a separate hot topic in adult strokes, especially post ECR! This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email.

20 million people around the world are living with a spinal cord injury (SCI). The medical issues they develop over the years differ to any other patient cohort. These complications include autonomic dysreflexia, management of pressure areas, specific infections, nuanced peri-operative care and highly specific issues such as baclofen pump management and syringomyelia. In this podcast Spinal Rehab Specialist Bonne Lee talk about this side of SCI care. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email.

A Talk by Amal Abou-Hamden on intracerebral haemorrhage (ICH) and the latest developments in the management of this devastating form of stroke, including the ongoing EVACUATE trial, a randomized controlled trial of ultra-early, minimally invasive, haematoma evacuation versus standard care within 8 hours of intracerebral hemorrhage. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email.

Social Worker Victoria Whitfield and Bereavement councilor Louise Sayers discuss the power of words when health professionals are communicating topics around of death and serious injury with relatives and patients in critical care. They use role plays to bring theories to life. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com.

Top 10 critical care papers of recent times Dr Paul Young From CICM Trainee Symposium 2019

How I manage: Productivity and self-organisation Dr David Anderson From CICM Trainee Symposium 2019

How to be an awesome ICU registrar (nurse's perspective). Mr Nigel Fealy From CICM Trainee Symposium 2019