Procedures

What’s the Diagnosis? By Dr. Loran Hatch

20 yo male presents to the ED with left hip pain after MVC PTA. Patient was restrained back seat passenger, no LOC. Patient appears very uncomfortable on stretcher, with left leg propped on rolled blanket. Tenderness at left hip but no obvious deformity. LLE with DP pulses 2+, sensation intact, will wiggles toes.

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Advanced Practice: Airway Mastery Series! DL vs VL for Airway Management in the ED

This is a summary of a portion of Dr. Byrne's talk on airway management presented at the August ResusEM conference at Cooper Medical School of Rowan University. This week we seek to answer the question: is video laryngoscopy superior to direct laryngoscopy for improved first pass success and decreased complication rates? Yes. Yes it is. Read on!

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Advanced Practice - Airway Mastery Series! Preoxygenation strategies

This post is a a summary of a portion of Dr Byrne's airway talk from last month's ResusEM conference at the Cooper Medical School of Rowan University. New techniques for preoxygenation before intubation can help to prolong time to desaturation and make this potentially dangerous procedure safer than ever!

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Airway Mastery Series: Got Oxygen? Head of Bed up for Preoxygenation Before Intubation

Intubation has traditionally been performed with patients in the full supine position. Recent data suggests that elevation of the head of the bed may be more effective during preoxygenation before intubation. Check out this summary of a paper from Anesthesia that put this idea to the test!

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Advanced Practice: Bedside Ultrasound for Improving First-Attempt Lumbar Puncture Success on Infants

Anatomic landmarks followed by a "blind" stick is currently the standard practice for performing bedside lumbar punctures, but with increasing use and ease of ultrasound, could we one day see lumbar punctures follow in the footsteps of central line placement?

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Advanced Practice: Bedside Two Point Compression Ultrasound to Rule-In Pulmonary Embolism by Chad Simpkins MD

You evaluate a patient complaining of acute onset of dyspnea with hypotension and hypoxia. You immediately consider the diagnosis of acute massive pulmonary embolism, but despite your best efforts can't get good cardiac windows on bedside ultrasound. Should you administer thrombolytics? Heparin? Send the shocky patient for a CT? Today Dr. Simpkins goes through the steps to perform 2-point compression ultrasound of the lower extremity to evaluate for DVT, an easy and rapid bedside test that may allow for indrect but more rapid diagnosis of acute, massive pulmonary embolism.

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Advanced Procedures: How to Create a Pericardiocentesis Model

Pericardiocentesis is a rarely performed, but potentially life-saving procedure. Commerical models are prohibitively expensive, but students and residents (and critical care fellows) still need to learn the mechanics, ideally with an ultrasound compatibile model. This week's post gives a step by step guide towards making a cheap, easy to fabricate phantom based on this fantastic paper published in the Journal of Emergency Medicne 2012: https://www.ncbi.nlm.nih.gov/pubmed/21925818

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