Ultrasound guidance has undeniably revolutionized IV access and is an incredibly useful skill for the ED physician. The following are by no means a comprehensive guide to the procedure but rather 10 tips for small changes that are often overlooked and can make a huge difference. If you have trained with ultrasound guided IV’s and feel comfortable already with your own style, this may not be as helpful for you. For the medical students, interns, and perhaps "less young attendings" that did not have a vascular probe attached to their hip during residency, read on!
In the emergency department, we are often asked by consultants to provide procedural sedation for reductions, suturing and repairs. Here is a cheat sheet to serve as your quick reference guide.
Modern immunizations in conjunction with better CT imaging has likely led to declining need for lumbar puncture in the emergency department to evaluate for meningitis and subarachnoid hemorrhage. This may contribute to physician discomfort with the procedure and lower likelihood of first attempt success. This study evaluated whether the addition of ultrasound guidance could increase first attempt success on infant lumbar puncture in the Emergency Department.
Intubation is a potentially dangerous procedure which may result in rapid hemodynamic collapse and cardiac arrest in the critically ill. This week we summarize the results of a large retrospective study to determine the clinical factors associated with cardiac arrest after intubation.
You are performing a laceration repair in the emergency department and plan to use lidocaine with epinephrine for local anesthesia. What is the maximum dose of lidocaine with epinephrine for this indication? (scroll down for the answer)
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.
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!
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!