Pulmonology

Advanced Practice: Nebulized TXA for Hemoptysis

As ER physicians, we are greatly limited in what we can do for patients with submassive to massive hemoptysis.
- Our job is to manage the airway (prevent asphyxiation), reverse coagulopathies and provide supportive care
- The definitive therapy is an urgent bronchoscopy with ENT or pulmonology
But what if there was more we could do during the bridging period waiting the specialist on call? Enter tranexamic acid!

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#EMconf - COPD management pearls!

You are caring for a sick patient with an acute COPD exacerbation. What O2 sat should you target? What meds should you give? If you have to intubate, what are the issues you'll have to deal with? This week we glean some valuable management pearls for the management acute COPD exacerbations from this month's Internal Medicine module at Cooper.

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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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The Myth of Dry Drowning

With summer in full swing now, swimming emergencies are bound to increase. A recent surge in media coverage may have raised many questions about the phenomenon known as “dry drowning." Variations in nomenclature regarding drowning can lead to confusion and imprecise terminology. Check out this post for a quick review:

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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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