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!
Last Thursday was the yearly Cooper EM residency retreat at the shore in Avalon, NJ. In addition to some spectacular teaching tips on summer emergencies, we had some great small group discussion and role-playing regarding one of the toughest (and least discussed) aspects of our jobs: difficult discussions with consultants, admitting physicians, and patients. Read on for some great interpersonal communications tips (and some pics of the Cooper EM residents hard at work).
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!
Looking for a high yield summary of post-cardiac arrest pearls? Look no further than this incredibly well acted video by the Cooper EM faculty recently presented by Dr. Brian Roberts, our very own NIH grant holding cardiac arrest researcher, at this year's NJ ACEP meeting in May
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.
For some, this topic may be more bread and butter than others. Many of you may work in cold areas where you are likely to see patients with hypothermia on a regular basis, especially in the winter. Whether you work shifts in a mountainous region or are simply catching up on EM topics while studying for boards in your in you flip flops by the beach, here are a few pearls regarding patients who present with hypothermia and their management.
Tranexamic Acid! It seems everywhere we look there are people touting TXA as the next miracle drug. This post introduces the clinical applications of TXA and the evidence supporting its use.
What's with the empty conference room? This week the Cooper EM Residents attended Resident Wellness Conference in Philadelphia, so today's content is from a lecture from November's module "Acute Signs and Symptoms" Enjoy!
You are intubating a sick patient in the ED via direct laryngoscopy. After opening the airway, sweeping the tongue with your blade, inserting into the vallecula, and lifting at the precisely correct angle your eyes behold....well...not the vocal cords! Maybe the arytenoid cartilages if you're lucky (aka Cormack Lehane 3 or 4 view). But wait, you aren't finished yet! You reach into your back pocket and remove your trusty bougie...