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...
In this video, Cooper Emergency Medicine Residency graduate and current ultrasound fellow at Hennepin County Mark Robidoux demonstrates a few tips and tricks to quickly become a pro in ultrasound guided angiocath insertion (with a little help from Cooper Assistant to the Program Director and volunteer pincushion Rich Byrne)
Lacerations of the tongue often require special consideration considering the tongue's anatomic location and functional importance. Repair of tongue lacerations are often plagued by patient intolerance and inadequate anesthesia of the area. This posts aims to introduce the basics of management of tongue lacerations.
Managing Tongue Lacerations:
Do you feel like you pour your heart, soul, blood, sweat, and tears into your fracture/reductions and still come up short? Does the orthopedics consultant always want to "re-do" your attempt? Here is a podcast interview between Patrick Sheehan, MD of the Department of Emergency Medicine and Joseph Legato, MD of the Department of Orthopedic Surgery at Cooper University Hospital on how to get a perfect reduction. Inside the interview are 5 tips on positioning yourself for success. Also included is a video of Dr.