A 23 yo male with a hx of insulin dependent diabetes and recurrent admissions for DKA presents to the ED with complaints of diffuse body aches. He is acutely ill appearing, agitated, and combative with staff, demanding pain medication, entering other patients rooms, and screaming. Realizing that this patient is severely ill, you wonder how you will de-escalate or sedate this patient safely to enable life-saving care to be rendered.....
A 56 yo male with a hx of TBI, subglottic stenosis, tracheomalacia, and tracheal stenosis presents in acute respiratory distress. There is a strange looking trach in place with no balloon for a cuff. You begin to wonder how you will manage this pt if he ultimately requires mechanical ventilation.....
Acute compartment syndrome is a surgical emergency. Measurements of compartment pressures are an important adjunct to making the diagnosis. Check out this post for a video demonstration on how to operate the Stryker Device
The ResusEM conference is coming back this August! This is a summary of a portion of Dr. Byrne's talk on airway management presented at the August 2017 ResusEM conference at Cooper Medical School of Rowan University. Check out some of the literature looking at the performance of video largyngoscopy versus direct laryngoscopy in various hospital settings.
Sore throat? Hot Potatoe voice? What's more bread and butter EM than drainage of a peritonsillar abscess?!?! Read on below for a few pearls when it comes to diagnosing and draining.
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)