In 2010, there were approximately 535,000 ED visits for foreign bodies. Approximately 80-90% of ingested foreign bodies pass through the GI tract without complications while the rest require intervention. What are some basics that you need to know about foreign bodies that ingested, aspirated and inserted?
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!
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.
Anatomic landmarks followed by a "blind" stick is currently the standard practice for performing bedside lumbar punctures, but with increasing use and ease of ultrasound, could we one day see lumbar punctures follow in the footsteps of central line placement?
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.