Troublesome G-Tubes

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Troublesome G-Tubes

Replacing gastrostomy tubes that have fallen out or are no longer functioning is a common procedure in the Emergency Department. Often, these replacements are smooth and easy. There are times however when the replacement process can get complicated with the need to dilate quickly stenosing tracts and/or the need to consult a sub specialist to assist with replacement. This post covers the key historical factors to gather on these patients and the basics steps in replacing the tubes.

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Troubleshooting Foley Caths and Suprapubic Caths

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Troubleshooting Foley Caths and Suprapubic Caths

Placement of a foley catheter is usually a simple process. However when it doesn’t go smoothly, when the foley just won’t seem to pass, there are specific approaches that are needed to successfully catheterize the patient. Suprapubic catheters will also frequently need replacement and troubleshooting in the ED.

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Diagnostics and Therapeutics: Ear Emergencies in the Department

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Diagnostics and Therapeutics: Ear Emergencies in the Department

Ear trauma, pain, and infection are a few of the common presenting complaints in emergency departments across the US, accounting for millions of visits annually. This post aims to review the diagnosis and treatment approaches for common ear emergencies including auricular hematomas, outer ear infections, and retained foreign bodies.

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Diagnostics and Therapeutics: Managing Pneumothorax

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Diagnostics and Therapeutics: Managing Pneumothorax

There are many different types of pneumothorax (PTX), and the management paradigm has shifted in recent years as the research has exploded on this topic. This topic is additionally complicated by the development of multiple diagnostic tools now available for diagnosis as well as variable sizing algorithms used around the world. Institutional resources and specialty services may further dictate the management of PTX. This post aims to broadly cover the types of PTX, the diagnostic modalities available, and the ideal management by PTX type in the Emergency Department.

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Riding the Waves: End-Tidal CO2 Monitoring

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Riding the Waves: End-Tidal CO2 Monitoring

End-Tidal CO2 monitoring has a variety of uses in the Emergency Department.  Whether used diagnostically or for monitoring of a patient’s physiology, clinicians must possess an understanding of the information that you can gather from EtCO2 waveform tracings. Knowing how to interpret the waveforms makes EtCO2 much more than a number, allowing the clinician to gain insight into minute to minute changes in a patients physiological state.

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Foot Injuries in the ED

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Foot Injuries in the ED

As an EM physician, it is important to have an understanding of the spectrum of foot injuries and how these are appropriately evaluated. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. This post will cover some of the most common and important injuries, but is not comprehensive. Injuries discussed are shown in Image 1.

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Twisting and Turning - Ankle Injuries in the ED

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Twisting and Turning - Ankle Injuries in the ED

As an EM physician, it is important to have an understanding of the spectrum of ankle injuries and how these are appropriately evaluated. Certain injuries carry risks of further injury, injury-related complications, and poor outcomes which are exacerbated if they are inappropriately managed in the ED. This post will cover some of the most common and important injuries, but is not comprehensive.

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Fearsome Foliage - An Overview of Toxic Plants

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Fearsome Foliage - An Overview of Toxic Plants

Spring has sprung... and so have many species of toxic plants! Poison centers across the United States receive over 100,000 reports of exposures to toxic plants annually. It is often difficult for Emergency Medicine providers to determine the quantity and time of exposure. Plant identification presents another challenge, and can even require the input of a botanist. Now that is an interesting consult! Thankfully, some of the more common and/or dangerous plant poisonings have been well-categorized, and are summarized in this post.

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Caustic Skin Injuries

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Caustic Skin Injuries

Chemical burns are also an evolving pathology, with thousands of new chemicals added to the market each year (4). Since 2000, both assault and warfare with chemical weapons have increased, although these pathologies vary based on practice location (1). For instance, chemical burns can comprise up to 14% of burns in the developing world, compared to 3% in the US and Europe (2, 5). It is therefore important to understand your local chemical burn patterns, in much the same way providers learn local patterns of antibiotic resistance.

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