Lumbar punctures can be a high stress and difficult procedure for many. Dr. Knudsen-Robbins walks us through the optimal setup, performance, and troubleshooting of this procedure, including the ultrasound-assisted LP! Check out this article before your next LP attempt to breeze through this procedure with ease.
Read MoreEstablishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons. In this post, we will review multiple alternative access options, as well as briefly discuss concerns related to PICC lines.
Read MoreReplacing 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.
Read MorePlacement 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.
Read MoreEar 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.
Read MoreJoin Dr. Qin as she reviews the data behind the hot topics in management of GI bleeding, from use of fecal occult testing, imaging and medications to give.
Read MoreThere 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.
Read MoreEver get an ESR or CRP signed out to you and wonder why they were ordered? Want to use them intentionally and in an evidence-based way? Join Dr. Eric Segev as he takes a dive into the data of inflammatory markers and the pathologies in which they have been studied.
Read MoreEnd-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.
Read MoreAs 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.
Read MoreAs 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.
Read MoreSpring 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.
Read MoreEver palpate the scalp of an altered patient to find a VP shunt you weren’t expecting? Have a febrile patient and wondering if it could be the cause? Join Dr. Cody Stothers as he dives into a case-based review of Hydrocephalus and VP Shunts
Read MoreNeed a quick reminder of what the MA means as you’re watching your TEG tick by? Join Dr. Della Porta for a quick hit review of Thomboelastography, aka TEG.
Read MoreChemical 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.
Read MoreSRU (pronounced "shrew") = Shock Resuscitation Unit
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
Training in, and managing, the SRU is one of the crown jewels of our residency. It is where the sickest of the sick patients are found in our ED. It is a crucible, a test of knowledge and strength, and a true manifestation of the tripartite mission of our department: Leadership, Excellence, and Opportunity.
