Written by: Taylor Douglas, M.D. You are the single provider in a rural Emergency Department, taking care of an unstable bradycardic patient. You are successfully pacing your patient transcutaneously, and now it’s time to get them a more definitive and comfortable method of pacing before they are transferred for cardiology Read more…
In the last few hours of your busy Pod A shift, you sign up for a patient with the chief complaint “penile pain.” His chart indicates a history of sickle cell and multiple prior urology appointments and ED presentations for recurrent priapism. As you enter the room, the patient yells, Read more…
Adapted from Morning Report by Chief Resident Rushabh Shah. Public fear regarding COVID-19 has caused the unexpected consequence of decreased ED volume in hospitals around the country. The much-needed breath of fresh air is appreciated, but fewer patients means fewer direct learning opportunities for EM residents. Here are some suggestions Read more…
How does one get a nail bed injury? Distal phalanx injuries are the most common hand injury, particularly in children. These are often due to crush injuries also resulting in subungual hematomas and nail bed lacerations. If a subungual hematoma involves more than half the nail plate, there is a Read more…
It’s another day at your local university hospital. You’re nearing the end of your shift and wrapping up your cases. Your mind is already starting to wander with thoughts of what you’ll do on vacation. Suddenly, you hear some commotion stir through the ED — TRAUMA CODE to the hospital Read more…
It’s August and as a resident, I sit at the crux of this famous teaching model. I’m still having some of my first “do ones” while daily “teaching one” to the medical students, juniors and interns who have spent the last few years seeing and are ready to “do.” Like Read more…
Thanks to Dr. Wang for today’s Morning Report! Lateral Orbital Canthotomy Indications: Retrobulbar hemorrhage Increase IOP (IOP >40mm Hg) Proptosis Contraindications: Globe rupture Hyphema Tear-drop-shaped pupil Peaked or irregularly shaped pupil Procedure: Positioning: patient in the supine position. Possibly restrained or undergo conscious sedation Local anesthesia Read more…
Today’s Morning Report is presented by Dr. Adal! Shoulder dislocation The most common joint dislocation (approximately 50% of all joints) Mechanism Presentation Associated injuries Anterior Indirect blow with arm in abduction, extension, and external rotation Arm is held in abduction and slight external rotation with shoulder appearing “squared Read more…
Dr. Gomes presents today’s Morning Report! PROCEDURAL SEDATION Definition: -technique of administering a sedative or dissociative agent along with analgesia to induce a state that allows patient to tolerate unpleasant procedures while maintaining adequate spontaneous cardiorespiratory function Complications: -oversedation, respiratory depression/arrest, hypoxia, hypotension, prolonged awakening, agitation, nausea/vomiting, Read more…
Supraclavicular CVC Placement First described in 1965 as an alternative method for obtaining central venous access At the insertion site the subclavian vein is closer to the skin than using the infraclavicular subclavian vein approach Insertion sites of the needle include One centimeter lateral to the lateral border of the Read more…