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…
That moment when an idea strikes you. Something stutters the laminar flow of the mind. A mental murmur, perhaps. It’s that hiccup that alerts you that something’s up, something needs to be reassessed. This happened to me at Janus General, where Grock works. Neurology clinic referred a patient to Read more…
Burr Hole Craniostomy Mark H Wilson, David Wise, Gareth Davies and David Lockey. “Emergency burr holes: “How to do it” “Scand J Trauma Resusc Emerg Med. 2012; 20: 24. 1) Ensure indications are appropriate 2) Ensure patient is supine and physiologically optimised (intubated, ETCO2 4.5kPa, normotensive, c-spine protection, mannitol/hypertonic saline Read more…
Thanks to Dr. Basile for today’s Morning Report! New Approach to the Digital Block Traditional digital nerve block: – two injections where you hit all four digital nerves with injections on both sides of the finger at MCP joint – Does not work at least 10% of the Read more…
After a small hiatus, MR is back with Dr. Reisman presenting today’s special Halloween edition! (sorry nothing really Halloween related but still good stuff!) Abdominal Paracentesis: prevention and management of persistent ascites leak Diagnostic paracentesis – New onset ascites – Patient with ascites and signs of SBP Read more…
Thanks to Dr. Lau for today’s Morning Report! The Case: Unknown male BIBEMS after being dragged by street cleaning vehicle for unknown distance, “lost vitals in ambulance bay”. Right side of chest visibly deformed (close flail chest). After definitive airway management, still no access. Tried multiple peripheral IVs, femoral central Read more…
Here’s Dr. Shin with today’s Morning Report! How to Tap a VP Shunt Ventriculoperitoneal (VP) shunts, which are used to treat hydrocephalus, shunt cerebrospinal fluid (CSF) from the lateral ventricles of the brain into the peritoneum. Tapping or aspirating the shunt is performed to obtain more information for evaluation for Read more…
For those of you who couldn’t make it, we started conference with a great sim case that reviewed cardiac tamponade and how to perform an emergent pericardiocentesis. I’ve posted below the video that Dr. Coquillon wanted to share with everyone that shows the apical approach using ultrasound by SonoSite (no Read more…