The Fascia Iliaca compartment block: as magical as it sounds!

In case you haven’t gotten to this month’s EM:RAP, there’s a really great segment on an important ED procedure that we definitely don’t do enough of in the ED: the nerve block. The section discusses the femoral nerve block and how to perform a fascia iliaca compartment block (the “3-in-1” block)–which hits 3 major nervesRead more

Daily Em Pearl, 5/2/12

An elderly man presents with new bloody urine x2days and abdominal distention/fullness. He noticed some clots prior to presentation and now hasn’t urinated x5hours despite a real urge to micturate. He has a h/o BPH and is on coumadin for afib. At clinic yesterday his INR was 2. On sono you appreciate a full bladderRead more

Daily Em Pearl, 4/21/12

An elderly man presents to the ED after falling down a flight of stairs at home. He has mild but worsening dementia and his wife called EMS when he couldn’t stand up from the fall. Your patient still does his own ADLs but is progressively forgetting things, like where he put his keys and toRead more

Daily Em Pearl 4/16/12

A 55yoM is BIBEMS after an MVC c/o RLE pain w/obvious deformity at the thigh. Distally he is NVI but is in excruciating pain. The portable plain film shows a mid shaft fracture. You order dilaudid but he’s still really uncomfortable. How can you help him?  Read more

Daily Em Pearl 4/15/12

A pleasant 64yoM w/NIDDM and afib (on coumadin) p/w an abscess to R-medial thigh. He is afeb but there is some surrounding erythema at the abscess site. You perform a thorough incision and drainage and instruct him to return in 2days for wound check; he is discharged with bactrim DS 2tabs BID for 10days. HeRead more