You’re on a lovely amble through the backcountry when suddenly you see smoke rising nearby and catch a whiff of a familiar scent that throws you back to your med school OR days: burning flesh. You quickly find one obtunded, severely burned…
THE EYE EXAM Keep it basic… APD Intra-ocular Pressures: Tono-pen v Applanator (Goldmann) Visual Acuity or be a Slit Lamp KWEEN Move outside in: Lids → Eyeball Lids: ducts, eyelashes, orbital lesions or findings EYE: Full EOM assessment and…
Here is a pearl about nasal foreign bodies: The nose is the MC site of fb insertion, seen mostly in children <5 years. Most of the time, the risk of aspiration and complications are low. However, if the fb is a button battery or a…
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 perfor…
A 45 year old male comes into the ED with a sudden, severe headache. It started while he was at work yesterday and was the worst of his life. It started feeling a little better, but hasn’t totally gone away and his wife made him come to get…
Tl;dr: (1) Never rock the pelvis. Firmly squeeze and hold. (2) Consider quickly assessing for rectal or vaginal bleeding prior to binder application as this would suggest an open fx into the vag / rectal vault. It will be difficult to compl…
Traditionally, central line placement in the subclavian vein (SCV) involves a landmark-based approach in which the needle is guided under the clavicle. For the U/S lovers, there is an alternative approach to the subclavian in which the sono…
As ED physicians, we fear the patient we can’t intubate, can’t ventilate. We’ve had a rash of emergency cricothyrotomies in our ED recently. Though rare, you never know when you might need to perform this life saving procedure. Review the b…
There you were, minding your own business when EMS brings you a sick-as-can-be patient, intubated in the field for who knows what. Someone gets overzealous with their trauma shears and cuts off the pilot balloon on the endotracheal tube. Th…
The Interscalene Block So, you want to provide local anesthesia to the patient with a broken clavicle or a dislocated shoulder. Maybe there’s a proximal / mid-humeral fracture or an injury over the deltoid. Whatever your needs may be,…
