Let’s talk about mandible dislocations & how we can reduce them. First, we need to take a look at the mandible anatomy – can refer back to this as we discuss mandible dislocation: So how does the mandible dislocate (also called te…
Headaches are the most common complication of doing a lumbar puncture (LP). Let’s dive into what causes them, how to prevent them, and what to do when patients come back suffering from a post-LP headache. Some major theories on why post-LP…
Let’s talk about large bore/central vascular access! We’ll review different kinds, their different names, and when to use them!Of note outside the scope of this review: how to insert each of these – I think this is better learned by watchin…
Ultrasound probe movements, the quest of the good vein, out-of-plane technique and in-plane technique of the ultrasound-guided intravenous line
This week, I wanted to touch a bit on Meconium Aspirators as apart of our GI Bleed intubation tool kit. At some point during second year, many of my fellow classmates and I started throwing these into airway boxes at Elmhurst. Especially in…
Why is this a pearl? We get G-tube dislodgments quite often at Sinai, and they can be an easy patient encounter with a quick note and quick dispo. But they made me so nervous as an intern and early 2! Now I love ‘em and you can love ‘em too…
CSF shunts – these are the most common pediatric neurosurgery procedure done in the United States. While very common, these also have the highest rate of neurosurgical complications. About 50% fail within the first year, and the median survival of a shunt is usually 8-10 years, so a patient can expect 2-3 shunt revisions over the course of 20 years.
You’re at Sinai – and your patient is a renal transplant patient. What do you do? “Don’t you just call renal transplant?” Yes, you should definitely call them. But there’s other things to consider – see below for today’s TR pearls.
Needle, wire, nick, dilate, catheter. Sounds simple right? However, simple doesn’t always mean easy. Placing a central line on a mannequin can be much easier than the 250lb ESRD patient with peripheral vascular disease and a MAP of 50. Belo…
“The HgB has dropped, have you checked a guaic?” How many times have you checked a FOBT in your workup for anemia? Let’s take a look at what FOBT is supposed to be used for. FOBT is a visual stool assay in which heme in th…
A 57yo M presents with new onset urinary retention for 3 days. The triage nurse attempts to place a foley catheter but is unable to pass it. Bedside ultrasound confirms a distended bladder. The patient is now complaining of urethral discomf…
A patient is sent from nursing home at 10pm for a non-functioning PEG tube. He has a prior history of stroke with L sided weakness and is now bedbound at baseline. He has stable vitals, no abdominal tenderness, and is otherwise well appeari…
Injuries to the hands are a frequent complaint in the emergency department. When the injury isn’t limited to a single digit, or involves larger areas of the hand such as a burn or deep laceration, a nerve block can be an effective opt…
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…
Many clinicians are challenged when evaluating patients for perisplenic fluid as part of the FAST or RUSH examination. Here are some common problems and how to fix them. Fix probe location Make sure you are holding the probe in a longitudi…
