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,…
Today’s lower extremity block is going to be the posterior tibial nerve. The sensory distribution should be helpful for things like foreign bodies that need to be taken out of the foot. Anatomy – The largest of the five…
The next three series in the SinaiEM pearls will be on nerve blocks of the foot. Today is going to cover the sural nerve block which should anesthetize the area depicted by the cross-hatched area in the figure. As a terminal b…
Compiled from a variety of sources from #FOAMed (specifically, NYSORA and the ACCRAC podcast) and inspired by morning report today with Taryn and Tina, here is a quick and dirty rundown for awake intubation. Firstly, we should be considerin…
When a patient presents with orbital compartment syndrome, performing a lateral canthotomy and cantholysis can be vision-saving. You may only have 60-100 minutes until the patient experiences permanent visual sequelae. Are you ready? …
“The role of a clown and a physician are the same – it’s to elevate the possible and to relieve suffering.” -Patch Adams Do you regularly raise the head of the bed when you intubate? Well, maybe you should! A recen…
“Childhood means simplicity. Look at the world with the child’s eye – it is very beautiful.” -Kailash Satyarthi Nursemaid’s elbow is a radial head subluxation, typically caused by a “pulling” mechanism. It occ…
“Nobody travels on the road to success without a puncture or two.” -Navjot Singh Sidhu Ultrasound can assist in determining the best site for lumbar puncture. Here is how to do it! 1. Palpate for the superior iliac…
