Lower Extremity Nerve Block: The Sural Nerve

  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 branch of the sciatic nerve, the sural nerve innervates the lateral portion […]

Awake Intubation Topicalization

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 considering this method when the two Venn diagrams of “anatomically challenging” and “enthusiastically cooperative” overlap in the […]

How-To: Preoxygenation via SIMV Noninvasive Ventilation

Inspired by a morning report discussion from our very own Lara Vanyo on preoxygenation strategies, I thought it would helpful for a brief run-down on the button-pushing needed to perform preoxygenation by way of noninvasive ventilation. The video below is specific to the vents we have at Sinai–Weingart and Elmer have already shown us how to […]

That Vitamin C in Sepsis Newsflash

A number of really bright people are still unsure of what to make about the vitamin C, steroids and thiamine newsflash that’s taken Twitter by storm yesterday. At Sinai here we’re the curious types, so we chatted with our pharmacist who similarly didn’t know what to make of the headlines given the lack of a randomized […]

That Prolonged QT Warning?! Magnesium for Cardiac Arrhythmias

You get a pop-up warning in the electronic medical record about potentially adverse interaction with a prolonged QT interval. What’s the risk, right? Afraid of a little torsades de pointes? Can’t we just give some prophylactic magnesium and call it a day? Let’s see if there’s any literature out there… First off, let’s review magnesium. […]

Mechanical Ventilation Protocol in the ED

Citation Fuller BM, Ferguson IT, Mohr NM, et al. Lung-Protective Ventilation Initiated in the Emergency Department (LOV-ED): A Quasi-Experimental, Before-After Trial. Ann Emerg Med. 2017; Clinical Question Does a multifaceted, 4-part, ED-based mechanical ventilator protocol improve respiratory and ventilator-associated outcomes? The Short Version: Using a mechanical ventilation protocol (i.e., protective tidal volumes, appropriate PEEP, low […]

Hypertonic Saline or Mannitol for Head Injury?

Traumatic Brain Injury & Neurocritical Care You’ve just intubated your traumatic brain injury patient and the repeat pupil exam shows signs of herniation. In addition to your other interventions (e.g., Reverse Trendelenburg positioning, optimization of sedation/analgesia), do you reach for the hypertonic saline or mannitol as osmotherapy? What risks and benefits come with either therapy? […]

September 2024
M T W T F S S
 1
2345678
9101112131415
16171819202122
23242526272829
30  

Archives