C: Joint Reduction

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on C: Joint Reduction

Shoulder Dislocation and Reduction Olabiyi Akala and Maureen Gang INDICATIONS  History and clinical examination consistent with shoulder dislocation     Anterior Dislocation (~95%)        Mechanism          Force applied to an externally rotated, abducted, and…

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Subclavian Vein—Central Venous Access

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Subclavian Vein—Central Venous Access

 Emergency venous access for fluid resuscitation and drug infusion  Central venous pressure and oxygen monitoring  Infusions requiring central venous administration (vasopressors, hyperosmolar solutions, hyperalimentation)  Routine venous access due to inadequate…

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Intubation of the Pediatric Patient

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Intubation of the Pediatric Patient

 Inadequate oxygenation or ventilation  Airway obstruction  Loss of protective airway reflexes (e.g., depressed cough and gag reflexes)  Excess work of breathing  Nonresponsive and apneic CONTRAINDICATIONS  Absolute Contraindications     None for unstable…

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Intubation: Tracheal and Nasotracheal

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Intubation: Tracheal and Nasotracheal

Rapid sequence intubation (RSI) is the preferred method of emergency airway management. It involves the near simultaneous administration of fast-acting induction and neuromuscular blocking agents to achieve optimal intubating conditions…

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Cricothyroidotomy—Standard and Needle

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Cricothyroidotomy—Standard and Needle

 To provide emergent airway access only when a safer, less invasive airway cannot be established or is contraindicated  For children younger than 12 years, needle cricothyroidotomy is the surgical airway…

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Emergency Department Thoracotomy

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Emergency Department Thoracotomy

 Penetrating Chest Trauma     Traumatic arrest with witnessed signs of life* in the field     Persistent hypotension (systolic blood pressure (SBP) <60 mm Hg) despite resuscitative efforts  Blunt Trauma     Traumatic arrest that…

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Digital Nerve Block

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Digital Nerve Block

 Used to provide local anesthesia to the digits for repair, reduction, or drainage     Lacerations     Nail bed injuries     Infections (i.e., felons, paronychias)     Amputations     Fractures or dislocations CONTRAINDICATIONS  Absolute Contraindications     Transthecal technique…

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Paracentesis

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Paracentesis

Paracentesis is the removal of fluid from the peritoneal cavity through the use of a needle for either therapy (to relieve patient symptoms) or diagnosis (to determine causes or complications…

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Elbow Dislocation and Reduction

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Elbow Dislocation and Reduction

 Clinical suspicion of acute anterior, posterior, lateral, medial, or divergent dislocation with or without neurovascular compromise     The clinical presentation depends on the type of dislocation     Suspected dislocation is clinically confirmed…

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Lumbar Puncture

Aug 9, 2016 by in EMERGENCY MEDICINE Comments Off on Lumbar Puncture

 Used to obtain cerebrospinal fluid (CSF) and to measure the opening pressure of the subarachnoid space to aid in the evaluation and management of patients with acute headache or other…

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