Episiotomy
To prevent severe spontaneous third- and fourth-degree perineal lacerations To increase the diameter of the soft-tissue pelvic outlet to relieve shoulder dystocia To facilitate delivery of fetus having nonreassuring fetal…
Bedside Echocardiography
Identifying the presence or absence of cardiac activity in cardiac arrest Identifying the presence or absence of pericardial effusion and differentiating from pleural effusion Identifying the presence or absence of…
Auricular Hematoma Drainage
A subperichondrial hematoma that separates the perichondrium from the underlying auricular cartilage Result of a shearing force to the ear, but can also develop after blunt trauma The hematoma disrupts…
Dental Nerve Blocks
To provide temporary analgesia for intraoral or facial pain related to the following: Trauma requiring intraoral or facial laceration repair Dental trauma resulting in fractured teeth Infection (tooth abscess, root…
Subungual Hematoma
Trephination: To create a fistula through the nail to the hematoma Decompression, drainage, and pain relief of small subungual hematomas Nail removal and nail bed laceration repair Large hematomas and…
Occipital Nerve Block
Occipital neuralgia is neuropathic pain that is classically described as a persistent dull pain at the base of the skull with intermittent, sudden shocklike pain or paresthesias radiating from the…
Knee Dislocation and Reduction
Clinical suspicion of knee dislocation with neurovascular compromise (FIGURE 63.1) Radiographic evidence of knee dislocation; anterior (associated with popliteal artery traction and intimal tears) more common than posterior (associated with…
Skin and Soft-Tissue Ultrasound
Identify and differentiate cellulitis from abscess with overlying cellulitis Procedural guidance for incision and drainage of abscess Assess soft-tissue masses CONTRAINDICATIONS None RISKS/CONSENT ISSUES Contact dermatitis from ultrasound gel (very…
Elbow Arthrocentesis
Used to evacuate abnormal fluid collections from the joint space for synovial fluid analysis Septic arthritis Crystal arthropathy Hemarthrosis Inflammatory process Used to diagnose occult fracture or ligamentous injury Used…
Peritonsillar Abscess
Clinical suspicion Swollen/red peritonsillar region causing uvular shift Fluctuance of area Interim treatment for peritonsillar closed space infection until tonsillectomy CONTRAINDICATIONS Extension into the deep neck tissue Septicemia/toxic appearance Airway…
