Rectal Prolapse Reduction
A rectal prolapse is when one or all layers of the rectal mucosa protrude out through the anal opening (FIGURE 32.1). Complete prolapse occurs when all layers of the rectum…
Patellar Dislocation and Reduction
Clinical suspicion of patellar dislocation The knee is held in 20 to 30 degrees of flexion An obvious deformity is typically seen Dislocated patella on x-ray (anteroposterior [AP] or sunrise…
Delayed Sequence Intubation
A strategy of time separation between the administration of a dissociative induction agent and the neuromuscular blocker to allow preintubation optimization. INTRODUCTION Delayed sequence intubation (DSI) differs from rapid sequence…
Hallpike Test (Dix-Hallpike, Nylan-Barany)
Used to confirm the diagnosis of benign paroxysmal positional vertigo (BPPV) of the posterior semicircular canal CONTRAINDICATIONS Unstable heart disease Ongoing cerebrovascular ischemia Severe cervical degenerative arthritis High-grade carotid stenosis…
Bedside Aorta Ultrasonography
Clinical suspicion of abdominal aortic aneurysm (AAA) Unexplained abdominal, back, or flank pain, particularly in the older patient Unexplained hypotension Syncope in the setting of abdominal pain Palpable and/or pulsatile…
Paronychia: Incision and Drainage
A localized infection at the nail fold and/or around the nail plate INDICATIONS Failed spontaneous drainage or improvement despite warm soaks CONTRAINDICATIONS Herpetic whitlow Coagulopathy General Basic Steps Analgesia Incision…
Bedside Gallbladder Ultrasonography
Clinical suspicion of cholecystitis or biliary colic: Abdominal pain, particularly right upper quadrant (RUQ), epigastric Right flank pain Right shoulder pain Nausea/vomiting Sepsis without source CONTRAINDICATIONS None: No contrast or…
Epley Maneuver
Used to treat posterior canal benign paroxysmal positional vertigo (BPPV) that has been confirmed through a positive Hallpike test (upbeat, ipsilateral, and torsional nystagmus in the head-hanging position) This is…
Arthrocentesis Appendix: Joint Fluid Analysis
Normal Fluid An ultradiasylate of plasma with protein and hyaluronic acid Clear to straw colored Viscosity of oil Crystals Gout Monosodium urate (MSU) crystals Negative birefringence Needle shaped Pseudogout Calcium…
Meconium Aspirator as Airway Suction Device
To suction/intubate a patient with significant blood, emesis, or secretions within the airway CONTRAINDICATIONS Contraindications to direct laryngoscopy SUPPLIES All necessary supplies for intubation (see Chapter 1) Endotracheal tube (ETT)…
