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…
Lateral Canthotomy
Orbital compartment syndrome (OCS) is an ocular emergency that is characterized by increased intraocular pressure (IOP). If untreated, optic nerve ischemia will develop, resulting in irreversible vision loss in as…
Intraosseous Vascular Access
Used as emergent vascular access for fluid resuscitation and drug infusion when unable to obtain peripheral venous access Primarily used in pediatric cardiac arrest—generally a faster access than central line…
Bedside Renal Ultrasonography: Limited, Goal-Directed
Confirmation of the diagnosis of obstructive uropathy in patients suspected of ureteral colic Abdominal or flank pain Hematuria Groin pain Acute urinary retention Known or suspected acute renal failure Laboratory…
Perimortem Cesarean Section
Gravid patient with a potentially viable fetus of ≥24 weeks’ gestational age and imminent maternal death or unresponsive to cardiopulmonary resuscitation (CPR) for 5 minutes Survival of mother and infant…
Vaginal Breech Delivery
Presentation of the infant buttocks or feet before the head Considered a high-risk delivery even among seasoned obstetricians PRESENTATION TYPES Frank breech—fetus with bilateral hip flexion and knees extended with…
