Nasotracheal intubation is an essential skill that allows a flexible approach to airway management. The BAAM device can speed and simplify both your blind and fiberoptic nasotracheal intubations. Instructions on proper use including patient selection.
An unconventional approach for treatment for ventricular storm may be an ultrasound-guided block of the stellate ganglion which provides sympathetic stimulation of the heart. This may reduce cardiac irritability and facilitate defibrillation.
My preferred method is the anterior-medial approach. Place the patient in the supine position with knee flexed, and foot plantar flexed and resting flat on the bed. An high-frequency linear probe is most useful for identifying the detailed structures. Using a combination of palpati
Zones of the Neck Defined by mandible, cricoid cartilage, and sternal notch. Most injuries sustained in Zone II, especially carotid injuries Zone I mortality high due to intrathoracic injuries. Posterior triangle with few vital structures. Important exception is subclavian at risk
Cardiac pacemakers and their malfunctions are often daunting for the emergency physician to diagnose and manage. This is the first part of a series covering this area. Part 1. Pitfalls and pearls of temporary transvenous pacing. Part 2. Procedural instructions for placing a transve
Tuberculosis is an endemic problem through most of the world. However, when it presents as active pulmonary disease in the United States, especially in nonimmigrrant, it is usually early in the disease process. This patient a native resident, had delayed seeking care for months. The c
Globe rupture is more often occult on presentation. The most frequent sites of rupture are not easily visualized, and more superficial injuries may block examination of the posterior segment. Very small sharp foreign bodies can enter the eye through small wounds that are difficult to visualize. Our institution has developed the following protocol for evaluation of clinically non-apparent ruptured globe injuries.
Venous air can be seen as incidental finding seen during routine contrast CT scans. This can also occur during IV placement if poor technique is used. The air typically collects in the right ventricle or proximal aorta, and is usually harmless.
Fracture of the base of the first metacarpal bone which extends into the carpometacarpal joint. This intra-articular fracture is the most common type of fracture of the thumb. Caused by an axial force directed against the partially flexed metacarpal, such as during a fight or fall
Reverse takotsubo (stress cardiomyopathy) with hyperdynamic apex and complete akinesia of the base (as opposed to the classic apical ballooning).
The leads V4-V6 are removed and substituted for V7-V9 as shown below. On most EKg machines, the labels areno automatically changed so it is important to cross out the labels for V4-V6 and write in V7-V9. It is also helpful for future clinicians, if you note in your read that it is a p
A 45-year-old man with severe coronary heart disease s/p CABG but with an unprotected left main, presented to the emergency department for evaluation and suffered a ventricular fibrillation cardiac arrest. CPR and BVM ventilation was initiated immediately. The patient underwent an