Arterial Lines Do Cause Bloodstream Infections

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Infections, medical procedures
More Tags – Arterial lines, bloodstream infections, HPC updates, Vascular access
Arterial lines are not completely benign.  They can definitely cause catheter-related bloodstream infections.  This study shows that arterial lines have a rate of bloodstream infection of about 1 in 1,000 catheter days.  Femoral arterial lines have a higher rate of…
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Can ultrasound predict volume responsiveness better than CVP?

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Central line, Medical General
More Tags – point of care ultrasound; IVC ultrasound: volume responsiveness; fluid responsiveness; volume status
For decades we have relied on static measurements of volume status such as central venous pressure, pulmonary artery occlusion pressure and right ventricular end diastolic volume.  CVP has been shown to have little better than a coin toss chance of…
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Massive Price Reduction on HPC Hospitalist and Emergency Procedures CME courses

Hospital Procedure Consultants
More Articles – Arterial line, Emergency Procedures, Medical General, Paracentesis, Thoracentesis
Early Registration Discount for ALL 2014 Hospitalist and Emergency Procedures CME courses is now $150 for physicians and $200 for nurse practitioners, physicians assistants, medical students, resident physicians, and military physicians Click Here for PDF version May 13, 2014 –…
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Procedural Sedation and Analgesia in the ED

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, medical procedures, Procedural Sedation
More Tags – capnography, conscious sedation, HPC updates, procedural sedation
The American College of Emergency Physicians (ACEP) just published a new clinical policy on procedural sedation and analgesia in the emergency department, which revised the previous policy from 2005.1  Procedural sedation (conscious sedation) is extremely common in the ED and…
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What is All the Fuss about Auto-PEEP?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hematology, Mechanical Ventilation, medical procedures, Respiratory diseases
More Tags – Auto-PEEP, hemodynamic monitoring, HPC updates, mechanical ventilation, ventilator
Lungs normally empty by passive recoil and the pressure in the alveoli at end-expiration is the intrinsic positive end-expiratory pressure (PEEP).  During spontaneous respirations and with normal lungs, the PEEP is equal to atmospheric pressure.  On a ventilator, auto-PEEP occurs…
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Informed Consent Discussion for Bedside Procedures

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Hospital Procedures, Medical General, medical procedures
More Tags – bedside procedures, decision-making capacity, HPC updates, Informed consent
I am frequently asked by my residents, “What elements are needed for informed consent?”  The first place to start is the definition of informed consent.  Applebaum defined informed consent as “the process by which the treating health care provider discloses…
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Ultrasound Guided Peripheral IV and Sterile Technique

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Central line, medical procedures, Ultrasound-Guided Peripheral IV
More Tags – central line bundle, HPC updates, peripheral line, sterile technique, Ultrasound guided peripheral IV, ultrasound guided peripheral line, UTZ Guided IV
Is Aseptic Technique for Ultrasound Guided Peripheral Lines Enough? Widespread use of ultrasound guided peripheral intravenous catheters will reduce reliance on central lines, thus decreasing the central line device utilization ratios (DUR).  In theory and practice, high DURs correlate with…
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Ultrasound-Guided Radial Arterial Line

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Arterial line, medical procedures
More Tags – Arterial lines, HPC updates, ultrasound-guided arterial lines, ultrasound-guided procedures
Ultrasound for Radial Arterial Line?   Do I really need to use an ultrasound for radial arterial lines?  For years I have used ultrasound guidance for brachial and femoral arterial line placement because the risk associated with puncturing or lacerating…
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Mortality Prediction Model for Patients with Prolonged Mechanical Ventilation

Hospital Procedure Consultants
More Articles – medical procedures, Respiratory diseases
More Tags – HPC updates, mechanical ventilation
Mortality Prediction Model for Patients with Prolonged Mechanical Ventilation One of the most difficult tasks for critical care physicians is approaching the patient and their families about end-of-life issues.  One scenario that often arises is the scenario of decision making…
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Endotracheal Intubation When You Can’t See the Cords: the Bougie is Your Friend

Hospital Procedure Consultants
More Articles – Emergency Procedures, Endotracheal Intubation, Laryngeal Mask Airway, medical procedures, Respiratory diseases
More Tags – airway management, Bougie, difficult airway management, intubation
Endotracheal Intubation When You Can’t See the Cords: the Bougie is Your Friend This is a problem that every emergency physician or hospitalist faces on occasion and if you haven’t encountered this problem then you haven’t done enough intubations.  There…
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