Are Lumbar Punctures Safe for Patients Taking Thienopyridines?

lumbar punctures
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Lumbar Puncture, medical procedures
More Tags – lumbar punctures and Thienopyridines, lumbar punctures Safety
Lumbar punctures (LPs) are a common medical procedure that is used to collect cerebrospinal fluid (CSF) to diagnose and manage neurological illnesses. Here, we delve into the results of a new study on the safety of LPs for patients undergoing…
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Evaluation and Management of Infants With Fever

Infants With Fever
Dr. Rick Rutherford, M.D., FAAFP
More Articles – Emergency Procedures, Featured, Lumbar Puncture, Medical General
More Tags – AAP’s guide, lumbar punctures in childrens, lumbar punctures in kids
Fever can be a serious complication in infants aged three months or younger.  Immediate medical intervention is necessary to treat the possible infection, although clinical evaluation can be quite a conundrum. This is because there’s no way of knowing what…
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Manual Aspiration vs Gravity Drainage

Manual Aspiration
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Chest Tube, Featured, medical procedures, Thoracentesis
More Tags – GRAVITAS Trial, Gravity in Thoracentesis, Manual Aspiration in Thoracentesis
Conditions like congestive heart failure, pneumonia, cancer, and lupus can cause excess fluid to accumulate in the pleural space or area between the lungs and chest wall. To aspirate fluid from a pleural effusion, a medical procedure known as thoracentesis…
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What Is Awake Videolaryngoscopy?

Awake Videolaryngoscopy
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Chest Tube, Endotracheal Intubation, Featured, Glidescope Intubation, King Tube, Medical General
More Tags – awake Suctioning, awake videolaryngoscopy, featured procedure, Fibreoptic Intubation
Videolaryngoscopy has quickly become a popular method for airway management because it provides better visuals of the glottis. Failed intubations have decreased since more clinicians have begun to rely on videolaryngoscopy and the greater visibility it provides.  Awake videolaryngoscopy is…
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Intraosseous Lines: Decreased ROSC Rates and Survival Compared to Peripheral IV Access

Intraosseous Lines
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Featured, Intraosseous line, medical procedures
More Tags – intraosseous line placement, intraosseous line vs Peripheral IV Access, intraosseous lines
Intraosseous lines are commonly associated with decreased return of spontaneous circulation or ROSC rates compared to peripheral IV access. Intraosseous lines have also been linked to decreased survival after out-of-hospital and in-hospital cases of cardiac arrest in comparison to IV…
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Pigtail Catheters vs Large-Bore Chest Tubes for Traumatic Hemothorax

Pigtail Catheters
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Chest Tube, Emergency Procedures, Featured, medical procedures
More Tags – Large-Bore Chest Tubes vs pigtail cathethers, pigtail catheters, pigtail catheters for Traumatic Hemothorax, pigtail catheters pros
Traditionally, traumatic hemothorax treatment called for the insertion of a 36-French (36F) to 40F large-bore chest tube (CT). In this article, we’ll delve into a study that shows how 14F percutaneous catheters (P-CATs or PCs) or pigtail catheters have equal…
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Peripheral Administration of Vasopressors and Their Safety

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Central line, Emergency Procedures, Featured, medical procedures, Needle Decompression, Ultrasound-Guided Peripheral IV
More Tags – PIV vasopressor administration, vasopressor administration, vasopressor administration in critical care, vasopressor administration through peripheral intravenous
While vasopressors are typically administered through a central venous catheter (CVC), peripheral intravenous (PIV) administration is becoming more common in clinical practice. The safety of this administration method is now well-established and is a good alternative to CVC placement for…
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Central Line or PICC Line Placement in Patients With CKD

central-line-placement
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Featured, medical procedures
More Tags – Alternatives to PICC, alternatives to picc line, Internal Jugular Central Line, PICC in patients who may need hemodialysis, PICC in patients with chronic kidney disease, picc line for dialysis, picc line placement, PICC line placement for long-term vascular access, Subclavian Central Line
A peripherally inserted central catheter (PICC) line refers to a type of central line that is used for long-term vascular access in patients with chronic kidney disease (CKD). However, the American Board of Internal Medicine’s (ABIM) Choosing Wisely campaign recommends…
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Brachial Arterial Catheterization and Its Low Risk of Complications

Radial arterial line training
Dr. Rick Rutherford, M.D., FAAFP
More Articles – Arterial line, Cardiovascular diseases, Emergency Procedures, Featured
More Tags – arterial sheath vs arterial line, artery catheterization, brachial and radial artery, Brachial arterial catheterization, brachial sheath, Brachial vs Radial Blood Pressure, main brachial artery, radial cardiac catheterization complications
Brachial arterial catheterization is widely chosen for constant blood pressure and hemodynamic monitoring in critically ill patients. It provides real-time measurements of physiologic parameters with a very low incidence of associated risks or complications. In this article, we will revisit…
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Central Line Insertion and Associated Challenges

central line insertion
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Emergency Procedures, Featured, medical procedures
More Tags – central line, Central line insertion, central line insertion course, hpc course, HPC updates, risk of central line insertion
Central line insertion can be a complicated process that requires proper training to minimize procedural risks. One of its most important aspects is the proper positioning of the patient during the procedure to ensure safety and success. Patients may also…
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When Should You Stop Using Chest Tubes?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Chest Tube, Emergency Procedures, Events, Featured, King Tube, Medical General, medical procedures
More Tags – central line placement, chest tube placement, E-FAST, featured procedure, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, POCUS, RUSH Exams, thoracentesis, tube thoracostomy, Vascular access
Thoracostomy or the insertion of chest tubes (CTs) is a frequent procedure in clinical practices. After inserting chest tubes in the patient’s pleural cavity, they become a route for administering antibiotics, sclerosing agents, fibrinolytics, and saline.  Meanwhile, indwelling pleural catheters…
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Role of Ultrasound in Lumbar Punctures

lumbar-punctures
Dr. Rick Rutherford, M.D., FAAFP
More Articles – Cardiovascular diseases, Emergency Procedures, Events, Featured, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Medical General, medical procedures, Ultrasound-Guided Peripheral IV
More Tags – central line placement, chest tube placement, E-FAST, featured, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, POCUS, RUSH Exams, thoracentesis, tube thoracostomy, Vascular access
For procedures involving lumbar punctures , sonographically guided lumbar punctures (SGLPs) have a higher propensity of being chosen when dealing with obese patients. This is based on findings of a randomized controlled trial conducted in 2007. The main takeaway from…
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Looking To Work in the ER? Here Are Its Benefits, Challenges, and What To Expect

emergency
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Featured, Intraosseous line, King Tube, Lumbar Puncture, medical procedures, Paracentesis, RUSH Exam, Thoracentesis
More Tags – central line placement, E-FAST, featured, HPC updates, intubation, lumbar puncture, paracentesis, RUSH Exams, thoracentesis, tube thoracostomy, Vascular access, working in an emergency room
The emergency room (ER) is an essential area of any hospital because it often deals with life-and-death situations. How medical personnel respond significantly affects the prognosis of patients who are in need of urgent care.  As a medical professional, experience…
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Dispelling Myths about Thoracentesis and Pleural Fluid Analysis

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Featured, medical procedures, Nephrology, Respiratory diseases, Thoracentesis
More Tags – CHF, diuretics, exudate, featured, HPC updates, Light's criteria, pleural effusions, pleural fluid analysis, re-expansion pulmonary edema, thoracentesis, transudate
There are two myths that have persisted about thoracentesis and pleural fluid analysis that must be dispelled. The first myth is that a large volume thoracentesis should not remove more than 1,500 mL fluid due to the risk of re-expansion…
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