Peudoexudative Pleural Effusions: Correctly Reclassifying Transudate Effusions

Pseudoexudative pleural effusion
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Featured Procedure, Hospital Procedures
More Tags – pleural effusion
Pleural effusions occur when excessive fluid such as blood or pus accumulates between the visceral pleura and parietal, known as the pleural cavity. Evaluating patients for pleural effusions involves certain challenges. However, prompt diagnosis and treatment are essential to reduce…
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Bacterial Meningitis Diagnosis and Management

bacterial meningitis diagnosis
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Hospital Procedures, Lumbar Puncture
More Tags – diagnosis for bacterial meningitis, treatment for meningitis
The number of bacterial meningitis cases is over 1.2 million each year while 1 in 10 people who have it may die from the infection despite receiving treatment. Bacterial meningitis is an extremely serious and life-threatening condition requiring prompt diagnosis.…
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Basic Management of Refractory Ascites: Part 2

refractory ascites
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Hospital Procedures
More Tags – refractory ascites life expectancy, what is refractory ascites
In the first part of this article, we covered that ascites occur when excessive fluid accumulates in the peritoneal cavity. Such occurrences must be treated with diuretics, paracentesis, and possibly TIPPS procedure. We also mentioned how refractory ascites occurs when…
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Clinical Uses of POCUS for Emergency and Hospital Clinicians

clinical uses of pocus
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, Featured, Hospital Procedures, medical procedures, Ultrasound-Guided Peripheral IV
Point-of-care ultrasound (POCUS) is a revolutionary diagnostic method that helps enhance physical examination at the point of care, that is, the patient’s bedside. Clinicians can use this tool to quickly diagnose medical conditions and guide treatment or bedside procedures, including…
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Conscious Sedation. What It Is, When to Apply It, and the Latest Updates

concious-sedation
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, Hospital Procedures, King Tube, Laryngeal Mask Airway, Medical General, medical procedures, Procedural Sedation
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
Conscious sedation, also known as procedural sedation, is a common practice in emergency departments for patients undergoing painful or anxiety-provoking procedures.  It is intended as a less invasive method. Generally, those who undergo this type of sedation can recover more…
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Airway Management Pearls to Optimize Your Chances of Securing an Airway

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Emergency Procedures, Featured, Hospital Procedures, Medical General, medical procedures, Procedural Sedation, Respiratory diseases
More Tags – airway management, Bougie, delayed sequence intubation, difficult airway, endotracheal intubation, featured, HPC updates, intubation, King tube, LMA, mechanical ventilation, rapid sequence intubation
TOP TEN AIRWAY MANAGEMENT PEARLS TO OPTIMIZE YOUR CHANCES OF SECURING AN AIRWAY Develop a difficult airway management plan Huddle with your nurse and respiratory therapist in advance to alert everybody what plan A/B/C/D are for the patient If plan…
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Recommendations for Invasive Hospital Procedures in Patients with Cirrhosis

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Chest Tube, Featured, Gastrointestinal diseases, Hospital Procedures, Paracentesis, Thoracentesis
More Tags – Arterial line placement, central line placement, chest tube placement, cirrhosis, DIC, featured, HPC updates, hyperfibrinolysis, paracentesis, thoracentesis, tube thoracostomy
This blog aims to summarize the data available on how to safely perform invasive hospital procedures in patients with cirrhosis. Unfortunately, no prospective randomized controlled trials have been conducted to inform the practice of procedural medicine in cirrhotic patients. Therefore,…
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Informed Consent and Ethical Challenges During the COVID-19 Pandemic

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Hospital Procedures, Medical General, medical procedures, Respiratory diseases
More Tags – COVID, CPR, featured, HPC updates, Informed consent
Informed consent can be challenging during “normal” times, but it has become increasingly complicated during the COVID-19 pandemic. The informed consent process ensures that a patient or their surrogate decision-maker understands the benefits, potential risks and any alternatives of a…
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Management of Vasopressor Extravasation Injuries

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Featured, Hospital Procedures, Ultrasound-Guided Peripheral IV
More Tags – central lines, extravasation injuries, featured, HPC updates, norepinephrine, phenylephrine, Vasopressor
Peripheral vasopressor infusions are generally safe at low-moderate doses and for short durations, but you must watch the patient carefully for extravasation that can cause serious tissue injury. Traditionally, central lines were placed for administration of vasopressor infusions at any rate. We…
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Which cirrhotic patients are at high risk for bleeding during hospital procedures?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Featured, Gastrointestinal diseases, Hospital Procedures, Lumbar Puncture, medical procedures, Paracentesis, Ultrasound-Guided Peripheral IV
More Tags – Arterial line placement, central line placement, chest tubes, cirrhosis, featured, HPC updates, lumbar puncture, paracentesis, thoracentesis, tube thoracostomy
This blog will offer some expert recommendations to help guide the safety of hospital procedures at different platelet and coagulation profiles.  Unfortunately, there are no strong evidence-based guidelines for hospital procedures dedicated to the study of patients with decompensated cirrhosis.…
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Why are Patients with Cirrhosis Readmitted to the Hospital?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured Procedure, Gastrointestinal diseases, Hospital Procedures, Medical General, medical procedures
More Tags – Alcoholic liver disease, cirrhosis, featured procedure, HPC updates, Nonalcoholic liver disease, readmission
Patients diagnosed with cirrhosis are regularly admitted and readmitted to the hospital. Statistics show that the 90-day readmission rate is approximately 50%. A recent study analyzed the rate of readmission at 30-days and 90-days and the relevant causes among patients…
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Which cirrhotic patients are at high risk for bleeding during hospital procedures?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Featured Procedure, Hospital Procedures, Lumbar Puncture, medical procedures, Paracentesis, Thoracentesis
More Tags – Bleed risk, central line, HPC updates, paracentesis, Procedures in Cirrhotic Patients, thoracentesis
How do we assess a cirrhotic patients bleed risk prior to a planned bedside procedure?  Can our standard platelet count and coagulation studies, prothrombin time (PT/INR) and partial thromboplastin time (aPTT), accurately predict bleed risk in cirrhotic patients?  The quick…
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