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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Retention of Simulation-Based Training for Emergency Procedures

Simulation-Based Training
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Emergency Procedures, Endotracheal Intubation, Featured, King Tube, Lumbar Puncture, Paracentesis, Pericardiocentesis, Thoracentesis
More Tags – emergency Simulation, Simulation training, Simulation Training for Lumbar Puncture
Critical emergency skills are an important tool in a healthcare provider’s arsenal. They must be able to safely perform emergency procedures to save lives when faced with a critical situation.  However, once they finish their studies and training, many physicians…
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How Hospitals Can Tap into the Power of Emergency Medicine PAs

emergency medicine PA
Dr. Rick Rutherford, M.D., FAAFP
More Articles – Arterial line, Central line, Emergency Procedures, Endotracheal Intubation, FAST Exam, Featured, Lumbar Puncture, Medical General, Paracentesis, Procedural Sedation, Thoracentesis
More Tags – emergency medicine PA
Delays to hospital inpatient admission in excess of five hours from arrival at an Emergency Department (ED) lead to a mortality rate of 8.71%. This increases by another 8% in cases where admission is delayed beyond six to eight hours. …
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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
Joseph Esherick, M.D., FAAFP, FHM
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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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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Basic Emergency Procedures You Should Know

emergency procedures - small
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Intraosseous line, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Needle Decompression, Paracentesis, Procedural Sedation, RUSH Exam, Thoracentesis, Ultrasound-Guided Peripheral IV
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
Physicians, physician associates (PAs), and nurse practitioners (NPs) need to be adept in a range of essential medical emergency procedures that they must perform in an inpatient settings. These bedside procedures are accomplished readily, but only if you have the…
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Live CME Course vs Online CME Course. Which One to Choose?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Intraosseous line, King Tube, Lumbar Puncture, Medical General, medical procedures, Paracentesis, RUSH Exam, Thoracentesis
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
A Continuing Medical Education (CME) Course is designed for doctors, nurses, nurse practitioners, physician associates and other healthcare professionals who want to learn more about certain topics in medicine.  The primary goal of CME is to improve the quality of…
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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
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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The Case for Simulation Based Training for Bedside Hospital Procedures

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Cardiovascular diseases, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Featured, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Paracentesis, Thoracentesis
More Tags – E-FAST, featured, HPC updates, lumbar puncture, paracentesis, POCUS, RUSH Exams, Simulation Based Training; Central Line Training, simulation-based procedural training, thoracentesis, Vascular access
For decades the mantra for procedural education in medicine has been “see one-do one-teach one”.  Those of us who learned bedside procedures and point-of-care ultrasound by this model understand that this approach does not optimize safe and competent performance.   At…
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Procedural Competency in Academic Emergency Medicine Attending Physicians

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Emergency Procedures, Endotracheal Intubation, Featured, Intraosseous line, Lumbar Puncture, medical procedures, Paracentesis, Pericardiocentesis, Procedural Sedation, Respiratory diseases, Thoracentesis
More Tags – ACLS, chest tube placement, difficult airway management, endotracheal intubation, featured, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, pericardiocentesis, procedural sedation, thoracentesis, tube thoracostomy
A recent article summarizes a cross-sectional survey aimed at determining the processes in place to assess the procedural competency of academic emergency medicine attendings.[i] The survey was sent to the 39 ACGME-accredited Emergency Medicine programs in the U.S. and had…
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Simulation Based Training Improves Airway Management Skills

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Endotracheal Intubation, Featured Procedure, Gastrointestinal diseases, Glidescope Intubation, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Paracentesis, Respiratory diseases, Thoracentesis
More Tags – airway management, central lines, endotracheal intubation, Glidescope intubation, King tube, laryngeal mask airway, lumbar puncture, paracentesis, thoracentesis
Simulation-based procedural training has been shown to improve procedural competence, safety, operator confidence and most importantly patient safety for every bedside procedure studied.  Now, a new systematic review and meta-analysis confirms that simulation-based training in airway management improves procedural competence…
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Periprocedural Bleeding Risk for Thrombocytopenia, Coagulopathy, Antiplatelets and Anticoagulation

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Chest Tube, Featured Procedure, Hematology, Lumbar Puncture, Medical General, medical procedures, Paracentesis, Thoracentesis
More Tags – anticoagulation, antiplatelets, central lines, chest tubes, coagulopathy, featured procedure, HPC updates, lumbar puncture, paracentesis, procedures, thoracentesis
This blog summarizes the 2019 Society of Interventional Radiology (SIR) for Periprocedural Management of Image-guided Procedures with regards to thrombocytopenia, coagulopathies, antiplatelets and anticoagulation.  The SIR guidelines are summarized as follows: Anticoagulation with heparin, LMWH, fondaparinux, argatroban, warfarin, DOAC, clopidogrel, ticagrelor…
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Incidence of Spinal Hematoma from Lumbar Punctures in Patients with a Coagulopathy or Thrombocytopenia

Lumbar Puncture CME
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Hematology, Lumbar Puncture, medical procedures
More Tags – coagulopathy, epidural hematoma, featured, HPC updates, lumbar puncture, thrombocytopenia
A recent cohort study using the Danish nationwide medical registry demonstrates that the incidence of a spinal or epidural hematoma from lumbar punctures in patients with pre-existing thrombocytopenia (Platelets<150 K) or coagulopathy (INR>1.4 or aPTT>39 seconds) is not significantly higher…
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Risk of Epidural Hematoma from Lumbar Puncture in Patients with a Coagulopathy

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Hematology, Lumbar Puncture, medical procedures
More Tags – coagulopathy, epidural hematoma, featured, HPC updates, lumbar puncture, thrombocytopenia
Class 1 evidence to inform decisions about the safety of lumbar punctures in patients with a coagulopathy are lacking. The only guidance we have regarding the safety of lumbar punctures is based on clinical guidance from organizations such as the…
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