Medical General Archives - Hospital Procedures Consultants

When Should You Stop Using Chest Tubes?

Joseph Esherick, M.D., FAAFP, FHM

January 24, 2023

More Articles – Cardiovascular diseases, Events, Featured, 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…

Role of Ultrasound in Lumbar Punctures

lumbar-punctures

lumbar-punctures

Dr. Rick Rutherford, M.D., FAAFP

January 24, 2023

More Articles – Cardiovascular diseases, Events, Featured, Medical General, medical procedures

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…

Conscious Sedation. What It Is, When to Apply It, and the Latest Updates

concious-sedation

concious-sedation

Joseph Esherick, M.D., FAAFP, FHM

January 20, 2023

More Articles – Cardiovascular diseases, Events, 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

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…

Basic Emergency Procedures You Should Know

emergency procedures - small

emergency procedures - small

Gabriela Delgado

December 30, 2022

More Articles – Cardiovascular diseases, Events, 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

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…

Live CME Course vs Online CME Course. Which One to Choose?

Gabriela Delgado

December 22, 2022

More Articles – Cardiovascular diseases, Events, Medical General, medical procedures

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…

What Is ACCME and Why You Should Know About It Before Taking a Course

ACCME

ACCME

Gabriela Delgado

December 22, 2022

More Articles – Medical General

As an aspiring doctor, nurse, nurse practitioner or physician associate you probably already know how important it is to have a license to practice. Not only does it allow you to work in your field, but it also shows that…

Clinical Pearls for Airway Management of Morbidly Obese Patients

Joseph Esherick, M.D., FAAFP, FHM

August 23, 2022

More Articles – Featured, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

More Tags – airway management, awake intubation, cricothyroidotomy, Difficult Intubation, featured, Glidescope intubation, ketamine, Ketofol, King tube airway, laryngeal mask airway, lorazepam, mechanical ventilation, midazolam, morbid obesity, paralytics, Propofol, video laryngoscopy

Morbidly obese patients can pose numerous challenges when it comes to airway management. Morbid obesity can make vascular access more difficult and you need good vascular access prior to any attempts at safe airway management. In addition, morbid obesity can…

The Case for Simulation Based Training for Bedside Hospital Procedures

Dr. Rick Rutherford, M.D., FAAFP

August 7, 2022

More Articles – Cardiovascular diseases, Events, Featured, Medical General, medical procedures

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…

Dexmedetomidine and Propofol performed equally well for the sedation of mechanically ventilated patients with sepsis

Joseph Esherick, M.D., FAAFP, FHM

April 15, 2022

More Articles – Featured, Medical General, medical procedures, Respiratory diseases

More Tags – ABCDEF bundle, CAM -ICU, Delirium, dexmedetomidine, featured, HPC updates, mechanical ventilation, Propofol, RASS, ventilator, ventilator sedation

The Society of Critical Care Medicine (SCCM) recommends that all mechanically ventilated patients receive analgesia, sedation, and delirium assessment and management while intubated. SCCM reinforced these principles in their 2018 clinical practice guideline on the prevention and management of pain,…

Protocolized Sedation is Recommended Over Usual Care for Mechanical Ventilation

Joseph Esherick, M.D., FAAFP, FHM

April 15, 2022

More Articles – Featured Procedure, Medical General, medical procedures, Respiratory diseases

More Tags – Delirium, featured procedure, HPC updates, mechanical ventilation, Protocolized Sedation, Sedation, Wake-up and Breath Protocol

A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effects of protocolized sedation in mechanically ventilated adult intensive care unit patients. Six randomized controlled trials and 1243 patients were studied. The results showed that protocolized…

Airway Management Pearls to Optimize Your Chances of Securing an Airway

https://hospitalprocedures.org/endotracheal-intubation-course/

https://hospitalprocedures.org/endotracheal-intubation-course/

Joseph Esherick, M.D., FAAFP, FHM

December 6, 2021

More Articles – Cardiovascular diseases, Featured, Medical General, medical procedures, 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…

How to Prevent and Manage Malpositioned Central Lines

Joseph Esherick, M.D., FAAFP, FHM

November 29, 2021

More Articles – Events, Featured, Infections, Medical General, medical procedures

More Tags – central line, central line complications, Central line insertion, central line malpositioning, featured, femoral lines, HPC updates, IJ lines, Simulation Based Training; Central Line Training, subclavian lines

Malpositioned central venous catheters occurs in about 7% of central line placements. A malpositioned central line is any central venous catheter where the tip is located anywhere other than the superior vena cava (SVC) for internal jugular lines or subclavian…

Simulation Based Training Improves Airway Management Skills

https://hospitalprocedures.org/endotracheal-intubation-course/

https://hospitalprocedures.org/endotracheal-intubation-course/

Joseph Esherick, M.D., FAAFP, FHM

November 4, 2021

More Articles – Cardiovascular diseases, Featured Procedure, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

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…

Periprocedural Bleeding Risk for Thrombocytopenia, Coagulopathy, Antiplatelets and Anticoagulation

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2021

More Articles – Cardiovascular diseases, Featured Procedure, Hematology, Medical General, medical procedures

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…

Tips for Management and Bedside Procedures in Critically Ill Patients with COVID Pneumonia

Joseph Esherick, M.D., FAAFP, FHM

October 15, 2021

More Articles – Cardiovascular diseases, Featured, Gastrointestinal diseases, Medical General, medical procedures, Respiratory diseases

More Tags – Arterial line insertion, asystole, cardiac arrest, Central line insertion, COVID pneumonia, CPR, featured, Glidescope intubation, HPC updates, intubation, mechanical ventilation, PEA, push dose pressors, video laryngoscopy

The SARS-COV-2 pandemic started in January 2020 and has decimated the majority of U.S. hospitals for the past 18 months. The impact of COVID-19 has not only affected available hospital beds, but has limited the ability of hospitals to perform…