Recent studies have determined the best technique for improving the safety of thoracentesis. The patient should be sitting as upright as possible. Then, ultrasound the posterior back and locate a catheter insertion point at least 6 cm lateral to the…
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Pediatric lumbar punctures can have much higher success rates when proper positioning and technique are emphasized. The position should be the lateral decubitus position with hips flexed, but the neck does not need to be flexed. The spinal cord ends…
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Recently, a retrospective review of over 14,000 adult patients who underwent general anesthesia were assessed. A multivariable analysis was used to determine risk factors of difficult laryngeal mask airways (LMA). The following four risk factors were identified: male gender, age…
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Previous trials have investigated the use of B-type natriuretic peptide (BNP) to assess patients with dyspnea in the ED. The sentinel trial was the BNP (Breathe Not Properly) trial that evaluated nearly 800 patients presenting to the ED with complaints…
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A study was executed to decipher the best cut-off point for a positive Allen’s test. Ninety-three hands of 47 patients undergoing coronary artery bypass surgery were screened. The average age of the patients was 63.3 years. Independent observers examined these…
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Target Audience: Emergency clinicians Background: A multidisciplinary group of emergency physicians, radiologists, cardiologists, and others has developed appropriateness criteria for the use of imaging to help inform clinicians for four clinical scenarios presenting as chest pain in the ED. Key…
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Every four years the American College of Chest Physicians (ACCP) disseminates a new set of guidelines on the evaluation and management of venous thromboembolic disease (VTE). The ACCP just released its updated guidelines for the treatment of VTE and I…
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More Articles – Cardiovascular diseases, Chest Tube, Hematology, King Tube, Medical General, medical procedures, Thoracentesis, Traumatology
A prospective cohort single center study was conducted to analyze the risk associated with patients undergoing thoracentesis or small-bore chest tube placement while taking clopidogrel. Twenty-five patients taking clopidogrel gave consent to remain on the antiplatelet medication while undergoing thoracentesis…
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More Articles – Infections, Lumbar Puncture, Medical General, medical procedures, Neurological diseases
Prior to the revised Swedish lumbar puncture guideline, a CT scan was often performed prior to lumbar puncture when acute bacterial meningitis was suspected. Taking the time to perform a CT scan of the head before lumbar puncture delays treatment…
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More Articles – Arterial line, Cardiovascular diseases, Chest Tube, Emergency Procedures, Hematology, Medical General, medical procedures
These guidelines are for physicians who care for patients with return of spontaneous circulation (ROSC) after cardiac arrest, including emergency physicians, critical care physicians, and cardiologists These guidelines update the 2010 International Liaison Committee on Resuscitation guidelines for patients with…
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More Articles – Arterial line, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, FAST Exam, Glidescope Intubation, Hospital Procedures, King Tube, Lumbar Puncture, Medical General, medical procedures, Needle Decompression, Paracentesis, RUSH Exam, Thoracentesis, Ultrasound-Guided Peripheral IV
Hospitalists are in the ideal position to perform bedside procedures on their patients. They know every aspect about their patients and have had the opportunity to develop a good rapport and the trust of their patients. So, why are they…
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A Canadian team has performed a population-based case-control study in Ontario to determine whether this interaction might confer risk for sudden death, which can be triggered by hyperkalemia. During an 18-year period, 349 patients (age, ≥66) died suddenly while taking both…
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More Articles – Emergency Procedures, Hematology, Medical General, medical procedures, Respiratory diseases
Most patients with pulmonary embolism (PE) do well, and outpatient management is becoming more common. Predicting which patients will have complications would be valuable in order to triage patients for discharge or admission to a ward or intensive care unit…
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CHOOSING WISELY RECOMMENDATIONS FROM THE CRITICAL CARE SOCIETIES COLLABORATIVE 1. Don’t order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions. Many diagnostic studies (including chest radiographs, arterial blood gases, blood chemistries…
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EEG in the Evaluation of Patients with Coma and Other Disorders of Consciousness The clinical evaluation of disorders of consciousness involves the challenge of distinguishing coma from vegetative state (VS) and from minimally conscious state (MCS). Recent neuroimaging studies have…
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