Ultrasound-Guided Pericardiocentesis: Benefits and Techniques

Joseph Esherick, M.D., FAAFP, FHM
More Articles – ACLS, Featured, medical procedures, Pericardiocentesis
More Tags – Apical Technique, Parasternal Technique, pericardiocentesis, Subxiphoid Technique, Ultrasound-Guided, Ultrasound-Guided techniques
Pericardiocentesis Pericardiocentesis or a pericardial tap is a life-saving invasive medical procedure that physicians perform to eliminate a pericardial effusion, built-up fluid in the pericardium or the pericardial sac. This double-walled fibrous sac protects the heart and big vessels while…
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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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Point-of-Care Ultrasound in the Emergency Department

Point-of-Care Ultrasound in the Emergency Department
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Emergency Procedures, FAST Exam, Featured, medical procedures, RUSH Exam
More Tags – POCUS, pocus in emergency, pocus training, Point-of-Care Ultrasound in the Emergency Department
Ultrasound technology has revolutionized the medical industry and provided physicians with the ability to visualize internal tissue and organs in real time. Advancements and changing trends in medical technology have also seen smaller and more affordable ultrasound machines cropping up…
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Ultrasound-Guided Paracentesis

Ultrasound-Guided Paracentesis
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Featured, King Tube, medical procedures, Paracentesis
More Tags – Administering Ultrasound-Guided Paracentesis, paracentesis contraindications, paracentesis procedures, Patient Preparation for Paracentesis
Ultrasound-guided paracentesis is a common hospital procedure that medical professionals perform to drain ascites in patients with advanced cirrhosis. It has a low bleeding risk and is used for diagnostic or therapeutic purposes. Although paracentesis is generally a safe procedure,…
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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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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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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

Joseph Esherick, M.D., FAAFP, FHM
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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Early Paracentesis in Patients Admitted With Cirrhotic Ascites

refractory ascites
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured Procedure, medical procedures, Paracentesis
More Tags – Cirrhotic ascites, cirrhotic symptoms, Early Paracentesis, featured, paracentesis
Cirrhosis refers to a chronic liver disease that causes the liver’s normal architecture to change. It leads to scarring, the formation of fibrous tissue, and fluid (ascites) in the abdomen. Some cases may require invasive hospital procedures. Ascites is cirrhosis’…
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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, Internal Jugular Central Line, PICC in patients who may need hemodialysis, PICC in patients with chronic kidney disease, 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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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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