If patients’ lymphatic systems aren’t working efficiently, they can experience water retention (edema) in various parts of their bodies. Edema commonly occurs when patients have an infection, kidney disease, venous insufficiency, heart failure, or cirrhosis of the liver. This abnormal…
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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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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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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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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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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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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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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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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 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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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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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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Rapid Ultrasonography in Shock:  Is this really useful? Caring for patients with undifferentiated hypotension, causes anxiety for most health care providers.  This is natural.  Fear, however, must not lead to hesitation or poor decision-making.  Therapies chosen early in shock disproportionately…
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