Hospital Procedures Consultants

Ultrasound-guided Central Venous Access: Are Landmarks a Thing of the Past?

More Articles – Central Line, central line placement, Central Venous Catheter, Featured Procedure, HPC Updates, Procedure Blog of the Week, Ultrasound-Guided Central Line Insertion, ultrasound-guided procedures
More Tags – , , , ,
Point-of-care ultrasound is one of the most rapidly evolving areas of medicine.  In addition to becoming the “stethoscope of the future” for bedside diagnostic evaluations, ultrasound has improved the safety and efficiency of a wide range of procedures.  The use…
Read More

Simulation Based Training Improves Airway Management Skills

More Articles – Airway management, Endotracheal Intubation, Featured Procedure, Glidescope Intubation, HPC Updates, Intubation, King Tube, Laryngeal Mask Airway, Procedure Blog of the Week
More Tags – , , , , , , , ,
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…
Read More

Simulation Based Training for Central Venous Catheters

More Articles – Central Line, central line placement, Central Venous Catheter, Featured Procedure, HPC Updates, Procedure Blog of the Week, Simulation Based Training, Ultrasound-Guided Central Line Insertion
More Tags – ,
Does Simulation Based Training Improve Central Line Success Rates? Simulation-based procedural training has become increasingly popular in academic medical centers and among medical trainees.  Limited data has suggested that simulation based training improves success rates and safety, but evidence has…
Read More

Do we really need to do a modified Allen’s Test before Radial Arterial Line Insertion?

More Articles – Arterial Lines, Featured Procedure, Procedure Blog of the Week
More Tags – , ,
It has long been Dogma that an abnormal modified Allen’s test is a contraindication to performing a radial arterial line in that arm.  The theory behind this is that the modified Allen’s test will identify patients who have insufficient collateral…
Read More

Troubleshooting Difficult Intubations

More Articles – Airway management, Endotracheal Intubation, Featured Procedure, Procedure Blog of the Week
More Tags – , , , ,
Have you ever been able to see the vocal cords during direct laryngoscopy but you weren’t able to pass the endotracheal tube cuff beyond the cords?  This occurs not too infrequently during endotracheal intubation and I am going to share…
Read More

Video laryngoscopy has a superior first pass success rate compared with direct laryngoscopy in the ICU

More Articles – Airway management, direct laryngoscopy, emergency procedures, Endotracheal Intubation, Featured Procedure, Glidescope Intubation, HPC Updates, Intubation, Procedure Blog of the Week, video laryngoscopy
More Tags – , , , , ,
Video laryngoscopy is superior to direct laryngoscopy for emergency intubations in the ICU. A recent meta-analysis based on nine trials evaluated 2,133 ICU patients and concluded that video laryngoscopy (VL) has a higher first pass success rate compared to direct…
Read More

Optimal Location for Needle Decompression For A Tension Pneumothorax

Hospital Procedure Consultants
More Articles – Needle Decompression, Procedure Blog of the Week
More Tags – , , ,
Optimal Location for Needle Decompression For A Tension Pneumothorax Traditionally, needle decompression for the emergent treatment of a tension pneumothorax is the second intercostal space in the mid-clavicular line.  This remains an option for needle insertion when you are treating…
Read More

Early Goal Directed Therapy for Sepsis: No Longer?

More Articles – Central Line, central line placement, Central Venous Catheter, HPC Updates, Procedure Blog of the Week, Sepsis, Septic Shock
More Tags –
In 2001, the Rivers trial showed that Early Goal Directed Therapy for septic shock resulted in a 16% absolute mortality risk reduction1. In the treatment arm of this trial, septic patients with a lactate above 4 mmol/L or systolic blood…
Read More

Does Cricoid Pressure Prevent Aspiration During Endotracheal Intubation?

More Articles – Airway management, Endotracheal Intubation, Glidescope Intubation, intermediate airways, King Tube, Laryngeal Mask Airway, Procedure Blog of the Week
More Tags – , , , , ,
There has always been some controversy about the utility of applying cricoid pressure (aka Sellick Maneuver) during rapid sequence intubation for the purpose of preventing aspiration.  Theoretically, applying pressure on the cricoid cartilage posteriorly should occlude the esophagus against the…
Read More

Should Endotracheal Intubation Become a Videogame?

More Articles – Endotracheal Intubation, Glidescope Intubation, HPC Updates, Procedure Blog of the Week
More Tags – , , , ,
Direct vs Video Laryngoscopy In 1878 William MacEwan first passed a tube into the trachea of an awake patient using his fingers as a guide.  Now health care providers routinely perform endotracheal intubation as a life saving intervention.  Despite over…
Read More

MRI is useful to distinguish between residual clot versus acute recurrent DVT

More Articles – Deep venous thrombosis, HPC Updates, Procedure Blog of the Week, venous thromboembolism
More Tags – , , ,
Frequently the combination of a serum D-dimer level and compression ultrasound testing can differentiate between a residual venous clot and an acute recurrent DVT.  However, sometimes the results are equivocal and in these situations an MRI direct thrombus imaging can…
Read More

Isolated free fluid on CT Imaging after Blunt Abdominal Trauma: Explore or Wait?

More Articles – emergency procedures, HPC Updates, Procedure Blog of the Week, Trauma CME
More Tags – ,
Patients with minimal free fluid and no abdominal tenderness can be observed, while patients with moderate-large amounts of free fluid and abdominal tenderness should undergo operative exploration. To determine if operative exploration or observation is the preferred management for hemodynamically…
Read More

Continuous capnography beneficial during mechanical ventilation

More Articles – HPC Updates, Mechanical Ventilation, Procedure Blog of the Week
More Tags – , ,
The American Association of Respiratory Care developed a clinical policy describing the benefit of continuous capnography during mechanical ventilation.  This policy statement recommends continuous capnometry during mechanical ventilation for a number of reasons:   1.  It confirms that the endotracheal…
Read More

Categories

Menu