Diagnostic Thoracentesis and Pleural Effusion Analysis

Thoracentesis
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Featured, Thoracentesis
More Tags – cause of pleural effusion, pleural effusion, Pleural Effusion Etiology
Pleural effusion is a common yet complex medical condition that requires tailored and multidisciplinary treatment. Despite being a common disease, its cause remains unknown in at least 20% of patients even after diagnostic workups. Fortunately, pleural fluid tests have improved…
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Retention of Simulation-Based Training for Emergency Procedures

Simulation-Based Training
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Emergency Procedures, Endotracheal Intubation, Featured, King Tube, Lumbar Puncture, Paracentesis, Pericardiocentesis, Thoracentesis
More Tags – emergency Simulation, Simulation training, Simulation Training for Lumbar Puncture
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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How Hospitals Can Tap into the Power of Emergency Medicine PAs

emergency medicine PA
Dr. Rick Rutherford, M.D., FAAFP
More Articles – Arterial line, Central line, Emergency Procedures, Endotracheal Intubation, FAST Exam, Featured, Lumbar Puncture, Medical General, Paracentesis, Procedural Sedation, Thoracentesis
More Tags – emergency medicine PA
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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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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Basic Emergency Procedures You Should Know

emergency procedures - small
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Intraosseous line, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Needle Decompression, Paracentesis, Procedural Sedation, RUSH Exam, Thoracentesis, Ultrasound-Guided Peripheral IV
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…
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Live CME Course vs Online CME Course. Which One to Choose?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Intraosseous line, King Tube, Lumbar Puncture, Medical General, medical procedures, Paracentesis, RUSH Exam, Thoracentesis
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…
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Looking To Work in the ER? Here Are Its Benefits, Challenges, and What To Expect

emergency
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Chest Tube, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Featured, Intraosseous line, King Tube, Lumbar Puncture, medical procedures, Paracentesis, RUSH Exam, Thoracentesis
More Tags – central line placement, E-FAST, featured, HPC updates, intubation, lumbar puncture, paracentesis, RUSH Exams, thoracentesis, tube thoracostomy, Vascular access
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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Dispelling Myths about Thoracentesis and Pleural Fluid Analysis

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Featured, medical procedures, Nephrology, Respiratory diseases, Thoracentesis
More Tags – CHF, diuretics, exudate, featured, HPC updates, Light's criteria, pleural effusions, pleural fluid analysis, re-expansion pulmonary edema, thoracentesis, transudate
There are two myths that have persisted about thoracentesis and pleural fluid analysis that must be dispelled. The first myth is that a large volume thoracentesis should not remove more than 1,500 mL fluid due to the risk of re-expansion…
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What is the true complication rate for thoracentesis?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Emergency Procedures, medical procedures, Respiratory diseases, Thoracentesis
More Tags – featured procedure, hemothorax, HPC updates, pneumothorax, re-expansion pulmonary edema, thoracentesis, thoracentesis complications, ultrasound-guided procedures
Thoracentesis is one of the most common bedside procedures performed in U.S. hospitals.  There are about 173,000 thoracenteses performed each year in the U.S.  A systematic review and meta-analysis in 2010 concluded that thoracentesis-related pneumothorax occurs 6% of the time…
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The Case for Simulation Based Training for Bedside Hospital Procedures

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Cardiovascular diseases, Emergency Procedures, Endotracheal Intubation, Events, FAST Exam, Featured, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Paracentesis, Thoracentesis
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…
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Pearls about Chest Tube Management

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Chest Tube, Featured, Thoracentesis
More Tags – air leak, chest tube placement, Chest tube removal, chest tubes, empyema, featured, hemothorax, HPC updates, parapneumonic effusion, pneumothorax, thoracentesis, tube thoracostomy
Chest tubes, or thoracostomy tubes, have been used since the fifth century BC when Hippocrates described the use of a hollow tin tube to drain fluid that was likely an empyema from his description.[i] Chest tubes started to be used…
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Procedural Competency in Academic Emergency Medicine Attending Physicians

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Emergency Procedures, Endotracheal Intubation, Featured, Intraosseous line, Lumbar Puncture, medical procedures, Paracentesis, Pericardiocentesis, Procedural Sedation, Respiratory diseases, Thoracentesis
More Tags – ACLS, chest tube placement, difficult airway management, endotracheal intubation, featured, HPC updates, intraosseous line placement, intubation, lumbar puncture, paracentesis, pericardiocentesis, procedural sedation, thoracentesis, tube thoracostomy
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 Training Improves Airway Management Skills

https://hospitalprocedures.org/endotracheal-intubation-course/
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Cardiovascular diseases, Central line, Endotracheal Intubation, Featured Procedure, Gastrointestinal diseases, Glidescope Intubation, King Tube, Laryngeal Mask Airway, Lumbar Puncture, Mechanical Ventilation, Medical General, medical procedures, Paracentesis, Respiratory diseases, Thoracentesis
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…
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Periprocedural Bleeding Risk for Thrombocytopenia, Coagulopathy, Antiplatelets and Anticoagulation

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Chest Tube, Featured Procedure, Hematology, Lumbar Puncture, Medical General, medical procedures, Paracentesis, Thoracentesis
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…
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Recommendations for Invasive Hospital Procedures in Patients with Cirrhosis

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Chest Tube, Featured, Gastrointestinal diseases, Hospital Procedures, Paracentesis, Thoracentesis
More Tags – Arterial line placement, central line placement, chest tube placement, cirrhosis, DIC, featured, HPC updates, hyperfibrinolysis, paracentesis, thoracentesis, tube thoracostomy
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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