Clinical Uses of POCUS for Emergency and Hospital Clinicians

clinical uses of pocus
Dr. Rick Rutherford, M.D., FAAFP
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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Peripheral Administration of Vasopressors and Their Safety

Dr. Rick Rutherford, M.D., FAAFP
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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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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Basic Emergency Procedures You Should Know

emergency procedures - small
Dr. Rick Rutherford, M.D., FAAFP
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, emergency medicine procedures, er procedures, 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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Management of Vasopressor Extravasation Injuries

norepinephrine extravasation
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Featured, Hospital Procedures, Ultrasound-Guided Peripheral IV
More Tags – antidote for norepinephrine, central lines, extravasation injuries, extravasation injury, featured, HPC updates, levophed infiltration treatment, norepinephrine, norepinephrine antidote, norepinephrine extravasation, phenylephrine, treatment of norepinephrine extravasation, Vasopressor
Peripheral vasopressor infusions are generally safe at low-moderate doses and for short durations, but you must watch the patient carefully for extravasation that can cause serious tissue injury. Traditionally, central lines were placed for administration of vasopressor infusions at any rate. We…
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Which cirrhotic patients are at high risk for bleeding during hospital procedures?

Joseph Esherick, M.D., FAAFP, FHM
More Articles – Arterial line, Cardiovascular diseases, Central line, Featured, Gastrointestinal diseases, Hospital Procedures, Lumbar Puncture, medical procedures, Paracentesis, Ultrasound-Guided Peripheral IV
More Tags – Arterial line placement, central line placement, chest tubes, cirrhosis, featured, HPC updates, lumbar puncture, paracentesis, thoracentesis, tube thoracostomy
This blog will offer some expert recommendations to help guide the safety of hospital procedures at different platelet and coagulation profiles.  Unfortunately, there are no strong evidence-based guidelines for hospital procedures dedicated to the study of patients with decompensated cirrhosis.…
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A Simple Checklist for Central Lines Saves Lives and Money

Ultrasound-Guided Internal Jugular Line Placement
Joseph Esherick, M.D., FAAFP, FHM
More Articles – Central line, Featured Procedure, medical procedures, Ultrasound-Guided Peripheral IV
More Tags – central line, checklists, HPC updates
Safety checklists have been adopted by numerous industries to prevent errors and save lives.  Checklists have been used for decades by industries as diverse as the aviation industry, construction companies, and professional chefs to prevent mistakes.  In medicine, checklists have…
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The Reasons Hospitalists Should Learn Hospital Procedures

Joseph Esherick, M.D., FAAFP, FHM
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
More Tags – emergency procedures, hospital procedures, HPC updates, medical procedures, simulation-based procedural training
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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Optimal Location for Needle Decompression For A Tension Pneumothorax

Hospital Procedure Consultants
More Articles – Central line, Emergency Procedures, medical procedures, Needle Decompression, Respiratory diseases, Thoracentesis, Ultrasound-Guided Peripheral IV
More Tags – HPC updates, needle decompression, needle decompression 5th intercostal space, needle insertion, needle thoracostomy placement, obstructive shock, pneumothorax
Needle decompression location 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 a tension pneumothorax.  This insertion point…
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Ultrasound Guided Peripheral IV and Sterile Technique

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Central line, medical procedures, Ultrasound-Guided Peripheral IV
More Tags – central line bundle, HPC updates, peripheral line, sterile technique, Ultrasound guided peripheral IV, ultrasound guided peripheral line, UTZ Guided IV
Is Aseptic Technique for Ultrasound Guided Peripheral Lines Enough? Widespread use of ultrasound guided peripheral intravenous catheters will reduce reliance on central lines, thus decreasing the central line device utilization ratios (DUR).  In theory and practice, high DURs correlate with…
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Ultrasound-Guided Peripheral IVs: An Alternative to Central Venous Catheters?

Dr. Rick Rutherford, M.D., FAAFP
More Articles – Central line, Emergency Procedures, medical procedures, Ultrasound-Guided Peripheral IV
More Tags – Ultrasound-Guided Peripheral IV Insertion, ultrasound-guided procedures
One of the most common indications for placing a central venous catheter is “no IV access”.  I certainly have placed numerous central lines for this reason.  Unfortunately, this practice is not without consequences.  In addition to patient discomfort and mechanical…
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