“To Do or Not to Do an Emergency Department (ED) Resuscitative Thoracotomy”: Alternatives to ED Thoracotomy at Non-Trauma Centers

While resuscitative thoracotomy and REBOA are often viewed as heroic procedures, both carry an exorbitant amount of mortality and morbidity, and few centers around the country are able to competently offer these options. It seems appropriate to consider alternatives, especially with the emergence of bedside ultrasound and its increasing applicability in the emergency setting. PEAC or US-guided PEAC may be more feasible, performable by mostly untrained staff, and may temporize bleeding to permit transfer to definitive care.

Community EM, TraumaAndy BeckFebruary 7, 2020#FOAMed, TraumaComment

Adding Salt to the Wound

A 28-year-old male with no past medical history presents to the emergency department with two days of gradually worsening right index finger pain and swelling. The patient reports that he works on a saltwater fishing boat and frequently has cuts on his hand. A few days ago, he noticed worsening pain and swelling to a cut on his right index finger. Today, the pain worsened and he is having difficulty bending his finger. He states that the pain radiates from his index finger up his hand and right forearm. He has not had any fevers and there is no associated numbness or tingling…

Community EMAlyssa MierjeskiDecember 20, 2019Community EM, FTSComment

Brown EM Whit-ticisms: Mandible Reduction

Procedures, Orthopedics, Community EM, Whit-ticismsGuest UserNovember 22, 2019#FOAMed, Mandible ReductionComment

Extra Dry or Up With a Twist? A Take on The ‘Migraine Cocktail’

You’re seeing a patient in the community emergency department with a primary headache disorder. Based on your history & physical examination skills, you have considered and ruled out all dangerous secondary headache causes such as intracranial hemorrhage, sentinel bleed, meningoencephalitis, abscess, tumor, temporal arteritis, hypertensive encephalopathy, acute angle closure glaucoma, etc. With many classes of treatments available, providers have typically used some form of a ‘migraine cocktail’ including IV prochlorperazine, IV ketorolac, IV diphenhydramine, IV dexamethasone, and/or IV normal saline…

Contact

Subscribe