This post explores the most common tracheostomy issues encountered in the ED with practical tips for management.
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Core
Common Tracheostomy Issues
Journal Review
High-Dose NTG in Acute Pulmonary Edema
Intravenous (IV) nitroglycerin (NTG) infusion is one of the mainstay treatments in acute pulmonary edema (aka acute decompensated heart failure (ADHF)), but is associated with increased hospital length of stay (LOS) and health care costs. Optimal NTG dosing isn’t established though physiologically, higher infusion doses (> 100 mcg/min) are helpful as they affect both afterload and preload.
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Core
Approach to Adult First Time Seizure in the ED
This post delves into the ED assessment and management of a patient presenting with a 1st time seizure.
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Post-It Pearls 5.0
Teaching on a clinical shift can sometimes be difficult: it’s busy, everyone’s running around and it’s hard to capture a trainees attention. Recently, on twitter, Amal Mattu (@amalmattu) has been posting pictures of his white board teaching: discrete pearls written down and shared with anyone who walks by. The pearls are often prompted by patients presenting during that shift but they don’t have to be.
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Journal Review
IO Needle Length in Obese Patients
This post is cross-posted on REBEL EM here.
Thanks to Salim Rezaie for his edits.
Intraosseous (IO) access can play an important role in the resuscitation of the critically ill patient to help expedite delivery of critical medications (i.e. RSI). Much like with peripheral or central access, obesity can present a challenge to placement of an IO as accurate placement relies on use of landmarks which may not be palpable in this group.
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Core
Non-Traumatic Low Back Pain
This post reviews an approach to non-traumatic low back pain in the ED focusing on catching the rare, serious pathology.
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Journal Review
Propofol vs. Ketofol in PSA (The POKER Study)
The ability to perform procedural sedation and analgesia (PSA) is essential to the practice of Emergency Medicine (EM). Which agent an Emergency Provider chooses to use depends on a variety of factors, including provider comfort and preference, ease of access and, most importantly, perceived safety of the medications.
Propofol and Ketamine are two commonly used agents for PSA,
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