Three anatomical sites are commonly used to insert central venous catheters, but insertion at each site has the potential for complications including infection, thrombosis and mechanical dysfunction (pneumothorax, hematoma). The authors’ previous research led them to believe that these complications will differ according to the site of insertion.
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Journal Review
Intravascular Complications of Central Line by Insertion Site
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Acromioclavicular (AC) Joint Injuries
AC joint injuries are commonly encountered in upper extremity injuries. This post reviews physical exam, x-ray findings and management.
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Journal Review
REVERT – The Modified Valsalva Maneuver
Supraventricular tachycardias (SVT) (excluding atrial fibrillation and atrial flutter) are common cardiac arrhythmias leading to presentation to the Emergency Department (ED). The Valsava maneuver is a recommended first-line method to cardiovert stable patients, but its reported efficacy is low (5-20%). Chemical cardioversion agents can have unpleasant side effects and require intravenous access. Increasing the success rate from the Valsava maneuver could lead to increased patient comfort and decreased resource utilization.
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Apparent Life-Threatening Event (ALTE)
ALTEs are relatively common presentations requiring thorough assessment and careful consideration for disposition.
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Journal Review
Ketamine vs. Morphine in Acute Pain Management
Ketamine, a noncompetitive N-methyl-D-asparate and glutamate receptor antagonist, is a Phencyclidine-like dissociative agent that possesses potent analgesic, anxiolytic and amnestic properties. In the Emergency Department (ED), ketamine is commonly used for procedural sedation. Outside of the ED, subdissociative doses (0.3 mg/kg), have been successfully used as an adjunct to opiate refractory pain. Recent data has shown that subdissociative doses of ketamine may be comparable to morphine as a first-line agent in out-of-hospital settings.
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Atrioventricular Nodal Reentrant Tachycardia
AVNRT is a frequently encountered tachydsyrhythmia in the ED with multiple management options.
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Journal Review
Isolated Scalp Hematoma in Peds Minor Head Trauma
There are more than 450,000 Emergency Department presentations each year for children with blunt head trauma. 25% of visits for blunt head trauma are in children less than 24 months of age. Scalp hematomas in this age group maybe the only sign of traumatic brain injury (TBI). An astute clinician must clinically assess those with possible TBI,
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Approach to Traumatic Shoulder Pain
This post reviews the basic approach to assessment of the traumatic shoulder injury. Subsequent posts will focus in on specific pathologies.
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