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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Ann Emerg Med. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med. J Emerg Med. Am J Emerg Med.

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Impact of Emergency Department Crowding on Lung Protective Ventilation

RebelEM

Over the past few years, there has been an increase in emergency department (ED) volumes and lengths of stay. The effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients. Paper: Owyang CG, et al. J Crit Care. N Engl J Med. 2000 May 4; PMID: 10793162 Harvey CE, et al.

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Proning for ARDS

Northwestern EM Blog

While a randomized control trial should be done to evaluate the effect of early proning in a controlled environment, these studies suggest that we should consider using this in our Emergency Department for patients who present with hypoxia and concern for mild to moderate ARDS without urgent need for intubation. Crit Care Med.

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SGEM#281: EM Docs Got an AmbuBag – The PreVent Trial

The Skeptics' Guide to EM

NEJM February 2019 Guest Skeptic: Andrew Merelman is a critical care paramedic and second year medical student at Rocky Vista University in Colorado. His primary interests are resuscitation, critical care, airway management, and point-of-care ultrasound. Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults.

EMS 40
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Myasthenic Crisis

EM Guide Wire

Can also try awake intubation with propofol, fentanyl or ketamine Avoid pyridostigmine during a crisis as it increases secretions and make airway management difficult! Retrieved February 27, 2019, from [link] Howard, J.F. Myasthenia Gravis and Crisis: Evaluation and Management in the Emergency Department.

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Intubation

PHEM Cast

Positioning From: [link] Recommended Rich Levitan resources Podcast 70 – Airway Management with Rich Levitan Airway axes From: McGuire B, Hodge K. Emergency tracheal intubation: complications associated with repeated laryngoscope attempts. Annals of Emergency Medicine 2012; Volume 60, Issue 6, Pages 749–754.e2

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Glasgow Coma Scale in Children

Pediatric EM Morsels

cats and dogs have their own GCS scores [Lapsley 2019, Ash 2018] Moral of the Morsel Modified can make it Merrier! Consider other indicators of need for airway management, such as gag reflex. 2019 Jul;20(7):660-666. 2019 Sep;241:112-118. Epub 2019 Apr 22. Ann Emerg Med. 2019 Jul;20(7):682-683.