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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

However, in at least 10% of patients, blind insertion of a peripheral IV may be unsuccessful for a variety of reasons including obesity, edema, IV drug use, surgical scars, dialysis, burns, and others (1,2). Ann Emerg Med. 2020 Aug;76(2):134–42. Intraosseous vascular access in adults using the EZ-IO in an emergency department.

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SAEM Clinical Images Series: Purple Finger

ALiEM

Shortly after that, the finger turned purple, so she came to the Emergency Department for evaluation. Many report a burning sensation to the finger. 2020 Apr;87(4):194. After the popping sensation, she noticed a cool sensation of the finger and numbness to the entire finger. She denied trauma to the hand or finger.

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High sensitivity cardiac troponins for ED chest pain evaluation (2022 ACC pathway)

ALiEM

Intermediate-risk patients may be further stratified based on recent stress testing or coronary angiogram findings plus a modified HEART or Emergency Department Assessment of Chest Pain (EDACS) score. Let’s apply the ESC 2020 0/1 hour pathway [2], with some modifications based on the 2022 ACC guidelines [1]: Figure 1.

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A review of the utility of the ECG in Pediatric Syncope

PEMBlog

History and physical examination are critical components to any emergency department evaluation but are especially helpful in syncope patients. Discussing obtaining an ECG with patients and families Presentations to the emergency department for syncope can be stressful for families. References Burns, Ed, et al. “QT

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

World J Emerg Surg 2023 PMID: 36918947 3. Intraosseous vascular access in adults using the EZ-IO in an emergency department. Int J Emerg Med 2009 PMID: 20157465 4. Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins.

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SGEM#307: Buff up the lido for the local anesthetic

The Skeptics' Guide to EM

Date: October 29th, 2020 Guest Skeptic: Martha Roberts is a critical and emergency care, triple-certified nurse practitioner currently living and working in Sacramento, California. She writes a blog […] The post SGEM#307: Buff up the lido for the local anesthetic first appeared on The Skeptics Guide to Emergency Medicine.

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Red Leg in the Heartland of America: A Rural Physician’s Approach to the Patient with a Potential DVT

EMDocs

Johnson, MD ( Community EM, Salina Regional Health Center) // Reviewed by: Joshua Lowe, MD (EM Attending Physician, USAF); Marina Boushra, MD (Cleveland Clinic Foundation, EM-CCM); Brit Long, MD (@long_brit) Case A 40-year-old woman presents to a rural emergency department (ED) with left leg pain and swelling for the past 5 days.