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Post-Tonsillectomy Hemorrhage: A Three-Pronged Approach

ACEP Now

A young woman, 13 days post-tonsillectomy, comes into your rural emergency department (ED) coughing up blood. Additionally, one must be prepared for definitive airway management and know when laboratory investigations will prove valuable to guide further management. CREDIT: Dr. P.

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Post-Tonsillectomy Hemorrhage: ReBaked Morsel

Pediatric EM Morsels

With that in mind, let’s review how to manage the post-tonsillectomy hemorrhage in children : Post-Tonsillectomy Hemorrhage : Management General Preparation Call for help… no time for your pride to get in the way! Get a hold of ENT early as OR management and/or admission are common. Set up suction x2 in the room!

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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. More pertinent and relevant takeaway messages have to do with staffing and operations.

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Bougie: First Pass or Rescue Device?

ACEP Now

A 68-year-old man presents to the emergency department (ED) with altered mental status and fever. There was no analysis of operator experience or expertise. These limitations are sufficient to question the recommendation to use a bougie as first line airway management. Ann Emerg Med. 2023;42(6):445-9.

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Airway Choices in the Era of Many Choices

EM Updates

The primary tool for emergency airway management then became the traditional laryngoscope , a device little improved since the 1940s, until the advent of video laryngoscopy in the early 2000s which changed everything. HAVL , which uses a blade that goes around the tongue, requires that the operator look at the screen.

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How To Use SALAD To Manage Unstable Epistaxis and the Airway

ACEP Now

A total of 400 mL of blood was suctioned throughout the procedure The SALAD Approach to Airway Management The presence of contaminants in the airway has been shown to decrease first-pass success at intubation, regardless of whether direct or video laryngoscopy is employed. Acad Emerg Med. References Prekker ME, et al.

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How To Manage Tracheo-Innominate Fistula

ACEP Now

A 24-year-old male with history of quadriplegia and traumatic brain injury presents to the emergency department with hemorrhage in his oral cavity and blood from his tracheostomy tube. Tracheo-innominate fistula (TIF) is an unusual and frequently lethal complication of such definitive airway placement. 2005;128: 3906-9.