Securing definitive control of a threatened airway is a fundamental skill in the care of critically ill patients and remains an ever-popular topic of discussion in Emergency Medicine. As Emergency Medicine providers, we find few procedures as satisfying or potentially difficult as airway management; we continually seek to hone ourRead More →
A checklist is a physical, cognitive aid that lists essential actions required for a task to compensate for limitations in human memory. While checklists have been around forever, the concept of checklists in medicine is much newer. Medical checklists have been gaining popularity and appearing on social media, but isRead More →
Journal Club Summary Methodology: 4/5 Usefulness: 3.5/5 Wang HE, et al. JAMA. 2018 Aug 28;320(8):769-778. Editorial: Pragmatic Airway Management in Out-of-Hospital Cardiac Arrest. Question and Methods: This multicenter pragmatic cluster-crossover randomized trial compared initial advanced airway strategy effectiveness between laryngeal tube (LT) and endotracheal intubation (ETI) in adults with OHCA. Findings: The LTRead More →
Journal Club Summary Methodology Score: 3.5/5 Usefulness Score: 2.5/5 Jabre P, et al. JAMA. 2018 Feb 27;319(8):779-787. Question and Methods: This was a multicenter randomized trial comparing bag valve mask ventilation with endotracheal intubation performed by emergency physicians in 2043 patients with out-of-hospital cardiac arrest in France and Belgium Findings: Their primary outcome ofRead More →
In this two part series, we are delving into a few of the many controversies regarding procedural sedation and explore how to reduce resource utilization and ED length of stay. In PART 1, we discussed preprocedural fasting and concluded that adherence to fasting guidelines is unnecessary in healthy patients undergoing proceduralRead More →
Procedural sedation is commonly performed in the Emergency Department. It is a critical tool that helps facilitate unpleasant but often necessary procedures that our patients would otherwise not tolerate. However, procedural sedation is also an extraordinarily resource-intensive endeavor. Most often, it requires cardiac monitoring and many interprofessional personnel. Also, despiteRead More →
Emergency medicine is a diverse specialty. We’ve all had the shift where you go from suturing an elderly woman’s scalp, to managing an anxious patient with chest pain, to running a cardiac arrest as EMS patches in with a trauma. We wear many hats throughout a single shift and it’sRead More →
Journal Club Summary Methodology Score: 4/5 Usefulness Score: 3/5 Driver BE, et al. JAMA. 2018 May 16. doi: 10.1001/jama.2018.6496. Question/Methods: This single-centre, randomized clinical trial enrolled 757 patients to compare first-attempt intubation success facilitated by the bougie to ETT plus stylet, in an ED where use of the bougie wasRead More →
In this post, we will review the anatomy, essential history, and common presentations of tracheostomy patients in the ED, including obstruction, decannulation, bleeding, tracheal stenosis, and infection. Anatomy of a tracheostomy tube Outer cannula Sits directly in the tracheal stoma Proximal end designed to allow tube to be easily securedRead More →