Trick of the Trade: Patient positioning for ultrasound-guided ulnar nerve block

Patients with 5th metacarpal fractures (commonly termed “boxer’s fracture”) are frequently treated in the emergency department (ED) with closed reduction and splinting. Obtaining analgesia and a successful closed reduction can often be challenging without procedural sedation. Severe swelling can make a hematoma block difficult, often resulting in inadequate analgesia. An ultrasound-guided ulnar nerve block provides a simple method to facilitate pain relief and allow for improved fracture site manipulation.

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By Kara Toles, MD|2018-10-28T21:25:09-07:00Jan 20, 2016|Tricks of the Trade, Ultrasound|

Diagnose on Sight: Shortness of Breath

Case: 55-year-old restrained driver is reporting severe shortness of breath and right sided chest pain after a high-speed motor vehicle collision. Her respiratory rate is 26 breaths/min and her oxygen saturation is 96% on a 15-liter non-rebreather. She has decreased breath sounds on the right, epigastric tenderness, and an abdominal seatbelt sign. What is the diagnosis?

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By Sarah G. Sifuentez MD|2016-12-22T19:21:45-08:00Jan 18, 2016|Diagnose on Sight, Trauma|

Trick of the Trade: Isopropyl Alcohol Vapor Inhalation for Nausea and Vomiting

Your triage nurse complains of numerous patients in the waiting room complaining of nausea, retching, and emesis. They ask you “why can’t we have an antiemetic on hand in triage?” Turns out they might have had an effective antiemetic on hand, or rather in their scrub pocket the entire time. They just didn’t know about it yet.
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By Mark Culver, PharmD, BCPS|2019-06-18T23:12:47-07:00Dec 21, 2015|Expert Peer Reviewed (Clinical), Gastrointestinal, Tricks of the Trade|

PEM Pearls: Cardiac causes of pediatric chest pain

Children with chest pain commonly present to the emergency department. Both the child and family members may think their symptoms are due to a serious illness. Among adolescents seen for their chest pain, more than 50% thought they were having a heart attack or that they had cancer.¹ In reality, only 6% of pediatric chest pain has a cardiac etiology.² Nonetheless, extensive and costly emergency department (ED) evaluations are common and there is wide practice variation.³

But prior to reassuring your patient, what can you do to reassure yourself that your patient doesn’t need a more extensive workup? What would make you suspicious for cardiac causes of pediatric chest pain?

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By Delphine Huang, MD|2017-10-26T14:34:30-07:00Dec 14, 2015|Cardiovascular, CME, Pediatrics, PEM Pearls|

Ultrasound For the Win! Case – 55-year-old man with chest pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this peer-reviewed case series, we focus on real clinical cases where bedside ultrasound changed management or aided in diagnoses. In this case, a 55-year-old man presents with acute-onset chest pain.

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By Jeffrey Shih, MD, RDMS|2017-07-19T00:06:58-07:00Dec 9, 2015|Cardiovascular, Ultrasound, Ultrasound for the Win|

AIR Series: Environmental Module 2

Unlike the previous cardiology modules, the environmental module was comparatively under-represented in the top 50 sites of the Social Media Index. Below we have listed our selection of the 4 highest quality blog posts within the past 12 months (as of October 2015) related to environmental emergencies, curated and approved for residency training by the AIR Series Board. More specifically in this module, we identified 2 AIRs and 2 Honorable Mentions.

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By Andrew Grock, MD|2017-03-05T14:14:16-08:00Dec 7, 2015|Approved Instructional Resources (AIR series), Environmental|

AIR-Pro Series: Trauma (2015)

Below we have listed our selection of the 6 highest quality blog posts related to 4 advanced level questions on trauma topics posed, curated, and approved for residency training by the AIR-Pro Series Board. The blogs relate to the following questions:

When to give tranexamic acid in the trauma patient
The pregnant trauma patient
Transfusions in the trauma patient
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

In this module, we have 6 AIR-Pro’s and we did not include any honorable mentions to prevent redundancy of the topics covered. To strive for comprehensiveness, we selected from a broad spectrum of blogs identified through FOAMSearch.net.

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By Fareen Zaver, MD|2017-03-05T14:18:42-08:00Nov 23, 2015|Approved Instructional Resources PRO (AIR-Pro Series), Trauma|

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