FOAMED

We’ve all heard it at one point or another: “Man, I’d HATE to have to intubate THAT!” Typically, this sentence is used to describe a patient in an ominous, sphincter-tightening situation, or the patient with the obviously suboptimal airway.

You walk by the door to the Resuscitation Bay or Trauma Bay, see that the patient is in respiratory distress, and rapidly breeze through your airway mnemonics and ultimately come to the conclusion that this would be a scary airway. The airways of myths and legends, and where heroes are made.

A great post by Core EM – Bringing core EM content to anyone, anywhere, anytime. Learn ultrasound guided pericardiocentesis for cardiac tamponade!

Every few years, we come to a crossroads that makes us reexamine our current clinical practice and consider a better intervention. For the past twenty years, patients presenting with acute ischemic stroke have had essentially one option for therapy: intravenous thrombolytics. Since the NINDS-2 trial in 1995 [1], tPA has erupted onto the scene of stroke management and has become the gold standard despite ongoing questions behind the true efficacy of tPA.

Is the use of oral contrast for abdominal CT still necessary?

Updates in wound care: Normal saline or tap water? What pressure do you need to use? What volume is needed? Should you irrigate clean wounds?

Is Tamsulosin actually useful for renal stone expulsion? Anand Swaminathan does a deep dive evaluation of the literature. You don’t want to miss this!

Death after discharge from the Emergency Department (ED) is an uncommon but nonetheless highly concerning event. Discharge from the ED, on the other-hand, is a frequent event, with over 80% of ED visits culminating in discharge to home or non-acute care. (1) That number may be increasing with more pressure to find alternatives to inpatient admissions. (1,2) Discharge from the ED is a vulnerable time for patients, and it is a high-stakes time for both patients and providers.

An update on awake intubation with a discussion of the needed supplies, various techniques, complications, and modifications.

Airway management is one of the most challenging and critical skills that the emergency medicine physician must master. This is particularly true in the setting of the trauma patient, where the ABCs of trauma evaluation begin with establishing the patency of the airway and ensuring adequate oxygenation and ventilation before moving through the remainder of the trauma algorithm. It is well known that delays in adequate airway management are one of the most common causes of preventable death in both the prehospital and emergency department setting.

To the Class of 2015 – Congratulations!! You’ve made it. After at least 11 years of post-high school education, you have finally reached that proverbial finish line and are ready to transition from resident to attending. What I would like to share with you is some advice about what life is like on the other side. Now that you have finished residency, it’s safe to say that you know the medicine really well. But, I have come to find that your learning about life as a professional is just beginning.