Wound Closure and Suture Techniques
Goals are to optimize wound strength, reduce inflammation, avoid infection, and minimize scar formation Time to wound cleaning is the most important factor To preserve viable tissue and restore continuity…
Shoulder Dislocation and Reduction
Shoulder Dislocation and Reduction Olabiyi Akala and Maureen Gang INDICATIONS History and clinical examination consistent with shoulder dislocation Anterior Dislocation (~95%) Mechanism Force applied to an externally rotated, abducted, and…
Cardiac Pacing
Hemodynamic instability (presyncope, angina, altered mentation, pulmonary edema) secondary to: Bradydysrhythmias: Sinus bradycardia Sinus node dysfunction Atrioventricular (AV) node conduction blocks (second and third degree) Acute myocardial infarction with bifascicular…
C: Joint Reduction
Shoulder Dislocation and Reduction Olabiyi Akala and Maureen Gang INDICATIONS History and clinical examination consistent with shoulder dislocation Anterior Dislocation (~95%) Mechanism Force applied to an externally rotated, abducted, and…
Subclavian Vein—Central Venous Access
Emergency venous access for fluid resuscitation and drug infusion Central venous pressure and oxygen monitoring Infusions requiring central venous administration (vasopressors, hyperosmolar solutions, hyperalimentation) Routine venous access due to inadequate…
Intubation of the Pediatric Patient
Inadequate oxygenation or ventilation Airway obstruction Loss of protective airway reflexes (e.g., depressed cough and gag reflexes) Excess work of breathing Nonresponsive and apneic CONTRAINDICATIONS Absolute Contraindications None for unstable…
Intubation: Tracheal and Nasotracheal
Rapid sequence intubation (RSI) is the preferred method of emergency airway management. It involves the near simultaneous administration of fast-acting induction and neuromuscular blocking agents to achieve optimal intubating conditions…
Cricothyroidotomy—Standard and Needle
To provide emergent airway access only when a safer, less invasive airway cannot be established or is contraindicated For children younger than 12 years, needle cricothyroidotomy is the surgical airway…
Emergency Department Thoracotomy
Penetrating Chest Trauma Traumatic arrest with witnessed signs of life* in the field Persistent hypotension (systolic blood pressure (SBP) <60 mm Hg) despite resuscitative efforts Blunt Trauma Traumatic arrest that…
Digital Nerve Block
Used to provide local anesthesia to the digits for repair, reduction, or drainage Lacerations Nail bed injuries Infections (i.e., felons, paronychias) Amputations Fractures or dislocations CONTRAINDICATIONS Absolute Contraindications Transthecal technique…
