Emergency medicine clinics of North America
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Emerg. Med. Clin. North Am. · Feb 2013
Ultrasound-guided procedures in the emergency department-needle guidance and localization.
Ultrasound has rapidly become an essential tool in the emergency department, specifically in procedural guidance. Its use has been demonstrated to improve the success rate of procedures, while decreasing complications. In this article, we explore some of these specific procedures involving needle guidance and structure localization with ultrasound.
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Emerg. Med. Clin. North Am. · Feb 2013
Critical trauma skills and procedures in the emergency department.
Injuries and illness associated with major trauma that require lifesaving procedures, such as surgical airway, chest tube thoracotomy, emergency department thoracotomy, early recognition and treatment of compartment syndrome, and venous cutdown, are seen in the emergency department. The emergency medicine physician must be proficient in recognizing these injuries and their associated complications and be able to provide appropriate management. This article discusses the most common trauma-related procedures in which emergency physicians must be proficient. A description of each procedure is discussed as well as the indications, contraindications, equipment, technique, and potential complications.
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Children comprise approximately one-quarter of all visits to most emergency departments. Children are generally healthier than adults, yet there are similar priorities in assessment and management of pediatric patients. ⋯ There are certain anatomic, physiologic, developmental, and social considerations that are unique to this population and must be taken into account during their evaluation and treatment. In this review, we present and discuss an evidence-based approach to high-yield procedures necessary for all emergency physicians taking care of children.
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Airway management is a critical procedure and essential skill necessary for all physicians working in the emergency department. Optimal resuscitative treatment of medical and trauma patients often revolves around timely and effective airway interventions that can be challenging in the acute setting, especially in critical patients. Time-honored airway techniques and procedures combined with recent advances in rapid sequence intubation, video laryngoscopy, and further advanced airway techniques now offer emergency clinicians a wide range of exciting new options for improving this crucial component of acute care and management.
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Emerg. Med. Clin. North Am. · Feb 2013
Critical skills and procedures in emergency medicine: vascular access skills and procedures.
The venous and/or arterial vasculature may be accessed for fluid resuscitation, testing and monitoring, administration of blood product or medication, or procedural reasons, such as the implantation of cardiac pacemaker wires. Accessing the vascular system is a common and often critically important step in emergency patient care. This article reviews methods for peripheral, central venous, and arterial access and discusses adjunct skills for vascular access such as the use of ultrasound guidance, and other forms of vascular access such as intraosseus and umbilical cannulation, and peripheral venous cut-down. Mastery of these skills is critical for the emergency medicine provider.