|
Tricks of the Trade
There are many exciting places we can turn to when we need to help a patient. The resuscitation room, gyn room, and decontamination shower may come to mind immediately. But another chamber of healing is your local "Break Room." This bleak refuge often contains a wonderland of overlooked medical remedies hidden amongst the soy sauce packets,... »
The greatest irony of this year’s influenza epidemic is the gulf between dire messages urging us to protect vulnerable children and the reality of our actual options. One of our best weapons against pediatric influenza is oseltamivir (Tamiflu) suspension, but you might as well be prescribing platypus blood. Nobody has it.
On a recent Friday night, a... »
Submit!
Over the last few months, many readers have sent suggestions of various "tricks" that they have found useful. For this installment, I'd like to honor these folks by featuring two submissions, along with one I came up with on my own but has probably been discovered many times over.
Papoose for a Moose
Suturing facial lacerations on an... »
Foleys Foil Feeding Failures
A dislodged gastrostomy or jejunostomy tube is a common problem in emergency departments everywhere, but it is one that must be addressed quickly: Even a very mature tract can close up in a matter of hours once the tube has been removed. Sending a patient to a gastroenterologist's office the next day may be too... »
The Wheal Deal
Emergency physicians face a great number of dermatologic complaints in the emergency department, and the majority of these are not life-threatening. These patients can still be a handful, though. One of the many cosmic ironies we face is that those with the least dangerous diseases can be the hardest to please.
Urticaria (hives) is a... »
Placing a nasogastric tube is a lot like cooking rice: If you rush it, you’ll end up with a huge mess and a miserable experience.
All too often, we hand the patient a cup of water with a straw and try to railroad a lubricated tube through the nares, only to have it spring out of the patient’s mouth like an angry cobra riding a wave of vomit. It is not... »
Nebulization isn’t just for those ho-hum bronchodilators and anticholinergic medicines we’re constantly pumping into our asthmatic patients. Literature abounds on the use of nebulized fentanyl (pediatric pain), midazolam (status epilepticus), and naloxone (guess) for those times when IV access is a problem and the need is urgent. For ENT emergencies,... »