Tuesday

Introduction to the Ultrasound Guided IV

In this video, Cooper Emergency Medicine Residency graduate and current ultrasound fellow at Hennepin County Mark Robidoux demonstrates a few tips and tricks to quickly become a pro in ultrasound guided angiocath insertion (with a little help from Cooper Assistant to the Program Director and volunteer pincushion Rich Byrne)

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Recognize Dynamic Hyperinflation (Air-Trapping) at the Bedside Using the Flow Curve

Dynamic hyperinflation (autoPEEP, air trapping, etc.) is a process leading to an increase in end-expiratory lung volumes and increased airway pressures. This process may occur secondary to obstructive lung pathology and/or an increase in minute-ventilation without sufficient time for expiration. The pathologic effects of dynamic hyperinflation include an increased work-of-breathing, barotrauma, pneumothorax, and an increase in intrathoracic pressure leading to a decrease in cardiac output and possible hemodynamic collapse. Rapid identification of this process is crucial for reversing it.

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Ottawa Aggressive Protocol: Treat and Street for Atrial Fibrillation?

It’s another busy shift in the Emergency Department and you are seeing the third patient of the day in atrial fibrillation with rapid ventricular response. You think to yourself, “simple plan and disposition: stabilize, start on a diltiazem infusion, anticoagulate and admit to cardiology, right?” Well before you proceed with this well accepted approach, consider an alternative management strategy where you can even discharge the patient home!

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How to Not Miss a Posterior Myocardial Infarction

The anatomical location of a posterior myocardial infarction makes it's diagnosis not readily apparent. Intimate knowledge of standard and posterior ECG manifestations of posterior myocardial infarctions is crucial to picking up on this potential fatal pathology. This post aims to provide tips for evaluating patients for posterior myocardial infarction.

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You Have Intubated an Asthmatic... Now What?: Initial Ventilator Settings in Severe Asthma Exacerbation

In the setting of a severe asthma exacerbation that is refractory to medical mangagment and noninvasive ventilation, mechanical ventilation can be life-saving. However, the ventilator can quickly kill your patient if careful thought is not taken to address the unique respiratory needs and pulmonary physiology inherent to severe asthma.

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Respiratory Failure: Indications for ECMO

Extracorpreal membrane oxygenation is a temporizing mechanical support to heart or lung function in the setting of cardiopulmonary failure. In the setting of severe respiratory failure, patients that may benefit from and/or have an indication for ECMO are described in the Extracorporeal Life Support Organization Respiratory Failure Supplement to ESLO General Guideline, December 2013:

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Orthopedic Injuries Around the NFL: Dez Bryant 's Tibial Plateau Fracture

In Week 3 of this NFL season, Dallas Cowboys wide receiver Dez Bryant suffered a non-displaced tibial plateau fracture against the Chicago Bears. In the news, the injury was labeled a "hairline fracture of the knee." The injury resulted from Bryant landing awkwardly on his leg while being tackled near the sideline. Bryant is expected to miss 4-6 weeks.

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