Welcome to the 60th edition of the #FOAMed Review!
The idea of the FOAMed review is to give you a digestible selection of reliable content from the online EM/CC world, including interesting and relevant evidence based medicine, that you can fit into your busy weekly schedule.
The Interscalene Block
Have a large abscess you have to drain on the upper extremity? Consider the interscalene block to provided dense anesthesia for expedient & painless drainage. Use a high frequency linear probe in a transverse plane at the level of the larynx and slide the transducer laterally until you identify the lateral border of the sternocleidomastoid. Here you can then identify the anterior and middle scalene muscles just deep to the SCM, with the nerve roots of C5-C7 running in between in a vertical fashion giving us a "traffic light" appearance. This will be your target. Learn more about this procedure here.
LITERATURE OF INTEREST
- An Age-Adjusted D-dimer Threshold for Emergency Department Patients With Suspected Pulmonary Embolus: Accuracy and Clinical Implications. PMID: 26320520
- A Report of Adverse Drug Reactions in Pediatric Emergency Medicine PMID: 26324354
- Double-Blind Prospective Randomized Controlled Trial of Dopamine Versus Epinephrine as First-Line Vasoactive Drugs in Pediatric Septic Shock PMID: 26323041
- Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes PMID: 26324049
- Conservative Versus Liberal Oxygenation Targets for Mechanically Ventilated Patients – a Pilot Multicenter Randomized Controlled Trial PMID: 26334785
THE UNDIFFERENTIATED SICK INFANT [PODCAST]: Pediatric Emergency Playbook is a new kid on the blog block, putting out excellent content so far. Listen to the podcast here on how to approach the undifferentiated sick infant.
THE PROBLEM WITH CALF CLOTS [PODCAST]: The management of isolated calf DVT in the ED has become quite an enigma. Rob Orman breaks down this topic on ER Cast to help us better understand the evidence and demystify this issue.
CUTTING EDGE ACUTE ISCHEMIC STROKE CARE [LECTURE]: Dr. Melissa Motta, a neuro-critical care expert breaks down current best practice in acute ischemic stroke in an excellent talk at Maryland CC Project.
EPIGLOTTITIS [BLOG]: While uncommon, this is a disease process we must be able to recognize. Learn the presentation and management of this disease process in the core content post at Core EM.
SEE YOU NEXT WEEK
Online Advanced Ultrasound Education
Northwestern EM Residency Education Coming soon...