Moderator EMEDPA Posted August 3, 2012 Author Moderator Share Posted August 3, 2012 I have seen flies, maggots, moths, cockroaches, and earwigs in pts ears. it's not that common, but it happens. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 3, 2013 Author Moderator Share Posted November 3, 2013 http://academiclifeinem.com/trick-of-the-trade-urine-pregnancy-test-without-urine/ good to know.... 1 Quote Link to comment Share on other sites More sharing options...
medic25 Posted November 4, 2013 Share Posted November 4, 2013 http://academiclifeinem.com/trick-of-the-trade-urine-pregnancy-test-without-urine/ good to know.... I've done this once or twice on trauma patients who had empty bladders and we needed to know sooner rather than later. It would be great if we could get the lab to sign off on it as an officially accepted technique... 1 Quote Link to comment Share on other sites More sharing options...
GreatChecko Posted November 4, 2013 Share Posted November 4, 2013 I've done this once or twice on trauma patients who had empty bladders and we needed to know sooner rather than later. It would be great if we could get the lab to sign off on it as an officially accepted technique... What would they do if you hand them the insert from the preg test box and a study? Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 12, 2014 Author Moderator Share Posted March 12, 2014 Subject: EMedHome Clinical Pearl Pediatric Asthma? Use DexamethasoneThere is an increasing amount of evidence, including a recent systematic review and meta-analysis, that dexamethasone is preferable to prednisone/prednisolone for pediatric patients presenting to the ED with an acute asthma exacerbation (1-3). A single IM/PO dose of dexamethasone (+/- a single PO dose to take at home) is as effective as 5 day dose of prednisone/prednisolone. In addition, dexamethasone offers the advantages of less vomiting (dexamethasone has antiemetic properties), improved compliance, and parenteral preference. Practitioners should consider single or 2-dose regimens of dexamethasone as a viable alternative to a 5-day course of prednisone/prednisolone for pediatric asthma. References:(1) Keeney GE, et al. Pediatrics March 1, 2014, 133: 493 -499. (2) Redman E, et al. Arch Dis Children 2013; 98: 916. (3) Williams KW, Â et al. Clin Pediatr 2013;52:30. Quote Link to comment Share on other sites More sharing options...
LoRezSkyline Posted March 12, 2014 Share Posted March 12, 2014 EMed, Good evidence to support this approach in adults as well - quote below is from the Jul. '13 edition of Emergency Medicine Practice's article "Management of Acute Asthma in the Emergency Dept." - sources quoted seem to all be from peds studies, but the article it's coming from doesn't suggest it be limited to peds pts. alone. Have changed my practice in turn... “Single-dose dexamethasone at 0.6 mg/kg (up to 18 mg), by both oral and intramuscular routes, is as effective as 3-day or 5-day therapy with prednisone.110-112 Nonadherence to medication regimens with prednisone therapy is a significant problem that this treatment method solves.113 For return to normal activity, 2 days of dexamethasone at 16 mg/ day is superior to 5 days of prednisone at 50 mg daily.114 Given the available evidence, we recommend dexamethasone over other regimens for outpatient treatment.” 110. Gordon S, Tompkins T, Dayan PS. Randomized trial of single-dose intramuscular dexamethasone compared with prednisolone for children with acute asthma. Pediatr Emerg Care. 2007;23(8):521-527. (Prospective randomized controlled trial; 88 patients) 111. Altamimi S, Robertson G, Jastaniah W, et al. Single-dose oral dexamethasone in the emergency management of children with exacerbations of mild to moderate asthma. Pediatr Emerg Care. 2006;22(12):786-793. (Prospective double-blind randomized controlled trial) 112. Cronin J, Kennedy U, McCoy S, et al. Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial. Trials. 2012;13:141. (Open-label randomized controlled trial; 232 patients) 113. Butler K, Cooper WO. Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization. Pediatr Emerg Care. 2004;20(11):730-735. (Prospective cohort study; 161 patients) 114. Kravitz J, Dominici P, Ufberg J, et al. Two days of dexamethasone versus 5 days of prednisone in the treatment of acute asthma: a randomized controlled trial. Ann Emerg Med. 2011;58(2):200-204. (Double-blind randomized controlled trial; 200 patients) 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 14, 2014 Author Moderator Share Posted December 14, 2014 easy reduction of mandibular dislocation: http://www.sinaiem.org/pearls/2014/11/21/dislocated-jaw-bite-down-on-this-syringe/ Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted December 29, 2014 Share Posted December 29, 2014 Subungual hematomas: instead of digital block & battery powered bove, soak affected finger/toe in ice water with betadine for 10-15 minutes, then use 18 gauge needle on 10 cc syringe (for a handle). Good results, much less pain. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted December 30, 2014 Author Moderator Share Posted December 30, 2014 Subungual hematomas: instead of digital block & battery powered bove, soak affected finger/toe in ice water with betadine for 10-15 minutes, then use 18 gauge needle on 10 cc syringe (for a handle). Good results, much less pain. if you do the electrocautery right and stop as soon as you see blood you don't need the digital block. last time I checked, fingernails don't have nerves. in almost 20 yrs doing this I have never blocked a subungal before electrocautery drainage, n= ten gazillion 2 Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 7, 2015 Share Posted September 7, 2015 if you do the electrocautery right and stop as soon as you see blood you don't need the digital block. last time I checked, fingernails don't have nerves. in almost 20 yrs doing this I have never blocked a subungal before electrocautery drainage, n= ten gazillion Where can one tie up a bed for 15" to allow a digit to soak before using a syringe/needle when you could've done one per minute with the cautery and still had time left over for coffee? Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted September 9, 2015 Share Posted September 9, 2015 If you see the patient before registration gets to them. 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted September 9, 2015 Author Moderator Share Posted September 9, 2015 If you see the patient before registration gets to them. our new model of "in room triage and registration" is a nightmare. between the triage nurse and registration we can't see a new pt within 40 min of their arrival, or if they are really sick and we push our way in and start care, they can't be transferred out of the dept until they are registered....!@#$% Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted November 24, 2015 Share Posted November 24, 2015 Or if your orders go through Epic, you can't place any orders until the patient is registered. So, no meds, because they have to come from the pyxis that's linked to Epic, unless the nurses go through a tedious override process. Quote Link to comment Share on other sites More sharing options...
melhhn330 Posted March 31, 2016 Share Posted March 31, 2016 Can we get this thread alive again? I loved reading the responses! One of my favorite is tick removal, counter clockwise with moistened cotton tip applicator. It has worked every single time, with the tick dead or alive. 2 Quote Link to comment Share on other sites More sharing options...
sk732 Posted April 1, 2016 Share Posted April 1, 2016 I treated a cool 2nd Deg burn on someone's neck once because of a tick...someone thought a Bic lighter on flame thrower level was the same as a lit cigarette beside it. The ick was charcoal, with its noodle stuck in buddy's neck. SK Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 1, 2023 Author Moderator Share Posted October 1, 2023 This is a new one for me. Have to try this: Emergency medicine cases this week discussed using dermabond for dental fxs if no temp filling (like cavit or calcium hydroxide)material present in the dept Quote Link to comment Share on other sites More sharing options...
sk732 Posted October 2, 2023 Share Posted October 2, 2023 4 hours ago, EMEDPA said: This is a new one for me. Have to try this: Emergency medicine cases this week discussed using dermabond for dental fxs if no temp filling (like cavit or calcium hydroxide)material present in the dept Is that to glue the tooth back together or to use as a temporary restoration? Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted October 2, 2023 Share Posted October 2, 2023 Has anyone tried the Foley catheter enema hack? It works great, high compliance, large volume returns and nurses really seem to like it. https://childrenswi.org/-/media/chwlibrary/publication-media-library/2021/03/25/18/54/1188en.pdf 1 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 3, 2023 Author Moderator Share Posted October 3, 2023 On 10/1/2023 at 7:50 PM, sk732 said: Is that to glue the tooth back together or to use as a temporary restoration? as temp filling material to cover the fracture and get the air off the nerve. 1 Quote Link to comment Share on other sites More sharing options...
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