Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.   Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Dabbling in Dentistry
Most people will experience dental pain or a dental complication at some point in their lives. Dental pain is an incredibly common complaint by people of all ages, especially those who lack dental insurance and suitable hygiene habits. Sometimes, though, poor dentition or injury is simply a result of bad luck. Patients often present to the ED hoping to find a dentist and an answer to their problems.   Your first thought? “I am not a dentist. What am I going to do?” You’re right to an extent. We are not dentists, and often feel we have little to offer patients for acute issues that require equipment we don’t have a...
Source: The Procedural Pause - July 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Hugest of the Huge Hematomas
Welcome to our new series, “Guts and Gore.” That title should serve as a warning that some of the videos we will use as teaching tools may be controversial and not for weak stomachs. We hope, however, that part of why you became an emergency provider was to handle sticky situations like the ones we will present. People like us have the ability to ignore blood and copious discharge, and instead focus on saving and improving the lives of our patients. Rarely are you thanked for this ability, and we hope this series on guts and gore will improve your technique, even when the going gets tough.   The Approach n Proper i...
Source: The Procedural Pause - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

The Hugest of the Huge Hematomas
Welcome to our new series, “Guts and Gore.” That title should serve as a warning that some of the videos we will use as teaching tools may be controversial and not for weak stomachs. We hope, however, that part of why you became an emergency provider was to handle sticky situations like the ones we will present. People like us have the ability to ignore blood and copious discharge, and instead focus on saving and improving the lives of our patients. Rarely are you thanked for this ability, and we hope this series on guts and gore will improve your technique, even when the going gets tough.   The Approach n Proper iden...
Source: The Procedural Pause - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Tenosynovitis: Two-Touch Diagnosis
Today you are the fast-track provider, and you are on the hunt for procedures. You notice a 35-year-old woman signing into triage with a chief complaint of wrist pain.   This patient looks otherwise healthy, is pushing a stroller with her right hand, and is carrying a second child on her left. What’s the emergency? There isn’t one, but it is an emergency to this patient because she cannot push that stroller another day! If she cannot push the stroller, then she cannot get the kids to day care. And, if she cannot get the kids to day care, then she cannot go to work. Ask anyone with children, it is an emergency.   ...
Source: The Procedural Pause - May 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Tenosynovitis: Two-Touch Diagnosis
Today you are the fast-track provider, and you are on the hunt for procedures. You notice a 35-year-old woman signing into triage with a chief complaint of wrist pain.   This patient looks otherwise healthy, is pushing a stroller with her right hand, and is carrying a second child on her left. What’s the emergency? There isn’t one, but it is an emergency to this patient because she cannot push that stroller another day! If she cannot push the stroller, then she cannot get the kids to day care. And, if she cannot get the kids to day care, then she cannot go to work. Ask anyone with children, it is an emergency.   This...
Source: The Procedural Pause - May 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Pearls for Abscess Incision and Drainage
Part 2 in a Series Abscess incision and drainage should be loved and adored by all emergency providers because another abscess is waiting just behind the curtain. This month we highlight general guidelines for abscess incision and drainage, and show how to treat one in the video below. We will follow up with some additional videos in the months to come focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.   Axillary abscess from hidradenitis. Photo by Martha Roberts.   The Approach n  Identification of an abscess appropriate fo...
Source: The Procedural Pause - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Pearls for Abscess Incision and Drainage
Part 2 in a Series Abscess incision and drainage should be loved and adored by all emergency providers because another abscess is waiting just behind the curtain. This month we highlight general guidelines for abscess incision and drainage, and show how to treat one in the video below. We will follow up with some additional videos in the months to come focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.   Axillary abscess from hidradenitis. Photo by Martha Roberts.   The Approach n  Identification of an abscess appropriate for I&D....
Source: The Procedural Pause - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

General Guidelines Related to Abscess Incision and Drainage: Part II
Greetings! We’re excited to continue our series on abscess incision and drainage. This procedure should be loved and adored, because another abscess is waiting just behind the curtain. This month we will highlight (in video format) the final cut of abscess incision and drainage. We will follow up with some additional videos in the months to follow focusing on scalp, vaginal, and facial abscesses. And, just when you think you have seen it all, we will reveal a few more surprises.     The Approach ·         Identification of an abscess appropriate for I&D ·         If unsure, use ultrasound guide...
Source: The Procedural Pause - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Pilonidal Abscess: The Very Bare (Back) Basics
This month we want to touch gently on treating pilonidal abscesses as we continue on our series on abscess incision and drainage. A pilonidal cyst or abscess is a fluid-filled pocket of dead skin cells, or pus. These pockets occur on the back over the tailbone, coccyx, or natal cleft. Pilonidal cysts often remain cysts and do not get infected. If the abscess is ignored or spreads (forms a fistula), then the practitioner should be concerned with a possible bacteremia or systemic infection. Infected pilonidal cysts are painful and sometimes dangerous.     A pilonidal abscess is lurking beneath the surface just above the...
Source: The Procedural Pause - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Pilonidal Abscess: The Very Bare (Back) Basics
This month we want to touch gently on treating pilonidal abscesses as we continue on our series on abscess incision and drainage. A pilonidal cyst or abscess is a fluid-filled pocket of dead skin cells, or pus. These pockets occur on the back over the tailbone, coccyx, or natal cleft. Pilonidal cysts often remain cysts and do not get infected. If the abscess is ignored or spreads (forms a fistula), then the practitioner should be concerned with a possible bacteremia or systemic infection. Infected pilonidal cysts are painful and sometimes dangerous.     A pilonidal abscess is lurking beneath the surface just above the na...
Source: The Procedural Pause - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Making it as a Midlevel among the Wolves
This spring, more advanced providers will be graduating from nurse practitioner and physician assistant programs than ever before. With that in mind, we want to take a break from procedures and focus on transitioning to becoming a provider.   If it were easy, everyone would be doing it. Always let the patient be your guide when you work in the emergency department. Don’t get hung up on workplace drama or fear of making a mistake. No one is perfect, and it will take time to find your niche. It is up to you to do a good job and seize the day, each and every day from here on out. We only hope we can help you find success...
Source: The Procedural Pause - February 18, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Making it as a Midlevel among the Wolves
This spring, more advanced providers will be graduating from nurse practitioner and physician assistant programs than ever before. With that in mind, we want to take a break from procedures and focus on transitioning to becoming a provider.   If it were easy, everyone would be doing it. Always let the patient be your guide when you work in the emergency department. Don’t get hung up on workplace drama or fear of making a mistake. No one is perfect, and it will take time to find your niche. It is up to you to do a good job and seize the day, each and every day from here on out. We only hope we can help you find success i...
Source: The Procedural Pause - February 18, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Abscess Basics: The Setup and Anesthesia
Part 1 in a Series   We are pleased to bring you our first full-length tutorial on abscess drainage. Part 1 of this series focuses on set up and basics for all beginners.   It is important to note that you should practice on injection techniques and how to properly hold instruments before draining your first abscess. No one likes a shaky, unsure hand. We also believe in the “see one, do one, teach one” mentality. Be sure to check out the stockroom at your facility so you, too, can become familiar with all of the equipment used to drain an abscess properly.   Stay tuned for next month’s blog when we get down ...
Source: The Procedural Pause - February 12, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

Abscess Basics: The Setup and Anesthesia
Part 1 in a Series   We are pleased to bring you our first full-length tutorial on abscess drainage. Part 1 of this series focuses on set up and basics for all beginners.   It is important to note that you should practice on injection techniques and how to properly hold instruments before draining your first abscess. No one likes a shaky, unsure hand. We also believe in the “see one, do one, teach one” mentality. Be sure to check out the stockroom at your facility so you, too, can become familiar with all of the equipment used to drain an abscess properly.   Stay tuned for next month’s blog when we get down to dra...
Source: The Procedural Pause - February 12, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs