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The Procedural Pause: Clinical Pearls: The JR Knot

Video Author: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Published on: 11.23.2015

This new bonus feature from James R. Roberts, MD, & Martha Roberts, CEN, ACNP, brings you tips, tricks, and pearls to make your emergency medicine practice easier. This month, their first Clinical Pearl features the JR Knot, invented by its namesake James Roberts. This easy pearl will show you how to secure a central line. Read the Roberts’ blog at http://bit.ly/ProceduralPause.

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Creator: Martha Roberts, ACNP
Duration: 02:59
Watch hematoma block for a wrist fracture.
Creator: Christine Butts, MD
Duration: 00:04
Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows the subxiphoid view and how nothing appears between the liver and heart. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:14
Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows a hypoechoic area between the heart and pericardium, an important clue. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 4:50
Compartment syndrome of the hand is a rare condition that can have devastating consequences. Watch this video of a man with late-presentation compartment syndrome whose hand was crushed after a fall from a ladder, and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 5:12
The Compass device is a disposable pressure gauge that efficiently and effectively measures compartment pressure. This video shows how to use the device—on oranges. Read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 4:42
It is rare when patients present with a lower extremity compartment syndrome. Watch this video to see a patient who developed a foot drop as a result of compartment syndrome. Read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 30:56
Sergey Motov, MD, reviews the top 10 2017 pediatric EM pain articles that might change your practice: http://bit.ly/EMN-EMedHomeVideos
Creator: Alice S.Y. Lee, MD
Duration:
Alice Lee, MD, and Mary Katherine Harper, MD, discuss an 89-year-old woman with abdominal pain, and wonder how you should proceed when the diagnosis could be one of many conditions. Watch to learn more about this intriguing case.
Creator: Alice S.Y. Lee, MD
Duration: 26:09
Alice Lee, MD, and Elisa Dannemiller, MD, discuss the cases of two men who present with flash burns. What is the right management? Watch to learn more about these fascinating cases.
Creator: Larry Mellick, MD
Duration: 4:50
Disulfiram treatment is considered a valuable option for treating alcohol dependence, and more recently, has shown potential benefit for treating other presentations. Just be on the lookout for patients with serious side effects such as refractory hypotension and its associated ischemic complications. Watch this video and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 98:51
Sergey Motov, MD, reviews the top 10 2017 adult EM pain articles that could change your practice: http://bit.ly/EMN-EMedHomeVideos
Creator: Christine Butts, MD
Duration: 00:03
Christine Butts, MD, says why wonder when you can know? No need to speculate about a diagnosis when you can know for sure with ultrasound. A case in point: Ultrasound is better than chest c-rays for diagnosing pneumonia. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 0:03
Christine Butts, MD, notes that chest x-rays are known to have significant deficiencies in diagnosing pneumonia because the radiographic appearance of infection lags behind the onset of symptoms, sometimes by several days. The answer? Ultrasound, of course! Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 4:37
How in the world does a hair get wrapped repeatedly and tightly around an appendage of the body? Watch this video and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 20:23
Another practice-changing video of Sergey Motov, MD, talking about ketamine for pain management in the ED: http://bit.ly/EMN-EMedHomeVideos.
Creator: Alice S.Y. Lee, MD
Duration: 23:55
Alice Lee, MD, and Bill Fulton, MD, discuss the case of a 62-year-old with a ground-level fall while intoxicated. He is on Plavix, sustained a facial trauma, has a 10 cm laceration and a GCS of 15, and can’t move his arms. What’s his diagnosis? Watch to learn more about this interesting case.
Creator: Christine Butts, MD
Duration: 00:06
Christine Butts, MD, has reviewed more than 9,000 ultrasound scans in her career and has seen many interesting cases, a lot of great diagnoses, and several significant mistakes in that time. Most of them were a result of misinterpretation of the images on screen, and these videos offer great ultrasound pearls. This video shows the sagittal view of the pelvis. The bladder is seen on the left, with a large complex collection extending to the right. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:06
This video from Christine Butts, MD, shows the transverse view of the pelvis. The bladder is seen anteriorly as a well-defined anechoic area, with a circular, hypoechoic, complex collection deep to it. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:06
This video from Christine Butts, MD, shows the sagittal view of the right upper quadrant. The liver is seen on the left of the image, with a hypoechoic area (C) in the hepatorenal space. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 2:48
Many types and etiologies of headache and facial pain afflict ED patients, and sorting through them can be a challenge. Craniofacial experts themselves, in fact, do not attempt to remember the subtle differences between the various conditions causing craniofacial pain, but instead refer to the third edition of the International Classification of Headache Disorders, says Larry Mellick, MD.

This video shows a 9-year-old boy who crashed his motor bike and had a concussion, forehead contusion, and broken nose. A month later, he was still experiencing pain in his forehead, but rather than go right to CT or MRI, Dr. Mellick tried a different approach. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.



Creator: Martha Roberts, ACNP
Duration: 02:59
Watch hematoma block for a wrist fracture.
Creator: Christine Butts, MD
Duration: 00:04
Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows the subxiphoid view and how nothing appears between the liver and heart. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:14
Christine Butts, MD, opens her FAST Files again to show how important location is in diagnosing pericardial effusions. This video shows a hypoechoic area between the heart and pericardium, an important clue. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 4:50
Compartment syndrome of the hand is a rare condition that can have devastating consequences. Watch this video of a man with late-presentation compartment syndrome whose hand was crushed after a fall from a ladder, and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 5:12
The Compass device is a disposable pressure gauge that efficiently and effectively measures compartment pressure. This video shows how to use the device—on oranges. Read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 4:42
It is rare when patients present with a lower extremity compartment syndrome. Watch this video to see a patient who developed a foot drop as a result of compartment syndrome. Read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 30:56
Sergey Motov, MD, reviews the top 10 2017 pediatric EM pain articles that might change your practice: http://bit.ly/EMN-EMedHomeVideos
Creator: Alice S.Y. Lee, MD
Duration: 26:09
Alice Lee, MD, and Elisa Dannemiller, MD, discuss the cases of two men who present with flash burns. What is the right management? Watch to learn more about these fascinating cases.
Creator: Larry Mellick, MD
Duration: 4:50
Disulfiram treatment is considered a valuable option for treating alcohol dependence, and more recently, has shown potential benefit for treating other presentations. Just be on the lookout for patients with serious side effects such as refractory hypotension and its associated ischemic complications. Watch this video and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 98:51
Sergey Motov, MD, reviews the top 10 2017 adult EM pain articles that could change your practice: http://bit.ly/EMN-EMedHomeVideos
Creator: Christine Butts, MD
Duration: 0:03
Christine Butts, MD, notes that chest x-rays are known to have significant deficiencies in diagnosing pneumonia because the radiographic appearance of infection lags behind the onset of symptoms, sometimes by several days. The answer? Ultrasound, of course! Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 4:37
How in the world does a hair get wrapped repeatedly and tightly around an appendage of the body? Watch this video and read more in Dr. Larry Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 20:23
Another practice-changing video of Sergey Motov, MD, talking about ketamine for pain management in the ED: http://bit.ly/EMN-EMedHomeVideos.
Creator: Alice S.Y. Lee, MD
Duration: 23:55
Alice Lee, MD, and Bill Fulton, MD, discuss the case of a 62-year-old with a ground-level fall while intoxicated. He is on Plavix, sustained a facial trauma, has a 10 cm laceration and a GCS of 15, and can’t move his arms. What’s his diagnosis? Watch to learn more about this interesting case.
Creator: Christine Butts, MD
Duration: 00:06
Christine Butts, MD, has reviewed more than 9,000 ultrasound scans in her career and has seen many interesting cases, a lot of great diagnoses, and several significant mistakes in that time. Most of them were a result of misinterpretation of the images on screen, and these videos offer great ultrasound pearls. This video shows the sagittal view of the pelvis. The bladder is seen on the left, with a large complex collection extending to the right. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:06
This video from Christine Butts, MD, shows the transverse view of the pelvis. The bladder is seen anteriorly as a well-defined anechoic area, with a circular, hypoechoic, complex collection deep to it. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 00:06
This video from Christine Butts, MD, shows the sagittal view of the right upper quadrant. The liver is seen on the left of the image, with a hypoechoic area (C) in the hepatorenal space. Read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 2:48
Many types and etiologies of headache and facial pain afflict ED patients, and sorting through them can be a challenge. Craniofacial experts themselves, in fact, do not attempt to remember the subtle differences between the various conditions causing craniofacial pain, but instead refer to the third edition of the International Classification of Headache Disorders, says Larry Mellick, MD.

This video shows a 9-year-old boy who crashed his motor bike and had a concussion, forehead contusion, and broken nose. A month later, he was still experiencing pain in his forehead, but rather than go right to CT or MRI, Dr. Mellick tried a different approach. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 8:07
Headaches can be caused by life-threatening conditions such as aneurysms, like this patient who experienced a posterior communicating artery aneurysm and was taken for emergent aneurysm coiling. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 19:08
Don’t miss this video of Michael Winters, MD, discussing Critical Care Quickies for the Crashing Patient: http://bit.ly/EMN-EMedHomeVideos.
Creator: Martha Roberts, ACNP, PNP
Duration: 14:40
Compartment syndrome made it on the weird and wild list not only because it is uncommon but also because it is difficult to identify. It presents in strange ways, and is often missed the first time a patient seeks care. Watch this video of Martha Roberts, ACNP, PNP, interviewing Adam Cohen, MD, about how to treat compartment syndrome, and read more in the Procedural Pause blog at http://bit.ly/ProceduralPause.
Creator: Larry Mellick, MD
Duration: 1:08
Uncircumcised boys and men are at increased risk of balanitis, posthitis, balanoposthitis, phimosis, and paraphimosis, says Larry Mellick, MD. This video shows a patient with this complaint and discusses the treatment plan. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 3:08
Circumcised boys and men can also experience complications, says Larry Mellick, MD. Meatal stenosis can be caused by diaper irritation and penile glans inflammation. See a case in this video. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.
Creator: Christine Butts, MD
Duration: 0:05
Ultrasound assessment of the IVC has fallen out of favor, but Christine Butts, MD, said it’s not time to give up on the IVC. Watch this video of the IVC in almost full collapse during respiration before the patient received hydration, and read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Christine Butts, MD
Duration: 0:05
Christine Butts, MD, notes that the IVC can show fluid status. This video shows the same IVC seen in Video 1 after a fluid bolus. Note that it has increased in size. Watch this video of the IVC before the patient received hydrations, and read more in Dr. Butts’ column at http://bit.ly/SpeedSound.
Creator: Larry Mellick, MD
Duration: 2:03
Dr. Larry Mellick looks at the softer side of emergency medicine for a change—how important pets are to patients and how they can help with treatment. In this video, he has insights about that after seeing his daughter interact with her new puppy. Read more in Dr. Mellick’s blog at http://bit.ly/Mellick.
Creator: Martha Roberts, ACNP, PNP
Duration: 5:12
Martha Roberts, ACNP, PNP, and James R. Roberts, MD, ask, what do you do when something weird and wild comes into your emergency department? This month, they we mean lacerations over tattoos or body piercings. Cosmetic repair of injuries involving tattoos and piercings are important to patients, and here’s how you can ensure proper wound closure while preserving the underlying body art.

Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Martha Roberts, ACNP, PNP
Duration: 7:32
Martha Roberts, ACNP, PNP, and James R. Roberts, MD, say scalp abscesses and kerions can be tricky and complicated. They can appear small and harmless, but require immediate attention. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: EMedHome.com
Duration: 44:15
Nilesh Patel, DO, with a new lecture, Recent Articles You Don’t Want to Miss. http://bit.ly/EMN-EMedHomeVideos.
Creator: Martha Roberts, ACNP, PNP
Duration: 2:34
Martha Roberts, ACNP, PNP, and James R. Roberts, MD, delve into splints for immobilizing and stabilizing injuries, alleviating pain and edema, and promoting healing. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: EMedHome.com
Duration: 19:28
Tune in for a lecture by Mike Winters, MD, Beyond the Golden Hour: Caring for the ICU Boarder: http://bit.ly/EMN-EMedHomeVideos
Creator: Alice S.Y. Lee, MD
Duration: 26:23
Alice Lee, MD, and Marc Zosky, MD, review the case from presentation to diagnosis and everything in between of a 53-year-old healthy man with sudden onset paralysis and slurred speech.
Creator: Alice S.Y. Lee, MD
Duration: 22:00
Alice Lee, MD, points out that Dr. Amal Mattu, MD, always says if your patient is sweating, you should be too. In this month’s screencast, she and Scott Megna, MD, discuss and diagnose a 36-year-old man who presents with burning pain and shortness of breath.
Creator: Martha Roberts, CEN, ACNP
Duration: 2:34
Martha Roberts, CEN, ACNP, and James R. Roberts, MD, review the basics of splinting and offer pearls and pitfalls for using ACE Wraps, Aircast, and Velcro. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Larry Mellick, MD
Duration: 4:39
The time for possible salvage and survival of a torsed testicle is commonly thought to be six to eight hours, but Dr. Larry Mellick says survival can actually occur after that. Watch this video of torsion in a 14-year-old. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Martha Roberts, CEN, ACNP
Duration: 9:03
Martha Roberts, CEN, ACNP, and James R. Roberts, MD, review the basics of splinting and offer pearls and pitfalls for these cases. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 2:29
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, bring you a clinical pearl from Helen Karellas Bardis, NP, on a less invasive way to administer ocular anesthetics. Don’t forget to visit their blog each month for more pearls and procedure tips at http://bit.ly/ProceduralPause.
Creator: Christine Butts, MD
Duration: 0:02
Read Dr. Christine Butts’ article, “A New Measure to Single Out High-Risk PE Patients,” in the March 2017 issue, and then watch this video that shows step 1 of the TAPSE measurement.
Creator: Christine Butts, MD
Duration: 0:04
Read Dr. Christine Butts’ article, “A New Measure to Single Out High-Risk PE Patients,” in the March 2017 issue, and then watch this video that shows step 2 of the TAPSE measurement.
Creator: Martha Roberts, CEN, ACNP
Duration: 2:33
Martha Roberts, CEN, ACNP, and James R. Roberts, MD, review the case of a boy who superglued his eye shut. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Martha Roberts, CEN, ACNP
Duration: 2:00
Martha Roberts, CEN, ACNP, and James R. Roberts, MD, with their favorite new ED gadget: the NIO, an intraosseous device that is ready to go in 18 seconds. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Larry Mellick, MD
Duration: 4:50
Many children are vaccinated against varicella, but breakthrough cases of chickenpox still occur, like in this 6-year-old boy. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 7:10
A young patient with hemiplegic migraine presents to the ED unable to walk or follow commands. Fifteen minutes after Dr. Larry Mellick treated him with paraspinous cervical injections of bupivacaine, the young man was able to move all extremities. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Martha Roberts, CEN, ACNP
Duration: 11:36
Martha Roberts, CEN, ACNP, and James R. Roberts, MD, with tips and tricks for repairing nail bed lacerations in children. Tip #1: Don’t lie to them. Give them just enough details to be able to complete your procedure. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Martha Roberts, CEN, ACNP
Duration: 4:13
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, with an alternative to the Morgan Lens: eye irrigation using IV saline, a nasal cannula, and the connector piece from a Salem Sump kit. This procedure is less invasive and less traumatic for patients and easier for providers. A win-win! Read more in their blog at http://bit.ly/ProceduralPause.
Creator: EMedHome.com
Duration: 69:11
Dr. Mattu discusses the modern management of cardiogenic pulmonary edema.
Creator: Martha Roberts, CEN, ACNP
Duration: 4:46
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, take on a thrombosed hemorrhoids in the ED. Surprised? You can do it, too. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Martha Roberts, CEN, ACNP
Duration: 13:30
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, focus on the best way to detect proximal lower extremity DVTs in the emergency department. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Martha Roberts, CEN, ACNP
Duration: 2:05
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, say it’s time to be fearless and embrace the true utility — and maybe implement a new policy in your ED — of ultrasound-guided intravenous (IV) line insertion. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration:
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, look at ocular ultrasound in this video, sharing tips for assessing the eye and diagnosing retinal detachment, which in the past required a referral to an ophthalmologist and often delayed therapy. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 2:44
This bonus feature from James R. Roberts, MD, & Martha Roberts, CEN, ACNP, brings you tips, tricks, and pearls to make your emergency medicine practice easier. This month, their second Clinical Pearl features how to diagnose and treat a mallet finger. Find out all you need to know by watching this video. Read more in their blog at http://bit.ly/ProceduralPause.
Creator: Larry Mellick, MD
Duration: 3:48
Dr. Larry Mellick shares tips and tricks that will help emergency physicians repair ear cartilage lacerations with ease. Read his blog post at http://bit.ly/Mellick, and then watch this video to see a laceration repair.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 8:31
This new bonus feature from James R. Roberts, MD, & Martha Roberts, CEN, ACNP, brings you tips, tricks, and pearls to make your emergency medicine practice easier. This month, their first Clinical Pearl features the JR Knot, invented by its namesake James Roberts. This easy pearl will show you how to secure a central line. Read the Roberts’ blog at http://bit.ly/ProceduralPause.
Creator: Larry Mellick, MD
Duration: 3:12
Dr. Larry Mellick has tips and tricks for examining and diagnosing patients with calf pain. Read his blog post at http://bit.ly/Mellick, and then watch this video to see how to examine an injured soleus muscle.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 5:54
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, note that foreign body removal may not be emergent, but it can be urgent. And your secret weapon for removing these items is fluoroscopy. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video to make sure you know all the basics.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 5:02
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, take on traumatic knee injuries this month. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video to make sure you know all the basics of a knee exam.
Creator: Larry Mellick, MD
Duration: 1:35
Dr. Larry Mellick acknowledges the bad blood that sometimes exists between emergency medicine and surgery, but says there are many times he is grateful for his surgical colleagues, like in this video. Read Dr. Mellick’s blog post at http://bit.ly/Mellick, and then watch this video to see him talk about a patient with a stiletto heel injury.
Creator: Larry Mellick, MD
Duration: 13:14
Dr. Larry Mellick interviews Ricaurte A. Solis, DO, who has created, with input from the FOAM community, a novel way to deliver oxygen during needle cricothyroidotomy. Read Dr. Solis’s blog post at http://bit.ly/Mellick, and then watch this video to hear him demonstrate this innovative technique.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 5:45
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, note that emergency providers must always consider a procedure’s impact on patient comfort, care, and outcome. Nowhere is that more of a concern than draining a sensitive vaginal abscess. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video for how to treat a broken tooth in the ED.
Creator: Larry Mellick, MD
Duration: 3:47
Peripheral and central sensitization of pain pathways are recognized as part of the process of chronic and subacute pain syndromes. Read Dr. Mellick’s blog post at http://bit.ly/Mellick, and then watch this video to hear how ketamine helped this patient with peripheral neuropathy pain.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 2:33
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, note that EPs aren’t dentists, but they can help patients with dental fractures until they can see a dentist. The best part about this particular procedure is that anyone can do it, and it only takes a few minutes. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video for how to treat a broken tooth in the ED.
Creator: Larry Mellick, MD
Duration: 2:13
Watch Dr. Larry Mellick diagnosis a young girl who presents with a targetoid rash on her arms and legs. Find more information in his vlog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 3:10
Watch as Dr. Larry Mellick figures out the type of rash this child has. Find more information in his vlog at a href="http://bit.ly/Mellick" target="_blank">http://bit.ly/Mellick.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 6:31
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, continue their series on abscess care with this video showing an I&D of an axillary abscess. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video for how to drain an abscess.
Creator: Larry Mellick, MD
Duration: 2:45
Once you see a case of pityriasis rosea, you won’t forget the rash, says Dr. Larry Mellick. This video shows you what to look for. Find more information about pediatric rashes in his vlog at http://bit.ly/Mellick.
Creator: Brita Zaia, MD
Duration: 0:10
Dr. Graham Walker discovers another practice-changer for patients with broken hips. Watch this video by Brita Zaia, MD, of a needle popping through the fascia iliaca, and read Dr. Walker’s column in the April issue or in his collection at http://bit.ly/WalkerEmergentology.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 12:34
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, start a new series on abscess care in the emergency department with their first full-length tutorial on abscess drainage. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video for how to set up to drain an abscess.
Creator: Larry Mellick, MD
Duration: 7:16
Each emergency physician has his favorite technique for reducing shoulder dislocations. Watch this video, the third of three from Dr. Larry Mellick this month, to learn tips for reducing dislocations. Find more information about shoulder reductions in his vlog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 3:47
Hesitating for even seconds during an open thoracotomy will guarantee failure or a poor patient outcome. Nevertheless, no matter how grisly and stressful this procedure may be, it has real potential for saving lives. Watch this video from Dr. Larry Mellick, and find more information in his vlog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 4:25
Oral nerve blocks are technically more difficult than most EPs realize or admit, says Dr. Larry Mellick. These two videos demonstrate techniques for giving these blocks. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn how to do an inferior alveolar nerve block.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 3:51
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, wrap up their lumbar puncture series with some pearls for LP patients. Read the blog post, “Lumbar Puncture: Golden Rules” at http://bit.ly/ProceduralPause, and then watch how to set up a sterile field in this video.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 0:06
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, wrap up their lumbar puncture series with some pearls for LP patients. Read the blog post, “Lumbar Puncture: Golden Rules” at http://bit.ly/ProceduralPause, and then watch how to do a needle insertion in this video.
Creator: Larry Mellick, MD
Duration: 4:11
Don’t cringe when you think of giving epinephrine outside of cardiac arrest, says Dr. Larry Mellick. These three videos demonstrate techniques for giving well calibrated and exact doses of epinephrine. This first video shows pulse dosing during intubation. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn more.
Creator: Larry Mellick, MD
Duration: 5:49
The videos this month explain how to mix and administer pulse dose epinephrine, says Dr. Larry Mellick. This second video shows how to mix epinephrine for pulse dosing. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn more.
Creator:
Duration: 5:03
Pediatric pulse dosing employs the same concentration used for adults, says Dr. Larry Mellick. This third video shows how to administer it to a child. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn more.
Creator: Larry Mellick, MD
Duration: 1:57
Diseases and complications associated with intravenous drug use are many and varied, says Dr. Larry Mellick. These three videos demonstrate three skin findings associated with drug addiction and IV drug use. This second video shows the piloerection that accompanies withdrawal. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn more.
Creator: Larry Mellick, MD
Duration: 2:24
Diseases and complications associated with intravenous drug use are many and varied, says Dr. Larry Mellick. These three videos demonstrate three skin findings associated with drug addiction and IV drug use. This third video shows the diffuse petechiae from septic emboli of life-threatening infective endocarditis. Read his video introduction at http://bit.ly/Mellick , and then watch this video to learn more.
Creator: Larry Mellick, MD
Duration: 0:32
Diseases and complications associated with intravenous drug use are many and varied, says Dr. Larry Mellick. These three videos demonstrate three skin findings associated with drug addiction and IV drug use. This first video shows the track marks associated with repeated intravenous injection. Read his video introduction at http://bit.ly/Mellick, and then watch this video to learn more.
Creator: Charles Bruen, MD
Duration: 0:05
Read Dr. Charles Bruen’s blog post at http://bit.ly/BruenSponCirc, and then watch this video to see an demonstrating angiography of the left main, LAD, and coronary arteries showing a 100% occlusion in the mid-LAD.
Creator: Larry Mellick, MD
Duration: 0:56
Relative bradycardia in the face of severe blood loss and hypotension contradicts what EPs have been taught about the body’s response to hemorrhage, but Dr. Larry Mellick sets the record straight. Read his blog post at http://bit.ly/Mellick, and then watch this video to learn more about hypotension and paradoxical bradycardia.
Creator: Charles Bruen, MD
Duration: 0:06
Read Dr. Charles Bruen’s blog post at http://bit.ly/BruenSponCirc, and then watch this video to see an emergent transthoracic echocardiogram in the parasternal long axis view. Left ventricular hypertrophy was present, systolic function was at the lower limits of normal, and he had a mild asynchronous kinesis of the septum.
Creator: Christine Butts, MD
Duration: 0:06
Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows the subxiphoid view of a pericardial effusion demonstrating mass effect on the right ventricle (RV).
Creator: Larry Mellick, MD
Duration: 5:50
Pyloric stenosis can occur in adults and children, with almost the same symptoms. Read this blog post and watch a video by Dr. Larry Mellick to recognize the signs when a patient presents in your ED.
Creator: Larry Mellick, MD
Duration: 1:31
Intussusception sometimes does not present with classic symptoms, and the only clue might be a comatose-appearing infant. Dr. Larry Mellick says this presentation has the potential to trip up even the most astute clinician.
Creator: Martha Roberts
Duration: 0:17
Watch Dr. James Roberts demonstrate the correct technique for patellar relocation.
Creator: Larry Mellick, MD
Duration: 8:22
Dr. Mellick’s suspicions smoldered for years; he even thought the problem resided with his technique. But one patient made him realize that the textbooks were just wrong: Wire cutters were not going to release a zipper from penile skin.
Creator: Christine Butts, MD
Duration: 0:29
Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows assessment of the venous anatomy as seen under ultrasound. The internal jugular (IJ) vein is seen as the triangular vessel that appears to fluctuate slightly with respiration. As the view progresses inferiorly, the IJ can be seen to join the SCV, which appears tubular in this orientation.
Creator: Larry Mellick, MD
Duration: 1:24
For a fantastic instructive 1:24-minute video on treating paronychia, just watch Dr. Larry Mellick, a professor of emergency medicine at the Medical College of Georgia, at work.
Creator: Larry Mellick, MD
Duration: 12:14
Chest tube placement borders on the barbaric, says Dr. Mellick. The use of large-bore chest drainage devices is not supported by most guidelines, and he explains in this month’s EduBlog that needle aspiration is just as effective, with a small-bore chest drain working if needle aspiration fails.
Creator: Graham Walker, MD
Duration: 2:01
See One, Do One. Watch Dr. Walker demonstrate intranasal medication administration.
Creator: Christine Butts, MD
Duration: 0:02
Watch the bedside echocardiogram performed on the patient featured in Dr. Christine Butts’ December 2012 column, “Identifying Right Ventricular Strain with Bedside ECHO.”
Creator: Christine Butts, MD
Duration: 0:03
Watch the bedside echocardiogram performed on the patient featured in Dr. Christine Butts’ December 2012 column, “Identifying Right Ventricular Strain with Bedside ECHO.”
Creator: Larry Mellick, MD
Duration: 6:53
Patients don’t come to the ED for headache unless the severity and duration are intolerable or the headache is frighteningly different. Emergency physicians need as many therapeutic arrows in their quiver as possible to treat those headaches. The bilateral paraspinous cervical injection with small amounts of bupivacaine in the lower neck is an excellent option for managing tough headache cases.
Creator: Larry Mellick, MD
Duration: 8:16
Video from the M2E Too! blog on inserting a word catheter in a patient with a Bartholin’s gland abscess.