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February 2020: The Procedural Pause with James R. Roberts, MD, and Martha Roberts, ACNP, CEN: Using Ultrasound for Paracentesis

Video Author: Martha Roberts, ACNP
Published on: 01.31.2020

Ultrasound can help lower the rate of complications, avoid solid organ or intestine puncture, and help identify which patients are best suited for paracentesis. Watch this video about prepping for this procedure, and learn more in their blog at http://bit.ly/EMN-ProceduralPause.

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Creator: Martha Roberts, ACNP
Duration: 6:22
The key to a successful paracentesis starts with identifying landmarks, using ultrasound to determine the evacuation site, and having all the equipment prepped and ready to go. Watch this video about performing the procedure, and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 27:55
Dr. Lu explores how to handle challenging pediatric cases.
Creator: Alice S.Y. Lee, MD
Duration: 23:39
Dr. Lee and Salim Rezaie, MD, delve into the case of a 73-year-old woman with acute onset of thoracic back pain.
Creator: Christine Butts, MD
Duration: 0:05
Christine Butts, MD, looks at the pros and cons of early systolic notching to rule in or out massive or submassive PE at the bedside. Read more in her column at http://bit.ly/SpeedSound, and watch this video to see a parasternal short axis view of the base of the heart.
Creator: Martha Roberts, ACNP
Duration: 3:49
Ultrasound can help lower the rate of complications, avoid solid organ or intestine puncture, and help identify which patients are best suited for paracentesis. Watch this video about prepping for this procedure, and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 25:06
Dr. Bontempo discusses how to treat the crashing patient.
Creator: Alice S.Y. Lee, MD
Duration: 20:21
Dr. Lee and Greg Henry, MD, discuss a 66-year-old man with diabetes, hypertension, and afib who presented with acute onset of vision problems.
Creator: Martha Roberts, ACNP
Duration: 1:52
This old-school technique will direct your therapy before performing a paracentesis. Watch this video and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Larry Mellick, MD
Duration: 5:01
Dr. Mellick delves into cricothyrotomies, focusing on the three variations for the surgical techniques. Watch this video, and learn more in his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 23:27
Dr. Mallemat features highlights from the 25th Annual Scientific Assembly of the American Academy of Emergency Medicine.
Creator: Alice S.Y. Lee, MD
Duration: 25:50
Dr. Lee and Evie Marcolini, MD, discuss an elderly woman with concerning symptoms for stroke, but is she really having a stroke?
Creator: Martha Roberts, ACNP
Duration: 10:48
Fingertip amputations are common in the ED, and simple closure and expert consultation are often required. Watch this video and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Larry Mellick, MD
Duration: 1:53
Dr. Mellick has been seeing a lot of second disease and fifth disease—it’s that time of year. Watch this video of a patient with a positive rapid strep test and prominent red lips, and learn more about all the rashes in his blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 1:51
Dr. Mellick has all you need to know about rashes. Watch this video of a child with fifth disease who presented with a slapped face appearance and a rash over his extremities, and learn more about all the rashes in his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 72:27
Dr. Patel explores current evaluation and management of complications of cirrhosis.
Creator: Alice S.Y. Lee, MD
Duration: 26:15
Jonathan Graff, MD, presents the case of a 66-year-old with an acute amitriptyline ingestion to Dr. Lee and James Roberts, MD.
Creator: Larry Mellick, MD
Duration: 7:14
Dr. Mellick talks to a mother whose toddler had a breath-holding spell and a vasovagal event. Read more his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 28:06
Dr. Moore explores cutting-edge resuscitation, including head-up CPR, eCPR, and more.
Creator: Martha Roberts, ACNP
Duration: 6:07
Subungual hematomas can be a terror, the Roberts say. They are painful, ugly-looking, and sometimes confusing, but a few tips make draining the accumulated blood and relieving the pressure simple. Learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Alice S.Y. Lee, MD
Duration: 23:30
Dr. Lee and Jonathan Graff, MD, diagnose a 29-year-old diabetic brought to the ED for an anxiety attack. He has shortness of breath, nausea, and stomach pain. What’s really going on here?



Creator: Martha Roberts, ACNP
Duration: 6:22
The key to a successful paracentesis starts with identifying landmarks, using ultrasound to determine the evacuation site, and having all the equipment prepped and ready to go. Watch this video about performing the procedure, and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 27:55
Dr. Lu explores how to handle challenging pediatric cases.
Creator: Alice S.Y. Lee, MD
Duration: 23:39
Dr. Lee and Salim Rezaie, MD, delve into the case of a 73-year-old woman with acute onset of thoracic back pain.
Creator: Christine Butts, MD
Duration: 0:05
Christine Butts, MD, looks at the pros and cons of early systolic notching to rule in or out massive or submassive PE at the bedside. Read more in her column at http://bit.ly/SpeedSound, and watch this video to see a parasternal short axis view of the base of the heart.
Creator: Martha Roberts, ACNP
Duration: 3:49
Ultrasound can help lower the rate of complications, avoid solid organ or intestine puncture, and help identify which patients are best suited for paracentesis. Watch this video about prepping for this procedure, and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 25:06
Dr. Bontempo discusses how to treat the crashing patient.
Creator: Alice S.Y. Lee, MD
Duration: 20:21
Dr. Lee and Greg Henry, MD, discuss a 66-year-old man with diabetes, hypertension, and afib who presented with acute onset of vision problems.
Creator: Martha Roberts, ACNP
Duration: 1:52
This old-school technique will direct your therapy before performing a paracentesis. Watch this video and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Larry Mellick, MD
Duration: 5:01
Dr. Mellick delves into cricothyrotomies, focusing on the three variations for the surgical techniques. Watch this video, and learn more in his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 23:27
Dr. Mallemat features highlights from the 25th Annual Scientific Assembly of the American Academy of Emergency Medicine.
Creator: Alice S.Y. Lee, MD
Duration: 25:50
Dr. Lee and Evie Marcolini, MD, discuss an elderly woman with concerning symptoms for stroke, but is she really having a stroke?
Creator: Martha Roberts, ACNP
Duration: 10:48
Fingertip amputations are common in the ED, and simple closure and expert consultation are often required. Watch this video and learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Larry Mellick, MD
Duration: 1:53
Dr. Mellick has been seeing a lot of second disease and fifth disease—it’s that time of year. Watch this video of a patient with a positive rapid strep test and prominent red lips, and learn more about all the rashes in his blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 1:51
Dr. Mellick has all you need to know about rashes. Watch this video of a child with fifth disease who presented with a slapped face appearance and a rash over his extremities, and learn more about all the rashes in his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 28:06
Dr. Moore explores cutting-edge resuscitation, including head-up CPR, eCPR, and more.
Creator: Martha Roberts, ACNP
Duration: 6:07
Subungual hematomas can be a terror, the Roberts say. They are painful, ugly-looking, and sometimes confusing, but a few tips make draining the accumulated blood and relieving the pressure simple. Learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Alice S.Y. Lee, MD
Duration: 23:30
Dr. Lee and Jonathan Graff, MD, diagnose a 29-year-old diabetic brought to the ED for an anxiety attack. He has shortness of breath, nausea, and stomach pain. What’s really going on here?
Creator: Martha Roberts, ACNP
Duration: 7:10
The Roberts say the figure-of-eight suture is a fascinating technique, often used in unique cases. Plus the stitch is extremely secure and easy to place. Learn more in their blog at http://bit.ly/EMN-ProceduralPause.
Creator: Alice S.Y. Lee, MD
Duration: 23:45
Dr. Lee and Seth Collings Hawkins, MD, discuss a 62-year-old woman with hypertension and hypothyroidism who was bitten by a snake and why you should not use a tourniquet, cut or suck the wound, or apply ice or electricity.
Creator: Larry Mellick, MD
Duration: 3:09
Prepubertal boys presenting to the ED with dysuria are uncommon, and Dr. Mellick reviews all the possible causes in this video. Read more in his blog at http://bit.ly/Mellick.
Creator: EMedHome.com
Duration: 20:04
Dr. Ahn describes how to find the subarachnoid in this illuminating video.
Creator: EMedHome.com
Duration: 38:48
Jean Klig, MD, reviews pediatric emergency medicine pearls you’ll use in your practice every day: http://bit.ly/EMN-EMedHomeVideos
Creator: Alice S.Y. Lee, MD
Duration: 31:38
Two patients present with chest pain and look really sick. Watch this screencast as Dr. Lee and Dr. Cristian Patterson diagnose these patients and learn lots of new info about how to diagnose this devastating illness.
Creator: Martha Roberts, ACNP
Duration: 5:26
The Roberts explain how to remove a punctual plug when it is irritating a patient’s eye. Learn more in their video at http://bit.ly/EMN-ProceduralPause.
Creator: Alice S.Y. Lee, MD
Duration: 29:00
Dr. Lee and and Nat Kittisarapong, MD, discuss a patient who drove himself to the ED and then became unconscious—because he had a gunshot wound to the chest.
Creator: Martha Roberts, ACNP
Duration: 9:02
Martha Roberts, ACNP, CEN, and James R. Roberts, MD, look at the trocar and whether it should be used in the ED: http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 30:32
Michael Winters, MD, delves into post-intubation analgesia and sedation in this fascinating video: http://bit.ly/EMN-EMedHomeVideos.
Creator: Larry Mellick, MD
Duration: 5:34
Conjunctivitis is a common condition and easy enough to treat, but several uncommon conjunctivitis syndromes require more care and should not be missed. Watch Dr. Mellick review acute hemorrhagic conjunctivitis, conjunctivitis-otitis syndrome, and parinaud oculoglandular syndrome in the videos, and read more in his blog at http://bit.ly/Mellick.
Creator: Martha Roberts, ACNP
Duration: 8:18
The slit lamp is a straightforward and user-friendly machine designed to make ocular exams easy. Martha Roberts, ACNP, CEN, and James R. Roberts, MD, show you what all its bells and whistles do: http://bit.ly/EMN-ProceduralPause.
Creator: EMedHome.com
Duration: 23:20
Michael Winters, MD, discusses post-arrest care in the ED: http://bit.ly/EMN-EMedHomeVideos.
Creator: Martha Roberts, ACNP
Duration: 7:57
Rectal exams are difficult for the patient and require true expertise. You cannot expect to complete a good rectal exam or remove a rectal foreign body without the correct information, good bedside relationship, and the right equipment, and Martha Roberts, ACNP, CEN, and James R. Roberts, MD, show you the best way to handle these cases: http://bit.ly/EMN-ProceduralPause.
Creator: Alice S.Y. Lee, MD
Duration: 33:28
Did you miss Dr. Lee trying to stump Seth Collings Hawkins, MD, at our ACEP booth? Watch her screencast this month to see if you can figure out this mystery case yourself!
Creator: Larry Mellick, MD
Duration: 4:08
The latest American Academy of Pediatrics guidelines are causing confusion for experienced andinexperienced emergency physicians alike. Dr. Mellick shines some light to make your practice easier. Read more in his blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 5:28
Sometimes when it’s time to remove a Foley catheter, the balloon won’t deflate. Then what? Dr. Larry Mellick has all the techniques you need in this video and in his blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 4:49
There’s more than meets the eye when treating bursitis, and Dr. Larry Mellick has all you need to know about subacromial bursitis in this video and in his blog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 5:07
Osteoarthritis of the knee commonly causes pes anserine bursitis, and this video and Dr. Larry Mellick’s blog shows how to inject the joint 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: 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: 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: 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: Alice S.Y. Lee, MD
Duration: 22:32
Alice Lee, MD, and Kevin Craig, MD, review the case of a 55-year-old man with a history of cirrhosis who presents with bloody emesis and hypotension. What’s the diagnosis?
Creator: Larry Mellick, MD
Duration: 15:08
Dr. Larry Mellick and colleagues cardiovert the first emergency medicine residency graduate, Bruce Janiak, MD, who narrates most of the procedure in this video! Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
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: Larry Mellick, MD
Duration: 10:42
Dr. Larry Mellick and colleagues test the bag-valve mask for preoxygenation. You will be surprised by the results! Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Alice S.Y. Lee, MD
Duration: 26:30
Alice Lee, MD, and Bill Fulton, MD, review the case of an 80-year-old man bleeding briskly from his gums.
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: Larry Mellick, MD
Duration: 4:05
Dr. Larry Mellick says EPs fail patients during cardiopulmonary resuscitation in many ways, so it’s critical to find the resuscitation sweet spot for each patient and to never waver during a CPR event. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 2:39
Too fast or too slow compressions, too shallow or two deep. Find out all the mistakes that EPs make during CPR and why code team leadership is needed in Dr. Larry Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 2:21
A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago, but experience has borne out their effectiveness. Listen in to this video as Dr. Mellick discusses double sickening in this mother’s daughter. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
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: Larry Mellick, MD
Duration: 1:00
A number of older clinical concepts may be unfamiliar to younger clinicians, but these clinical concepts are useful in pediatric medicine. Some of these concepts showed up in the medical literature for the first time nearly a century ago, but experience has borne out their effectiveness. This video shows an oldie but goodie tip for how to position a child properly for ear cleaning. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 2:47
Varicella cases have markedly declined, and presentations are often atypical since the advent of immunizations, so younger physicians are less aware of the appearance and clinical presentations of this viral infection. This video shows disseminated varicella in an HIV patient. Find out more in Dr. Mellick’s blog and video at http://bit.ly/Mellick.
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: 9:55
Using pain as a diagnostic tool may seem contrary to the basic tenets of medicine, but it can be a lifesaving maneuver. Dr. Mellick reviews a new test for conversion disorder, created by Mario Soto, MD, in which saline is squirted into the eye of a comatose or seizing patient. 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: Larry Mellick, MD
Duration: 5:50
How could a Lyme disease lookalike rash and anaphylaxis to meat have anything in common? Find out more as Dr. Larry Mellick reviews their common vector in this video and blog post, which you can find at http://bit.ly/Mellick.
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: Larry Mellick, MD
Duration: 2:51
Multiple methods are touted for reducing anterior shoulder dislocations, but the Davos technique is a nontraumatic, patient-controlled, and auto-reduction technique that does not require the use of anesthesia. Dr. Larry Mellick reviews it in this video and blog post, which you can find at http://bit.ly/Mellick.
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: Larry Mellick, MD
Duration: 5:30
The thought of blindly “slicing and dicing” fingertips leaves Dr. Larry Mellick cold. Instead, he reviews the best approaches for fingertip abscesses in this video and blog post, which you can find at http://bit.ly/Mellick.
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: Larry Mellick, MD
Duration: 2:43
Dr. Larry Mellick says emergency physicians have mental blocks when it comes to managing priapism. He helps dispel some of the performance anxiety associated with this condition by teaching how to mix up the phenylephrine used for intracavernosal blocks, which means this penile compartment syndrome doesn’t languish while EPs wait for the urologist. Read his blog post at http://bit.ly/Mellick, and then watch this video.
Creator: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 9:37
This month James R. Roberts, MD, & Martha Roberts, CEN, ACNP, start a series on ultrasound with a look at the basic functionality of the machine and how to look for foreign bodies in the extremities. 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: 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: 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: 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: 1:51
EPs are frequently heard to say that they aren’t good at diagnosing pediatric rashes, but this video from Dr. Larry Mellick will help with identifying shingles in children. Find more information about rashes in his vlog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 2:15
Some rashes aren’t difficult to diagnose once you’ve seen a case or two. This video from Dr. Larry Mellick helps with diagnosing strep. Find more information about pediatric rashes in his vlog at http://bit.ly/Mellick.
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: 4:45
Shoulder dislocations are fairly common orthopedic emergencies presenting to the emergency department. Watch this video, the first of three from Dr. Larry Mellick this month, to learn tips for reducing an inferior shoulder reduction. Find more information about shoulder reductions in his vlog at http://bit.ly/Mellick.
Creator: Larry Mellick, MD
Duration: 3:21
Posterior shoulder dislocations are rare, and factors such as the dislocation duration, patient comorbidities, prior dislocation events, and associated fractures or bony lesions will determine the specific technique used. Watch this video, the second of three from Dr. Larry Mellick this month, to learn tips for reducing a posterior shoulder reduction. Find more information about shoulder reductions in his vlog at http://bit.ly/Mellick.
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: James R. Roberts, MD, & Martha Roberts, CEN, ACNP
Duration: 0:15
James R. Roberts, MD, & Martha Roberts, CEN, ACNP, turn their attention to eyebrow lacerations repair. Read their blog post at http://bit.ly/ProceduralPause, and then watch this video of an eyebrow laceration repair.
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: 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: Larry Mellick, MD
Duration: 1:29
The management of sucking chest wounds and open pneumothorax has changed. Dr. Larry Mellick explains the current guidelines for treatment, whether on the battlefield or off. Read his blog post at http://bit.ly/Mellick, and then watch this video to learn more.
Creator: Martha Roberts
Duration: 1:35
Olecranon bursitis can be painless or an irritating condition involving the bursa of the ulna in the elbow. James Roberts, MD, and Martha Roberts, ACNP, CEN, review the best way to treat this condition in their blog post. Read that at http://bit.ly/ProceduralPause, and then watch this video showing aspiration of a patient’s elbow.
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: Martha Roberts
Duration: 0:17
Watch Dr. James Roberts demonstrate the correct technique for patellar relocation.
Creator: Christine Butts, MD
Duration: 0:11
Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows the technique to assess the venous anatomy of the neck and to identify the subclavian vein (SCV). The high-frequency transducer should be placed in the transverse orientation just lateral to the trachea. Once the internal jugular (IJ) is identified, it can be followed inferiorly until it is seen to join the SCV. Angling the transducer anteriorly will help to visualize this junction.
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: Christine Butts, MD
Duration: 0:05
Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows an “in-plane” approach to a vessel (using a simulator). As the needle is inserted from the end of the transducer, rather than at its mid-point, it traverses the path of the transducer. This enables the entire needle, including the tip, to be visible throughout the procedure, minimizing complications such as arterial puncture or pneumothorax.
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: 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.