Emergency Procedures Video

The following posts contain videos shown or discussed during a recent NPI Emergency Procedures Course taught by Dr. John Shields.

PLEASE FEEL FREE TO EMAIL ME WITH QUESTIONS OR COMMENTS AT EJSHIELDS@GMAIL.COM.

Paracentesis

UNFORTUNATELY WE WERE UNABLE TO DEMONSTRATE THIS WITH THE ULTRASOUND BUT THIS VIDEO WILL GIVE YOU A WAY TO DO THIS PROCEDURE EITHER WITH OR WITHOUT ULTRASOUND. REMEMBER, DOING A THERAPEUTIC PARASCENTESIS IN THE ER IS NOT RECOMMENDED FOR A VARIETY OF REASONS.

Lumbar Puncture

REMEMBER THE TRICKS... MARK YOUR PATIENT, SUPINE IF OPENING PRESSURE, UPRIGHT I FIND TO BE EASIER. SQUARE THE SHOULDERS, HAVE THE PATIENT GET INTO A NICE 'CANNONBALL' OR 'CURLED UP CAT' POSITION. LIBERAL USE OF LIDOCAINE ALL THE WAY TO THE PERIOSTEUM. PREPARE YOUR KIT BEFORE YOU GET GLOVED. GET AN EXTRA TUBE FOR THE LAB.

Z Plasty

Click here for the video.

NICELY DONE... I HAVE ALWAYS HAD A HARD TIME UNDERSTANDING THIS IN MY HEAD. THIS MAKES IT EASY.

Wound Irrigation

Pericardiocentesis

Cardiac Tamponade

Thorascentesis (Diagnostic)

NICE GUIDE TO THIS PROCEDURE

Needle Thorascentesis

THE MIDCLAVICULAR LINE IS NO LONGER PREFERRED BY TRAUMA TEAMS, THE MID-AXILLARY LINE, FOURTH INTERSPACE IS THE WAY TO GO AND IS ALSO WHERE YOU WILL PLACE YOUR CHEST TUBE.

EZIO

THE EZIO IS THE PREFERRED METHOD AND CAN TECHNICALLY BE DONE WITHOUT LOCAL.

Intaosseous Access

TRADITIONAL METHOD, REMEMBER THE BACK AND FORTH TECHNIQUE

External Jugular Cannulation

REMEMBER, THE EJ IS THE LINE TO SHOOT FOR BEFORE YOU GO TO THE CENTRAL LINE.

Arterial Line Placment

Subclavial Central Line Placement in 1950s OR

REMEMBER TO ANGLE SHALLOW, SHOOT FOR THE BEND IN THE CLAVICLE, AND MARCH THE NEEDLE UNDER THE PERIOSTEUM USING FINGER ON OTHER HAND.

Internal Jugular Dummy

BLIND IJ PLACEMENT ON MANNEQUIN INTERNAL JUG

EM Central Lines

THIS SERIES OF VIDEOS IS TOP NOTCH AND SHOULD BE BOOKMARDED AND WATCHED AND SHOWN TO RESIDENTS. TRICKS OF THE TRADE FOR CENTRAL LINES, AND, THE 'HAND BREADTH' TRICK FOR A PULSELESS FEMORAL LINE.

CPAP/BIPAP

THESE TWO VIDEOS WERE NOT SHOWN AT THE CONFERENCE BUT ARE REALLY NICE REVIEWS OF THE THEORY AND PRACTICE OF BIPAP AND CPAP AS A BRIDGE TO THE VENT.

Mechanical Ventilation

PROPER TECHNIQUE FOR BAG VALVE MASK VENTILATION... VERY IMPORTANT.

Predicting the Difficult Intubation

IS HELPFUL IF YOU HAVE TIME TO WORRY ABOUT PATIENT ANATOMY

Use of the Bougie in the Difficult Intubation

GREAT REVIEW OF THE $5 BOUGIE. IF YOUR FACILITY DOESN'T HAVE ONE THEY ARE NOT EXPENSIVE.

LMA Insertion

BETTER LMA VIDEO IN TERMS OF THE STEP BY STEP TECHNIQUE.

LMA Animation

GOOD 3D VIEW OF HOW THE LMA SITS IN THE AIRWAY.

Surgical Airway

GOOD VIDEO. HOPE YOU NEVER HAVE TO DO THIS BUT, IF YOU DO, APPROACH IT WITH CONFIDENCE.

View of Vocal Cords

REAL TIME VIEW OF THE CORDS. THEY ARE WHITE. WATCH THE TUBE PASS THROUGH IF YOU CAN.

Rapid Sequence Intubation

THE MEDS ARE DIFFERENT BUT THE TECHNIQUE IS NICE. REMEMBER TO "LOAD" YOUR PATIENTS IF NECESSARY. REFER TO POWER POINT PRESENTATION FOR FURTHER. ALSO, REMEMBER TO HAVE THREE TECHNIQES TO SECURE THE AIRWAY THAT YOU ARE VERY COMFORTABLE WITH... AS WE PRACTICED THOSE WOULD BE ENDOTRACHEAL INTUBATION, BOUGIE RESCUE, AND LMA OR KING AIR AS YOU PREFER. REMEMBER THE NEEDLE TECHNIQUE FOR SURGICAL AIRWAY AS IT IS A LOT LESS DAUNTING THAN THE BLOODY MESS WHICH TENDS TO BE THE SURGICAL CRIC.