Emergency Medicine Procedures

1296 Pages·2013·84.48 MB·English

by  Eric Reichman

Emergency Medicine
Procedures
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Emergency Medicine
Procedures
Second Edition
Eric F. Reichman, PhD, MD, FAAEM, FACEP
Associate Professor of Emergency Medicine
Attending Physician, Department of Emergency Medicine
Medical Director, Surgical and Clinical Skills Center
University of Texas Health Science Center at Houston-Medical School
Attending Physician, Emergency Department
Memorial Hermann Hospital-Texas Medical Center
Attending Physician, Emergency Department
Lyndon Baines Johnson General Hospital
Houston, Texas
New York Chicago San Francisco Lisbon London Madrid Mexico City
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Copyright © 2013 by Eric F. Reichman, PhD, MD. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication
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To my wife, Kristi. Th anks for your patience with the
semi-permanent card table and computer in the living room,
and the mess with all the papers and fi les. Th anks for your support
and understanding. Th anks to Joey, Jake, Rocky, and Phoebe
for entertaining me each day.
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Contents
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii 18 Supraglottic Airway Devices . . . . . . . . . . . . . . . . . . . 106
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii Fred A. Severyn
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiv 19 Laryngeal Mask Airways . . . . . . . . . . . . . . . . . . . . . 110
Katrin Takenaka and Theltonia Howard
SECTION 1 Introductory Chapters . . . . . . . . . . . . . . . . 1 20 Double Lumen Airway Tube Intubation . . . . . . . . . . . . 122
Joseph Weber
1 Informed Consent for Procedures
in the Emergency Department . . . . . . . . . . . . . . . . . . . 1 21 Fiberoptic Endoscopic Intubation . . . . . . . . . . . . . . . 127
Eric Isaacs Erika D. Schroeder, M. Scott Linscott, and Joseph Bledsoe
2 Aseptic Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 22 Nasotracheal Intubation . . . . . . . . . . . . . . . . . . . . . 134
John S. Rose Ned F. Nasr, Raed Rahman, and Isam F. Nasr
3 Basic Principles of Ultrasonography . . . . . . . . . . . . . . . 13 23 Retrograde Guidewire Intubation . . . . . . . . . . . . . . . 139
Gregory M. Press Roland Petri
4 Ultrasound-Assisted Procedures . . . . . . . . . . . . . . . . . 24 24 Percutaneous Transtracheal Jet Ventilation . . . . . . . . . . 143
Jehangir Meer, Sam Hsu, and Brian Euerle Eric F. Reichman and Aaron Brown
5 Trauma Ultrasound: The FAST Exam . . . . . . . . . . . . . . . 28 25 Cricothyroidotomy . . . . . . . . . . . . . . . . . . . . . . . . 148
Wes Zeger Eric F. Reichman
26 Tracheostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
SECTION 2 Respiratory Procedures . . . . . . . . . . . . . . 35 Teresa M. Romano and Christopher J. Haines
6 Essential Anatomy of the Airway . . . . . . . . . . . . . . . . 35 27 Tracheostomy Care . . . . . . . . . . . . . . . . . . . . . . . . 171
Ned F. Nasr, Serge G. Tyler, H. Gene Hern Jr.
Gennadiy Voronov, and Isam F. Nasr
28 Transtracheal Aspiration . . . . . . . . . . . . . . . . . . . . . 177
7 Basic Airway Management . . . . . . . . . . . . . . . . . . . . 40 Joseph A. Salomone III
Christopher J. Russo and Zach Kassutto
8 Pharmacologic Adjuncts to Intubation. . . . . . . . . . . . . . 47 SECTION 3 Cardiothoracic Procedures . . . . . . . . . . . 181
Ned F. Nasr, David W. Boldt, and Isam F. Nasr 29 Cardiac Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . 181
9 Endotracheal Medication Administration . . . . . . . . . . . . 56 Gregory M. Press and Amy Rasmussen
Shoma Desai 30 Cardioversion and Defibrillation . . . . . . . . . . . . . . . . 193
10 Rapid Sequence Induction . . . . . . . . . . . . . . . . . . . . . 60 Payman Sattar
Piotr C. Aljindi, Ned F. Nasr, and Isam F. Nasr 31 Transcutaneous Cardiac Pacing . . . . . . . . . . . . . . . . . 197
11 Orotracheal Intubation . . . . . . . . . . . . . . . . . . . . . . . 64 Todd M. Larabee
Eric F. Reichman and Joseph Cornett 32 Transthoracic Cardiac Pacing . . . . . . . . . . . . . . . . . . 202
12 Confirmation of Endotracheal Intubation . . . . . . . . . . . . 76 Simon M. Pulfrey
Tarlan Hedayati and Leonardo Rodriguez 33 Transvenous Cardiac Pacing . . . . . . . . . . . . . . . . . . . 205
13 Video-Assisted Orotracheal Intubation Devices . . . . . . . . 80 Eric F. Reichman, Myles C. McClelland, and Brian Euerle
Pholaphat Charles Inboriboon 34 Pacemaker Assessment . . . . . . . . . . . . . . . . . . . . . 212
14 Fiberoptic-Assisted Orotracheal Intubation Devices . . . . . 89 Nnaemeka G. Okafor
Michael Lutes and Olga Pawelek 35 Automatic Implantable
15 Endotracheal Tube Intubating Introducers and Bougies . . . 95 Cardioverter-Defibrillator Assessment . . . . . . . . . . . . . 218
Olga Pawelek and Eric F. Reichman Carlos J. Roldan
16 Digital (Tactile) Orotracheal Intubation . . . . . . . . . . . . 100 36 Pericardiocentesis . . . . . . . . . . . . . . . . . . . . . . . . . 225
O. John Ma and Amanda Munk Eric F. Reichman, Elisabeth Kang, and Jehangir Meer
17 Lighted Stylet Intubation . . . . . . . . . . . . . . . . . . . . . 102 37 Intracardiac Injection . . . . . . . . . . . . . . . . . . . . . . . 236
Philip Bossart and Michael Wallace Payman Sattar
vii
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viii Contents
38 Needle Thoracostomy . . . . . . . . . . . . . . . . . . . . . . 238 61 Whole Bowel Irrigation . . . . . . . . . . . . . . . . . . . . . . 398
Eric F. Reichman and Elizabeth Sowell Steven E. Aks and David D. Gummin
39 Tube Thoracostomy . . . . . . . . . . . . . . . . . . . . . . . . 242 62 Esophageal Foreign Body Removal . . . . . . . . . . . . . . 401
Kimberly T. Joseph Bashar M. Attar
40 Thoracentesis . . . . . . . . . . . . . . . . . . . . . . . . . . . 250 63 Balloon Tamponade of Gastrointestinal Bleeding . . . . . . 407
Eric F. Reichman, Cristal R. Cristia, and Jehangir Meer Bashar M. Attar
41 Open Chest Wound Management . . . . . . . . . . . . . . . 263 64 Gastrostomy Tube Replacement . . . . . . . . . . . . . . . . 414
Eric F. Reichman Maggie Ferng and Ryan C. Headley
42 Emergency Department Thoracotomy . . . . . . . . . . . . 267 65 Paracentesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421
Kenny Banh Susan B. Promes, Elizabeth M. Datner, and Sam Hsu
43 Open Cardiac Massage . . . . . . . . . . . . . . . . . . . . . . 271 66 Diagnostic Peritoneal Lavage . . . . . . . . . . . . . . . . . . 431
Eric F. Reichman Sandeep Johar and Umashankar Lakshmanadoss
44 Cardiac Wound Repair . . . . . . . . . . . . . . . . . . . . . . 274 67 Anal Fissure Management . . . . . . . . . . . . . . . . . . . . 439
Eric F. Reichman Marilyn M. Hallock and Eric F. Reichman
45 Hilum and Great Vessel Wound Management . . . . . . . . 280 68 External Hemorrhoid Management . . . . . . . . . . . . . . 443
Eric F. Reichman Charles Orsay and Eric F. Reichman
46 Thoracic Aortic Occlusion . . . . . . . . . . . . . . . . . . . . 282 69 Prolapsed Rectum Reduction . . . . . . . . . . . . . . . . . . 446
Eric F. Reichman Jamil D. Bayram and Eric F. Reichman
70 Anoscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
SECTION 4 Vascular Procedures . . . . . . . . . . . . . . . . 287 Charles Orsay and Eric F. Reichman
47 General Principles of Intravenous Access . . . . . . . . . . . 287 71 Rigid Rectosigmoidoscopy . . . . . . . . . . . . . . . . . . . . 453
Daniel Belmont Charles Orsay and Eric F. Reichman
48 Venipuncture and Peripheral Intravenous Access . . . . . . 296 72 Rectal Foreign Body Extraction . . . . . . . . . . . . . . . . . 458
Daniel Belmont Charles Orsay and Eric F. Reichman
49 Central Venous Access . . . . . . . . . . . . . . . . . . . . . . 308
Arun Nagdev and Craig Sisson SECTION 6 Orthopedic and
50 Ultrasound-Guided Vascular Access . . . . . . . . . . . . . . 327 Musculoskeletal Procedures . . . . . . . . . . 465
Srikar Adhikari 73 Bursitis and Tendonitis Therapy . . . . . . . . . . . . . . . . 465
51 Troubleshooting Indwelling Central Venous Lines . . . . . . 337 Dedra Tolson
James J. McCarthy 74 Compartment Pressure Measurement . . . . . . . . . . . . 473
52 Accessing Indwelling Central Venous Lines . . . . . . . . . . 340 Matt Kleinmaier and Sanjeev Malik
Lisa Freeman Grossheim 75 Fasciotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 480
53 Pulmonary Artery (Swan-Ganz) Catheterization . . . . . . 344 Justin Mazzillo, Sobia Ansari, and Eric F. Reichman
Pratik Doshi 76 Extensor Tendon Repair . . . . . . . . . . . . . . . . . . . . . 490
54 Peripheral Venous Cutdown . . . . . . . . . . . . . . . . . . . 350 Jaime Harper, Stanley Harper, and Ramasamy Kalimuthu
Flavia Nobay 77 Arthrocentesis . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
55 Intraosseous Infusion . . . . . . . . . . . . . . . . . . . . . . . 361 Eric F. Reichman, John Larkin, and Brian Euerle
Amanda Munk and O. John Ma 78 Methylene Blue Joint Injection . . . . . . . . . . . . . . . . . 517
56 Umbilical Vessel Catheterization . . . . . . . . . . . . . . . . 369 Joseph E. Tonna, Heather H. Bohn, and Matthew R. Lewin
Eric F. Reichman, Amy Noland, and Antonio E. Muñiz 79 Basic Principles of Fracture and Joint Reductions . . . . . . 522
57 Arterial Puncture and Cannulation . . . . . . . . . . . . . . . 376 Scott C. Sherman
Zak Foy and Susan Stroud 80 Sternoclavicular Joint Dislocation Reduction . . . . . . . . . 526
Eric F. Reichman
SECTION 5 Gastrointestinal Procedures . . . . . . . . . . 387
81 Shoulder Joint Dislocation Reduction . . . . . . . . . . . . . 531
58 Nasogastric Intubation . . . . . . . . . . . . . . . . . . . . . . 387 Eric F. Reichman
Lisa Freeman Grossheim
82 Elbow Joint Dislocation Reduction . . . . . . . . . . . . . . . 549
59 Activated Charcoal Administration . . . . . . . . . . . . . . . 391 Angelique S. Kelly Campen
Jenny J. Lu
83 Radial Head Subluxation (“Nursemaid’s Elbow”)
60 Gastric Lavage . . . . . . . . . . . . . . . . . . . . . . . . . . . 393 Reduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 553
Jenny J. Lu Mark P. Kling and Eric F. Reichman
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Contents ix
84 Metacarpophalangeal Joint Dislocation Reduction . . . . . 557 107 Paronychia or Eponychia Incision and Drainage . . . . . . 713
Michael Bublewicz and Antonio E. Muñiz Lisa R. Palivos
85 Interphalangeal Joint Dislocation Reduction . . . . . . . . . 561 108 Felon Incision and Drainage . . . . . . . . . . . . . . . . . . 716
Matt Kleinmaier and Sanjeev Malik Lisa R. Palivos
86 Hip Joint Dislocation Reduction . . . . . . . . . . . . . . . . 565 109 Pilonidal Abscess or Cyst Incision and Drainage . . . . . . . 718
George Chiampas and Steve Zahn Lauren M. Smith
87 Patellar Dislocation Reduction . . . . . . . . . . . . . . . . . 571 110 Perianal Abscess Incision and Drainage . . . . . . . . . . . . 722
Mark P. Kling Maggie Ferng and Ryan C. Headley
88 Knee Joint Dislocation Reduction . . . . . . . . . . . . . . . 574 111 Sebaceous Cyst Incision and Drainage . . . . . . . . . . . . 728
Sharad Pandit and Zach Kassutto Carlos J. Roldan
89 Ankle Joint Dislocation Reduction . . . . . . . . . . . . . . . 577 112 Hemorrhage Control . . . . . . . . . . . . . . . . . . . . . . . 731
Jim Comes Christopher Freeman and Eric F. Reichman
90 Common Fracture Reduction . . . . . . . . . . . . . . . . . . 582 113 Trigger Point Injections . . . . . . . . . . . . . . . . . . . . . . 738
Eric F. Reichman and Robert M. Zesut Danielle Campagne
91 Casts and Splints . . . . . . . . . . . . . . . . . . . . . . . . . 592 114 Escharotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741
Eric F. Reichman and Harold A. Sloas Michael A. Schindlbeck
SECTION 7 Skin and Soft Tissue Procedures . . . . . . . 609 SECTION 8 Neurologic and
92 General Principles of Wound Management . . . . . . . . . 609 Neurosurgical Procedures . . . . . . . . . . . . 747
Lisa Freeman Grossheim 115 Lumbar Puncture . . . . . . . . . . . . . . . . . . . . . . . . . 747
93 Basic Wound Closure Techniques . . . . . . . . . . . . . . . 623 Eric F. Reichman, Kevin Polglaze, and Brian Euerle
Eric F. Reichman and Candace Powell 116 Burr Holes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 761
94 Tissue Adhesives for Wound Repair . . . . . . . . . . . . . . 647 Eric F. Reichman
Hagop M. Afarian 117 Lateral Cervical Puncture . . . . . . . . . . . . . . . . . . . . 767
95 Advanced Wound Closure Techniques . . . . . . . . . . . . 650 Eric F. Reichman
Eric F. Reichman 118 Ventriculostomy . . . . . . . . . . . . . . . . . . . . . . . . . . 770
96 Management of Specific Soft Tissue Injuries . . . . . . . . . 659 Eric F. Reichman
Christopher J. Russo and Ajay Desai 119 Ventricular Shunt Evaluation and Aspiration . . . . . . . . . 775
97 Subcutaneous Foreign Body Eric F. Reichman
Identification and Removal . . . . . . . . . . . . . . . . . . . 669 120 Subdural Hematoma Aspiration in the Infant . . . . . . . . 779
Samuel J. Gutman and Michael B. Secter Eric F. Reichman
98 Ultrasound-Guided Foreign Body 121 Skeletal Traction (Gardner-Wells Tongs) for
Identification and Removal . . . . . . . . . . . . . . . . . . . 676 Cervical Spine Dislocations and Fractures . . . . . . . . . . 783
Daniel S. Morrison Eric F. Reichman
99 Tick Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679 122 Edrophonium (Tensilon) Testing . . . . . . . . . . . . . . . . 786
Zach Kassutto Eric F. Reichman
100 Fishhook Removal . . . . . . . . . . . . . . . . . . . . . . . . 681
Eric F. Reichman and Renee C. Hamilton SECTION 9 Anesthesia and Analgesia . . . . . . . . . . . . 789
101 Ring Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . 684 123 Local Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . . . 789
Steven H. Bowman Michael A. Schindlbeck
102 Subungual Hematoma Evacuation . . . . . . . . . . . . . . . 690 124 Topical Anesthesia . . . . . . . . . . . . . . . . . . . . . . . . 795
Steven H. Bowman Erika D. Schroeder and Peter Taillac
103 Subungual Foreign Body Removal . . . . . . . . . . . . . . . 694 125 Hematoma Blocks . . . . . . . . . . . . . . . . . . . . . . . . . 799
Steven H. Bowman Thomas P. Graham
104 Nail Bed Repair . . . . . . . . . . . . . . . . . . . . . . . . . . 697 126 Regional Nerve Blocks (Regional Anesthesia) . . . . . . . . 802
Raemma Paredes Luck and Eric F. Reichman Eric F. Reichman, Jehangir Meer, and Nikesh Seth
105 Ganglion Cyst Aspiration and Injection . . . . . . . . . . . . 704 127 Intravenous Regional Anesthesia . . . . . . . . . . . . . . . . 843
Thomas P. Graham Christopher Freeman
106 Subcutaneous Abscess Incision and Drainage . . . . . . . . 706 128 Nitrous Oxide Anesthesia . . . . . . . . . . . . . . . . . . . . 849
Samuel J. Gutman and Michael B. Secter Antonio E. Muñiz
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