Run Time: 3 minutes Author: Suzanne Chilton M.D. Educational Pearls: Patient presentation: 2 weeks of mouth pain, no recent dentist visit, low grade fever, and muffled or hot potato voice. Patient exam: swollen tongue that is located up and back in the mouth, edema under tongue, diffuse erythema, and rancid breath. This patient has Ludwig’s…
Read MoreRun Time: 7 minutes Author: Aaron Lessen M.D. Educational Pearls: It is important to differentiate between an airway foreign body, which presents as more respiratory choking and difficulty breathing VS esophageal foreign body, patients often complain “I can’t swallow” or spit up what they try to drink /swallow. 1-2 year old children are the most…
Read MoreRun Time: 2 minutes Author: Dr. Erik Verzemnieks Educational Pearls: Caused by inhalation of spores – most common source is soil and honey. 50% of cases are in California followed by Pennsylvania – due to agricultural and industrial nature of the states. Symptoms start as poor feeding, weakness, and constipation – eventually leads to paralysis,…
Read MoreRun Time: 4 minutes Author: Dr. Aaron Lessen Educational Pearls: Over the last few years, general consensus has strayed away from pre-hospital intubation in the field. This is because it has been found that interruptions to CPR (namely intubation and airway management) decrease the success of the patient. This was believed to be solved via the quick…
Read MoreRun Time: 4 minutes Author: Dr. Brent Levy Educational Pearls: Etomidate: longer acting and causes less hemodynamic instability, but causes adrenal suppression – not good for septic patients. Propofol: quick acting, but causes hemodynamic instability – not good for hypotensive patients. Ketamine: does not suppress the breathing drive, but increases HR – not good for…
Read MoreRun Time: 3 minutes Author: Dr. Samuel Killian Educational Pearls: Agitation – 16% of patients experience agitation with Ketamine. Aspiration – rare with 1 in 2500 cases exhibiting aspiration. Bradycardia – Happens most often with Etomidate, 1 in 250 cases. Hypotension – 2% of cases with Propofol – still less frequent than patients on a…
Read MoreRun Time: 4 minutes Author: Dr. David Rosenberg Educational Pearls: Preoxygenation provides plenty of oxygen to the patient so that he/she does not desaturate during RSI. Even if the patient is at 100% on spO2 monitor, preoxygenation is necessary for continued saturation of hemoglobin and transport of oxygen to the rest of the body – respiration…
Read MoreRun Time: 3 minutes Author: Dr. Aaron Lessen Educational Pearls: The “bougie” or “endotracheal tube introducer” is a low tech adjunct for difficult airway management. The bougie is a flexible stylet that can be used almost blindly when the vocal cords cannot be visualized. The stylet has a Coude tip at the end, which allows you…
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