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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Sunday, May 1, 2022

ED Procedures without an IV

REBEL EM - By WriSalim Rezaie - October 04, 2018
Background: Establishing IV access has become the norm for patients presenting to the ED. However with increasing patient volumes, difficulty and delays in acquiring IV access, it seems that anything that could expedite care, reduce pain and suffering, and improve patient care would be welcomed in the ED. There are several tricks I have learned along the way to achieve just this: No IV access, no problem…performing procedures like a boss…
  • Isopropyl alcohol inhalation for nausea/vomiting is reasonable
  • Sphenopalatine ganglion block for frontal headaches may have a roll
  • Modified valsalva maneuver for stable SVT is superior to standard valsalva techniques
  • Use a spinal needle with sheath (for better visibility and protection) and disposable speculum (to put the light source anteriorly) for peritonsillar abscess drainage
  • Davos and Spaso techniques with intra-articular lidocaine could reduce procedural sedation with anterior shoulder dislocation
  • Nebulized TXA can be a temporizing measure to halt acute bleeding in patients with acute hemoptysis