Trick of Trade: Alternative to a Pressure Bag for IV Fluids
July 22, 2023
You have a severely dehydrated patient with a peripheral IV line, requiring urgent fluid resuscitation. However, the crystalloid fluids are not flowing freely. Multiple attempts...
Michael Cataldo, DO
Trick of Trade: Inflating the Esophageal Balloon of a Blakemore/Minnesota Tube without a Manometer
May 19, 2023
A heavy alcohol drinker, who is well known to your Emergency Department, presents with altered mental status, except that he looks different this time. He...
Ivan Ivanov, DO
ALiEM AIR Series | Procedures Module
April 14, 2023
Welcome to the AIR Procedures Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Social...
Chris Belcher, MD
Trick of the Trade: Chest tube rewarming with Foley tubing connector
March 31, 2023
You have a pulseless hypothermic patient requiring aggressive internal rewarming. ECMO is not available, and you’ve made the decision to initiate thoracic lavage. After placing...
Landon McNeely, DO
SAEM Clinical Images Series: Found Down
August 8, 2022
A 67-year-old caucasian male experiencing homelessness was “found down” in a parking lot. EMS reported that he had a GCS of 6 with a systolic...
Jonathan Trinh
Trick of the Trade: A “Fiberbougie” through a supraglottic airway device (King tube)
July 6, 2022
Resuscitation before intubation is a critical construct in modern emergency medicine. The prevention of peri-intubation arrest by correcting pre-intubation hypoxia, hypotension, and acidosis is often...
Graham E. Snyder, MD, FACEP
Trick of Trade: Large-Bore Endotracheal Tube To Suction the Occluded Airway
October 31, 2021
The paramedics just arrived with a new patient to the resuscitation room. You find an altered patient actively vomiting bloody vomitus and food particles. You...
Brenda Sokup, DO
Pre-Arrest Acidemia and the Effect of Sodium Bicarbonate on ROSC
September 18, 2021
Background Sodium bicarbonate during a cardiac arrest is widely debated and used in many cases. In a 2018 PULMCrit post, Dr. Josh Farkas reviews much...
Mike O'Brien, PharmD
Beta-Blockers for Inhalant-Induced Ventricular Dysrhythmias
June 26, 2021
Background There are a few unique scenarios when beta-blockers may be indicated for patients in cardiac arrest. Use of esmolol for refractory ventricular fibrillation was...
Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP
Trick of the Trade: Upsize the IV with the tourniquet infusion technique
May 31, 2021
There you are, middle of the night and EMS just brought you one of the sickest of the sick: a septic-looking, chronically ill-appearing, frail, and...
Ryan Ernst, MD
2020 ACLS Guidelines on Medications for Toxicology-Related Conditions
January 23, 2021
The 2020 ACLS guidelines provide recommendations on the medication-specific management recommendations for toxicology [1]. Although the name of the guidelines emphasize they are ‘Advanced,’ these...
2020 ACLS Guidelines on Medications for Management of Specific Arrhythmias
The 2020 ACLS guidelines provide recommendations on the medication-specific management for arrhythmias including wide-complex tachycardia, regular narrow-complex tachycardia, atrial fibrillation/flutter, and bradycardia [1]. There are...