Tactical Medicine News Blog

ALiEMU, Approved Instructional Resources (AIR series), Critical Care/ Resus, procedure
ALiEM AIR Series | Procedures Module
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 Media Index, the ALiEM AIR...
Chris Belcher, MD | April 14, 2023
Gastrointestinal, procedure, Tricks of the Trade
Trick of the Trade: Persistent Paracentesis Leakage 2.0
You’re seeing a patient returning to the ED after a recent diagnostic paracentesis. The patient is complaining of persistent peritoneal fluid leakage. They’ve tried putting pressure with no success. You...
Carmen Estrada | October 20, 2021
Critical Care/ Resus, procedure, Tricks of the Trade
Trick of the Trade: Tibial Intraosseous Line Stabilization in an Agitated Patient
With the advent of commercial intraosseous (IO) needles for vascular access, administering IV medications for patients in extremis has been made much easier. Securing the IO needle to the patient’s tibia,...
Eric Shappell, MD | July 20, 2016
Medical Education, procedure, Simulation, Tricks of the Trade
Simulation Trick of the Trade: Bleeding Cricothyroidotomy Model
One advantage of simulation as an educational tool is the re-creation of cognitive and emotional stresses in caring for patients. Doing this for a high fidelity scenario is relatively easy – add additional patients,...
Jeffrey Hill, MD | June 3, 2014
procedure, Tricks of the Trade
Trick of the Trade: EMLA for Lumbar Punctures
A 9 year-old patient presents with a headache and fever after swimming, along with subjective neck stiffness. Meningitis was of concern especially because the serum WBC count was 25,000 and...
Jeff Wiswell, MD | September 26, 2013
Cardiovascular, procedure, Ultrasound
Ultrasound-Guided Pericardiocentesis
All the years of ultrasound training in residency has paid off. You found the large pericardial effusion in the hypotensive patient who is still alive, but looks sick. You are...
Arun Nagdev, MD | August 22, 2013
procedure, Tricks of the Trade, Ultrasound
Trick of the Trade: The PIPP for deep peripheral IVs in obese patients
The Case A 500-pound morbidly obese male presents to your ED complaining of mild shortness of breath and palpitations. A quick ECG shows SVT with a rate of 160 bpm....
Noah Sugerman, MD | August 5, 2013
ENT, procedure, Tricks of the Trade
Trick of the Trade: Less traumatic nasopharyngoscopy
A fiberoptic nasopharyngoscope is a handy tool to check patients for suspected foreign bodies (e.g. fishbone stuck in throat) or laryngeal edema. Depending on the diameter of your fiberoptic cable,...
Michelle Lin, MD | July 16, 2013
Orthopedic, procedure, Tricks of the Trade
Trick of the Trade: Stimson technique using wrist restraints
A patient presents with an anterior shoulder dislocation on x-ray. Your ED just received 5 new patients via ambulance and you are trying to prioritize your patients as they come...
Michelle Lin, MD | July 10, 2013
Orthopedic, procedure, Tricks of the Trade, video
Trick of the Trade: Got a shoulder dislocation? Park it
Myriad techniques exist to reduce shoulder dislocations, which includes scapular rotation, Hennepin, Snowbird, Cunningham, and Legg maneuvers. They are nicely reviewed at ShoulderDoc.co.uk. You can also supplement any technique with ultrasound-guided intraarticular...
Michelle Lin, MD | June 25, 2013
procedure, Tricks of the Trade
Trick of the Trade: Making the NG and NP procedures less painful
When doing nasogastric (NG) tubes and fiberoptic nasopharyngoscopy (NP) procedures, there many approaches in how patients can be locally anesthetized. Getting things pushed up your nose is so profoundly irritating...
Michelle Lin, MD | April 23, 2013
procedure, Tricks of the Trade
Trick of the Trade: External jugular tourniquet
Paitents can be a challenge when trying to obtain peripheral IV access. The vein may be collapsed from dehydration or scarred because of IV drug use or repeated cannulation. Before...
Timothy Peck, MD | March 5, 2013
procedure, Tricks of the Trade
Trick of the Trade: Use the angiocatheter for central lines
Central lines come packed with a long introducer needle (pink arrow) to feed the guidewire through AND a long angiocatheter (yellow arrow). Most people cannulate the vein by using the...
Michelle Lin, MD | February 26, 2013

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