Archive

Author: Rob Bryant

More Dogma: Epinephrine in Digital Nerve Blocks

You are working as an EM resident and have just evaluated a patient with a right long finger DIP joint dislocation. You perform a digital nerve block with 1% lidocaine with 1:100,000 epinephrine, and go to present to your attending …

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Trauma

Post Intubation Sedation for Pregnant Patients

  You have just intubated a seizing eclamptic woman who is 34 weeks pregnant. As she is being prepped for transfer to the OB unit for an emergent C-section your nurse asks you what medications you would like for post …

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Obstetrics and GynecologyResuscitation

Beyond ACLS: CPR, Defibrillation, and Epinephrine

Advanced Cardiac Life Support (ACLS) provides a well structured framework for those who resuscitate infrequently. There is room to move beyond the algorithm to potentially provide better care for our patients for those who resuscitate frequently. I will describe some …

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Resuscitation

Skin Anesthesia: Lidocaine vs Bupivacaine +/- Epinephrine

When selecting a local anesthetic agent for skin wounds I have historically been taught to use lidocaine to provide a faster onset, and to use bupivacaine for a longer duration of action. It can be time consuming to find 0.5% …

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Trauma

Lidocaine + Bupivacaine vs Bupivacaine Alone for Digital Nerve Blocks

When I first learned digital nerve blocks in the late 1990’s I was taught to mix Lidocaine and Bupivacaine 50/50 to provide faster onset (Lidocaine) and a longer duration of action (Bupivacaine). My use of two agents for digital nerve …

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Trauma

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