October 24, 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…

June 15, 2017

Background: Presentations to the Emergency Department for acute headache are remarkably common, with more than 2 million visits each year in the United States (Goldstein 2006). Emergency clinicians are tasked with dual roles of excluding life-threatening pathology while rendering effective pain relief and symptomatic care. Treatment patterns for isolated benign headache are widely variable, reflecting the array of symptoms and diversity of therapeutic response among patients presenting for care. One observational cohort of ED patients reported the routine use of 36 different medications for the treatment of headache, with most patients receiving more than one parenteral agent, as well as frequent use of opioid therapy despite recommendations to avoid the same except as a last resort (Vinson 2002). While a variety of effective medications are available for treatment of primary headache in the Emergency Department, including NSAIDs, neuroleptics, anti-emetics, anti-epileptics, and more, there is a growing interest in alternative headache therapies that offer rapid relief without the side effects and time investment of more traditional agents.