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On "unnecessary" ED visits: background reading

Here are a bunch of very informative pieces on why trying to blame excessive costs or busy-ness on low acuity patients in the ED is, at be...

July 28, 2014

RSI & Laryngoscopy #EMconf

Lecture I gave to the new interns at my new job:
MDaware RSI & Laryngoscopy from md aware on Vimeo.

I also Solicited Advice from the FOAMites, check out everyone's tips

My initial math didn't take into account how many of our cells don't have nuclei (ie RBCs) so I revised my estimate down a bit.

July 7, 2014

Solicited advice

Thanks to everyone who responded!
  1. be ready to do a tracheostomy on yourself
  2. I'm an emergency physician — I do crics, not trachs.
  3. preparation wards off the evil airways. and vice versa.
  4. agree w the sentiment. my version: the more I prepare, the luckier I get
  5. exactly. You don't need airway checklist ! You need group prayer :-)
  6. FTFY: : exactly. You need airway checklist ! You need group preparation :-)
  7. Assume Seth will be teaching them the Airway Hail Mary and the ritual airway dance.
  8. It's not really an airway course unless you've learned to secure one with a ballpoint pen and a straw.
  9. + in a crowded restaurant with cute chicks looking on
  10. I feel like we're being really helpful. Are you ready for your talk now?
  11. Drugs and dosages. I'm a little tough, but I tell the interns they get one free pass if they don't know them and why they're used.
  12. If they don't know after that, they don't intubate. (I know, I sound mean, I'm really not). They never disappoint though
  13. Also, recommend teaching them to set everything up themselves in case resp. isn't there. And always have backup--bougie, glidescope
  14. Sorry I don't have any of those accounts to leave a message on your blog where are you working now?
  15. 6P's of Preparation: Proper Preparation Prevents Piss Poor Performance. Preoxygenation is key
  16. -good laryngoscopy is good epiglottoscopy - which drugs do you use in special populations? - when to pull out/ a 'code' for help
  17. if lost, pull back. Then you'll be unlost (probably). I think I may have recalled that mid intubation from you.
  18. remember when all else fails, have a blade handy and don't be afraid to use it!
  19. I like emphasizing BVM, if BVM not good on crashing pt, will be doing DL on dead person
  20. for DL, every micro step in prep, positioning, and technique done well increases chance of success. Neglect no detail

Minh Le Cong
Jul 8, 2014
this is one of the best FOAMEd resources I have seen so far.


Minh Le Cong
Jul 8, 2014
and its a bit surprising coming from you since you wrote a whole book chapter on emergency airway care!

Minh Le Cong
Jul 8, 2014
these free videos are a great way to showcase the anatomical landmarks of DL


Minh Le Cong
Jul 8, 2014
my other teaching exercise for DL  is to have the class try to draw a larynx from viewpoint of intubator.

the winner gets a free VL!

Cedric Dark
Jul 8, 2014
My only advice. (1) Video. (2) Get the tube in there...somehow.