The Big Five-Lifesaving Procedures in the Trauma Bay.

Although resuscitation in trauma requires a multidisciplinary and multifaceted approach, one of the Big Five procedures may need to be performed as lifesaving and improving intervention. Your patient's lives depend on understanding, timing, and techniques of these elusive and difficult-to-master procedures. This article focuses on and reviews these five critical procedures: cricothyroidotomy, burr hole craniotomy, resuscitative thoracotomy, emergent hysterotomy, and lateral canthotomy.

Minor Procedures in Trauma.

Procedures such as central access and tube thoracostomy are integral in the care of the injured patient. However, both increasing life span and patient complexity of comorbidities can hinder procedural success. Careful forethought should be completed before, simply, charging ahead with a procedure.

Sedation for Rapid Sequence Induction and Intubation of Neurologically Injured Patients.

There are subtle physiologic and pharmacologic principles that should be understood for patients with neurologic injuries. These principles are especially true for managing patients with traumatic brain injuries. Prevention of hypotension and hypoxemia are major goals in the management of these patients.

Transport Blood Pressures and Outcomes in Stroke Patients Requiring Thrombectomy.

Objective: Mechanical thrombectomy is the treatment of choice for acute ischemic strokes from large vessel occlusions. Absolute blood pressure and blood pressure variability (BPV) may affect patients' outcome. We hypothesized that patients' outcomes were not associated with BPV during transport between hospitals in the era of effective thrombectomy.

Ultrasound physics.

Bedside ultrasound has become an important modality for obtaining critical information in the acute care of patients. It is important to understand the physics of ultrasound in order to perform and interpret images at the bedside. The physics of both continuous wave and pulsed wave sound underlies diagnostic ultrasound.

Need for standardized sign-out in the emergency department: a survey of emergency medicine residency and pediatric emergency medicine fellowship program directors.

Objectives: To determine the existing patterns of sign-out processes prevalent in emergency departments (EDs) nationwide. In addition, to assess whether training programs provide specific guidance to their trainees regarding sign-outs and attitudes of emergency medicine (EM) residency and pediatric EM fellowship program directors toward the need for the development of standardized guidelines relating to sign-outs.

Methods: A Web-based survey of training program directors of each Accreditation Council for Graduate Medical Education (ACGME)-accredited EM residency and pediatric EM fellowship program was conducted in March 2006.