M2E Too! Mellick's Multimedia EduBlog 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.How I Break Down Pediatric Rashes
More than once, I’ve heard colleagues and residents make the statement, “I’m no good at pediatric rashes.” The truth is that there is usually a large waste basket of “nonspecific viral exanthems” that are easy to bring to closure in your conversation with parents, and then there are similar-appearing rashes associated with drug reactions.
Then there are the targeted lesions, which include acute annular urticaria or urticaria multiforme, erythema multiforme minor, and serum sickness-like rashes that are frequently confused for each other.
My simplistic approach continues by acknowledging that there are...
Source: M2E Too! Mellick's Multimedia EduBlog - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
How I Break Down Pediatric Rashes
More than once, I’ve heard colleagues and residents make the statement, “I’m no good at pediatric rashes.” The truth as I see it is that there is usually a large waste basket of “nonspecific viral exanthems” that are easy to bring to closure in your conversation with parents and then similar appearing rashes associated with drug reactions. Then there are the targeted lesions, which include acute annular urticaria or urticaria multiforme, erythema multiforme minor, and serum sickness-like rashes that are frequently confused for each other. My simplistic approach continues by acknowledging that there are rare r...
Source: M2E Too! Mellick's Multimedia EduBlog - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Owning Procedural Expertise
Emergency medicine, since its inception as a specialty, has continuously redefined itself by absorbing intellectual and procedural expertise traditionally owned by other specialties. Whether it is performing advanced airway procedures formerly unique to anesthesia, reducing and splinting various orthopedic dislocations and fractures, or managing urological emergencies such as priapism or otolaryngology procedures, emergency physicians have relentlessly expanded their procedural expertise. Some consultants have forced our hands by delaying or being reluctant to see these emergencies in the emergency department. Others willi...
Source: M2E Too! Mellick's Multimedia EduBlog - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Owning Procedural Expertise
Emergency medicine, since its inception as a specialty, has continuously redefined itself by absorbing intellectual and procedural expertise traditionally owned by other specialties. Whether it is performing advanced airway procedures formerly unique to anesthesia, reducing and splinting various orthopedic dislocations and fractures, or managing urological emergencies such as priapism or otolaryngology procedures, emergency physicians have relentlessly expanded their procedural expertise. Some consultants have forced our hands by delaying or being reluctant to see these emergencies in the emergency department. Others willi...
Source: M2E Too! Mellick's Multimedia EduBlog - March 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Shoulder Dislocations
Shoulder dislocations are fairly common orthopedic emergencies presenting to the emergency department. And anterior to the glenoid fossa and labrum is far and away the most common final resting location of the humeral head. Consequently, most emergency physicians develop their own favorite technique for reducing anterior dislocations.
Factors such as the dislocation duration, patient comorbidities, prior dislocation events, and associated fractures or bony lesions will determine the specific technique used and whether procedural sedation is utilized. Posterior and inferior shoulder dislocations, however, are relativel...
Source: M2E Too! Mellick's Multimedia EduBlog - January 30, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Shoulder Dislocations
Shoulder dislocations are fairly common orthopedic emergencies presenting to the emergency department. And anterior to the glenoid fossa and labrum is far and away the most common final resting location of the humeral head. Consequently, most emergency physicians develop their own favorite technique for reducing anterior dislocations.
Factors such as the dislocation duration, patient comorbidities, prior dislocation events, and associated fractures or bony lesions will determine the specific technique used and whether procedural sedation is utilized. Posterior and inferior shoulder dislocations, however, are relatively ...
Source: M2E Too! Mellick's Multimedia EduBlog - January 30, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Stress of Open Thoracotomy
EPs frequently discuss the issue of low-volume, high-acuity procedures that we must be ready to perform, and there is no higher stress or professionally memorable procedure than the open thoracotomy. This is one of the most time-sensitive procedures, and is unquestionably the most invasive procedure in emergency medicine. Hesitating for even seconds will guarantee failure or a poor patient outcome. Nevertheless, no matter how grisly and stressful this procedure may be, it has real potential for saving lives.
Controversies continue to surround this procedure. It is relegated to the trauma team in most Level I trauma ce...
Source: M2E Too! Mellick's Multimedia EduBlog - January 9, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Stress of Open Thoracotomy
EPs frequently discuss the issue of low-volume, high-acuity procedures that we must be ready to perform, and there is no higher stress or professionally memorable procedure than the open thoracotomy. This is one of the most time-sensitive procedures, and is unquestionably the most invasive procedure in emergency medicine. Hesitating for even seconds will guarantee failure or a poor patient outcome. Nevertheless, no matter how grisly and stressful this procedure may be, it has real potential for saving lives.
Controversies continue to surround this procedure. It is relegated to the trauma team in most Level I trauma cent...
Source: M2E Too! Mellick's Multimedia EduBlog - January 9, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Oral Nerve Blocks Made Easy
The alveolar and other oral nerve blocks are technically more difficult than most of us realize or admit. In fact, I have heard several emergency physicians admit over the years that they have given up trying to do inferior alveolar nerve blocks because of their failure rate.
It’s actually understandable when you peruse the literature. The reported failure rate for inferior alveolar nerve blocks can range as high as 30-45 percent of cases, depending on the study.
An obvious and critical first step is to make sure you have the correct techniques down. These two videos show a dental colleague performing expert st...
Source: M2E Too! Mellick's Multimedia EduBlog - December 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Oral Nerve Blocks Made Easy
The alveolar and other oral nerve blocks are technically more difficult than most of us realize or admit. In fact, I have heard several emergency physicians admit over the years that they have given up trying to do inferior alveolar nerve blocks because of their failure rate.
It’s actually understandable when you peruse the literature. The reported failure rate for inferior alveolar nerve blocks can range as high as 30-45 percent of cases, depending on the study.
An obvious and critical first step is to make sure you have the correct techniques down. These two videos show a dental colleague performing expert step-b...
Source: M2E Too! Mellick's Multimedia EduBlog - December 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Pulse Dose Pressors for Children and Adults
The three videos presented this month demonstrate the technique for mixing and administering pulse dose epinephrine with actual patients. Particularly helpful is the one that demonstrates the administration of pulse dose epinephrine to a pediatric patient. What I really like about the demonstrated pediatric technique (first discussed in my Emergency Medicine News blog on anaphylaxis: http://bit.ly/1CHsX6h) is that it uses the same 1:100,000 concentration used for adults. And, the 0.1 mL/kg is easily remembered because it is the same mL/kg recommendation for the ACLS concentration of epinephrine. There is essentially nothin...
Source: M2E Too! Mellick's Multimedia EduBlog - October 30, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Pulse Dose Pressors for Children and Adults
The three videos presented this month demonstrate the technique for mixing and administering pulse dose epinephrine with actual patients. Particularly helpful is the one that demonstrates the administration of pulse dose epinephrine to a pediatric patient. What I really like about the demonstrated pediatric technique (first discussed in my Emergency Medicine News blog on anaphylaxis: http://bit.ly/1CHsX6h) is that it uses the same 1:100,000 concentration used for adults. And, the 0.1 mL/kg is easily remembered because it is the same mL/kg recommendation for the ACLS concentration of epinephrine. There is essentially nothin...
Source: M2E Too! Mellick's Multimedia EduBlog - October 30, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Drug Use and Skin Conditions
Diseases and complications associated with intravenous drug use are many and varied. These three videos demonstrate three skin findings associated with drug addiction and IV drug use: the track marks associated with repeated intravenous injection, the piloerection that accompanies withdrawal, and the diffuse petechiae from septic emboli of life-threatening infective endocarditis.
Click here to see the track marks associated with repeated intravenous injection.
Click here to see the piloerection that accompanies withdrawal.
Click here to see the diffuse petechiae from septic emboli of life-threateni...
Source: M2E Too! Mellick's Multimedia EduBlog - October 10, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Drug Use and Skin Conditions
Diseases and complications associated with intravenous drug use are many and varied. These three videos demonstrate three skin findings associated with drug addiction and IV drug use: the track marks associated with repeated intravenous injection, the piloerection that accompanies withdrawal, and the diffuse petechiae from septic emboli of life-threatening infective endocarditis.
Click here to see the track marks associated with repeated intravenous injection.
Click here to see the piloerection that accompanies withdrawal.
Click here to see the diffuse petechiae from septic emboli of life-threatening infecti...
Source: M2E Too! Mellick's Multimedia EduBlog - October 10, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Sucking Chest Wound Management
A sucking chest wound or open pneumothorax is a fairly uncommon event off the battlefield, and civilian guidelines as a result are highly dependent on the experience of the military expert opinion concerning their management. Past recommendations were to place a three-sided occlusive dressing to allow air to egress to prevent a tension pneumothorax, but battlefield guidelines calling for an occlusive dressing closed on three of four sides have not proven to be effective or realistic. Covering the wound improves respiratory mechanics, but the three-sided occlusive dressing on bleeding chest wounds is no longer recommended. ...
Source: M2E Too! Mellick's Multimedia EduBlog - September 3, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
