Procedural sedation and analgesia (PSA) refers to the use of analgesic, dissociative, and sedative agents to relieve the pain and anxiety associated with diagnostic and therapeutic procedures. PSA is an integral element of emergency medicine residency and pediatric emergency medicine…
Clinical use of intravenous regional anesthesia (IVRA) has been well established as a safe, quick, and effective alternative to general anesthesia in selected cases requiring surgical manipulation of the upper and lower extremities. Though historically relegated to the operating room,…
Virtually every peripheral nerve can be blocked at some point along its course from the spine to the periphery ( Videos 31.1 to 31.14 ), but digital nerve blocks (e.g., fingers and toes) are more commonly used than proximal blocks.…
Emergency physicians encounter patients with dental pain, facial lacerations, and other injuries of the head on a regular basis. The assessment of these injuries can be both time consuming and painful. Thankfully, regional anesthesia for these conditions is easy to…
Local anesthetic agents are important tools used in the everyday practice of emergency medicine. This chapter describes the mechanism of action, the nuances of clinical use, and the adverse reactions to anesthetics that are commonly used in the emergency department…
Transfusion of blood components (red cells, white cells, platelets, whole plasma, or plasma fractions) is commonplace in the emergency department (ED). Annually in the United States, 15 million blood donations take place and 14 million units of red blood cells…
Introduction Autologous blood transfusion, or autotransfusion, is the collection and reinfusion of a patient's own blood for volume replacement. Preoperative blood banking and intraoperative cell salvage techniques have increased in a multitude of surgical specialties. Autotransfusion in the emergency department…
The rapid administration of lifesaving, pain-relieving, and sedative medications lies at the core of the practice of emergency medicine. The intravenous (IV) route is usually the delivery method of choice. However, there are circumstances in which vascular access is either…
Establishing vascular access in critically ill and injured patients is central to the practice of emergency medicine. Moreover, placing an intravenous (IV) catheter in an acutely ill child can be one of the most challenging and frustrating procedures that a…
Indwelling vascular access devices (IVADs) provide routes for short- and long-term infusion of antibiotics, antifungal agents, hyperalimentation fluids, chemotherapeutic agents, blood products, analgesics, and anesthetic agents. In addition, they provide access for lifesaving procedures such as hemodialysis (HD) and plasmapheresis.…