Thanks to a frenzy of hormones, many women have some sensation of nausea early in pregnancy (which may even be worse when expecting twins). Some women find that eating manages to “quiet” their stomach and they actually gain a lot of weight early on in their pregnancy, but others may feel averse to eating anything during the first few months.
Vampires make it look easy on TV, but in reality, it’s not always easy finding a good vein. Health care providers rely on a visual examination to find the perfect vein for intravenous access; however, when working with children, obese patients, trauma patients or patients who have scarring from numerous IVs, it can be challenging.
In a recently published New England Journal of Medicine video, Hennepin County Medical Center (HCMC) emergency physicians and nurses offer expertise in IV placement using ultrasound-guided techniques.
“When traditional techniques won’t work, we rely on ultrasound to help us visualize a vein with good potential for IV access,” explains Dr. Scott Joing. “It’s much easier to cannulate a vein you can see.”
The video outlines all the steps needed to successfully employ ultrasound guidance to place IVs, including various approaches (transverse, longitudinal), where to place and rotate the transducer, and common errors or complications to consider.
HCMC’s emergency department has been a pioneer in the use of point-of-care ultrasound (see HCMC Network Feature, Dec. 16, 2011). A comprehensive academic medical center and public teaching hospital, HCMC was Minnesota’s first Level 1 Trauma Center and has the largest emergency department in the state.
HCMC EMS participates in NIH study that finds method safe, effective
for pre-hospital use
Delivering drugs into muscle using an autoinjector, akin to the EpiPen (used to treat serious allergic reactions), is faster and may be a more effective way to stop statusepilepticus (a prolonged seizure lasting longer than five minutes), according to a study sponsored by the National Institutes of Health (NIH). Status epilepticus is a potentially life-threatening emergency that causes 55,000 deaths each year.
Anticonvulsant drugs are typically delivered intravenously (IV) as a first-line treatment for status epilepticus; however, starting an IV in a patient experiencing seizures can pose a challenge for paramedics and waste precious time. Giving an intramuscular shot is easier, faster, and more reliable, especially in patients having convulsions. The researchers sought to determine whether an intramuscular injection, which quickly delivers anticonvulsant medicine into a patient’s thigh muscle, is as safe and effective as giving medicine directly into a vein. The study, which was carried out by paramedics, compared how well delivery by each method stopped patients’ seizures by the time the ambulance arrived at the emergency department. Several local hospitals participated in the 4-year study, but Hennepin Emergency Medical Service (EMS) was the only ambulance service in Minnesota to participate in the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART). RAMPART was conducted through the NINDS’ Neurological Emergencies Treatment Trials (NETT) network conducted locally by researchers at the University of Minnesota. Continue reading “Autoinjectors offer a way to treat prolonged seizures”→