Procedures in Emergency Medicine

I took a two evening elective on procedures in emergency medicine which was lots of fun. The first evening discussed central lines, and it was good to review everything I had learned in my ICU rotation. We also practiced the Seldinger technique on models and ultrasound on each other. The ultrasounding was fairly useful and fun; playing around with the machine is the best way to learn how it works. We looked at internal jugulars and peripheral veins on each other. The second evening was the hands-on cadaver lab where we could practice multiple procedures. Although I had done central lines and chest tubes before, we also did cricothyrotomy, an emergency procedure involving cutting a patient's neck to insert a plastic tube into the trachea (windpipe). This is a really important procedure to learn on cadavers because cricothyrotomies are incredibly rare yet life-saving.

I was also excited to do intraosseous lines and a saphenous cutdown, both emergency procedures to get venous access when an IV (or central line) cannot be placed. The intraosseous line, used mostly in children, uses a drill and made me feel like an orthopedic surgeon. The saphenous cutdown required a lot of fine motor skills to dissect down to the vein and reminded me of vascular surgery. All in all, it was a fun evening which allowed us to practice important emergency procedures on cadavers. Again, I greatly appreciate the generosity of these donors to medical education.

Image of a triple lumen internal jugular central venous catheter. It is in the public domain, from Wikipedia.