Congestive Heart Failure: Bring on the Leeches?

Wikimedia photo.

The April edition of Right on Prime covers everything you need to know about congestive heart failure from the definition to palliative care, including advice on therapeutic phlebotomy. No matter where you practice you will find breath-taking take home points. Take a listen or read: The Generalist: Acute and End Stage CHF in the ED by Vanessa Cardy MD, Mel Herbert MD, and Heidi James MD in the April edition of Right on Prime available to all CMES participants using either the CMES thumb drive or Pi.

Leech application tubes and blood letting tool, probably from 1800s. Photo from Wikimedia.

Who Knew? Bloodletting (or blood-letting) is the withdrawal of blood from a patient to prevent or cure illness and disease. Bloodletting, now called therapeutic phlebotomy, whether by a physician or by leeches, was based on an ancient system of medicine in which blood and other bodily fluids were regarded as “humours” that had to remain in proper balance to maintain health. It is claimed to have been the most common medical practice performed by surgeons from antiquity until the late 19th century, a span of almost 2,000 years. (article content from Wikipedia)

How to Kill a Patient During Airway Management

Airway Management is just that…managing the airway upside down and inside out. Take a quick read of the PDF or listen to EM:RAP’s November MP3 audio podcast called Strayerisms: Fluid Filled Airway. It’ll float your boat.

Correct ET tube placement, but if you tube the esophagus, leave the ET tube in place and use it as a landmark.

According to Dr. Reuben Strayer MD, the author, there are four ways to harm your patient during airway management: failure to oxygenate; failure to ventilate; worsening perfusion; and aspiration. His suggestions are doable no matter where you practice or what resources you lack…remember…your greatest resource is knowledge.

 

 

 

Who Knew? Probably the oldest recovered boat in the world, the Pesse canoe, found in the Netherlands, is a dugout made from the hollowed tree trunk of a Pinus sylvestris that was constructed somewhere between 8200 and 7600 BC. This canoe is exhibited in the Drents Museum in Assen, Netherlands. (Not looking too seaworthy these days.)