Point of Care Essential Procedures for Emergency, Urgent, CAMPO Ultrasound LAFFERTY Guided and Primary Care Settings A Clinical Companion Procedures Third Edition Editors Associate Editors Editors Theresa M. Campo, DNP, APRN, FAANP, FAAN Thomas G. Costantino, Jr., MD, FAAEM aE Keith A. Lafferty, MD, FAAEM Jacob W. Ufberg, MD ns THERESA M. CAMPO s Jennifer Wilbeck, DNP, APRN, FAANP, FAAN d e Pn DNP, APRN, FAANP, FAAN A comprehensive, step-by-step, well-illustrated guide to common clinical procedures rt ii ma KEITH A. LAFFERTY This text is a user-friendly guide to performing 77 clinical procedures, ranging from those commonly performed to those l infrequently called upon when minutes count in emergency, urgent, and primary care settings. This heavily updated third edition a P includes current and comprehensive text, graphic, and video instruction on the use of bedside ultrasound for procedural guidance rr MD, FAAEM in order to increase procedural accuracy and mitigate complications. Edited and written by academically accomplished physicians, yo physician assistants, and nurse practitioners, an interprofessional approach to the performance of procedures is highlighted Cc e throughout the book. a d r Essential Procedures Procedures are consistently formatted and presented in clear language with step-by-step detail organized by system-specific eu categories for easy access to information. Each procedure includes background considerations, indications and contraindications Sr for performing the procedure, technique for safe and correct performance, special considerations, complications, postprocedure ee considerations, and patient education points. Original photos, videos, high-quality sonographic footage, line drawings, ts and tables reinforce the guidelines and procedures. Abundant clinical “Pearls” throughout the manuscript offer practical tf io applications of key information representing years of clinical technical experience. Extensive references at the end of each n chapter further enhance the book’s utility. gr for Emergency, E sm New to the Third Edition: • A e Delivers 16 completely new chapters covering a plethora of newly added procedures, incorporating an interprofessional C r approach to performing procedures l g • i • PPrroevviioduess mchoarpet ethrsa hna 1v0e0 b ielleuns terxatteinvesi vveidlye ouspdated and expanded nic en Urgent, and Primary • Presents a corresponding list of CPT codes a c l y C Key Features: o , m U • • DPreolviviedress caubrurnendta, ncto fnocuisre-,c ostleopr- pbhy-osttoesp a inndfo frimguarteiso nil lfuosrt rpaetrinfogr emacinhg p 7r7o ccelidnuicreal procedures pa rg Care Settings • Organized by body system to provide fast access to key information n e • Enriched with point-of-care ultrasound guided procedures io n • Thoroughly introduces and teaches sonography at the most fundamental level as an important tool to enhance accuracy n t , of procedures • Reflects latest guidelines and evidence-based practice • Includes prominently displayed links to numerous videos throughout the text • Purchase includes 12 months’ digital access for use on most mobile devices or computers A Clinical Companion Third Edition Third Edition ISBN 978-0-8261-4104-0 Associate Editors THOMAS G. COSTANTINO, JR., MD, FAAEM 11 W. 42nd Street JACOB W. UFBERG, MD New York, NY 10036-8002 www.springerpub.com JENNIFER WILBECK, DNP, APRN, FAANP, FAAN 11..2266__CCaammppoo__99778800882266114411004400__mmeecchh..iinndddd 11 11//2266//2211 99::3377 AAMM This book is composed in a manner that will help busy clinicians at the bedside.  Those writing are active clinicians in busy, high acuity EDs who understand the value of  quickly getting to the point when it comes to procedures in the practice settings this book is targeted for.  A definite strength is the emphasis on ultrasound and procedures guided by ultrasound.  My compliments to the editorial and writing team for “getting” what the frontline clinician needs in a procedure book. Robert McNamara, MD, FAAEM Professor and Chair, Emergency Medicine Chief Medical Officer, Temple University Physicians The editors have assembled a group of emergency care providers to offer the newest trends in proce- dures for those working in emergent, urgent, and ambulatory care settings. Each chapter provides a step-by-step procedural guide which is informative and concise. This is the perfect resource for the student or novice advanced practice provider who is looking for a real hands-on approach to procedures. K. Sue Hoyt, PhD, RN, FNP-BC, CEN, FAEN, FAAN Professor and Director NP/ENP Programs, University of San Diego Founding Member AAENP As a physician assistant in a busy emergency department and as a member of a trauma service in a level 2 trauma center, being proficient in procedures is critical.  Whether it is in the ED, the trauma bay, or the ICU, if a procedure is needed it is often needed right away.  It is imperative to be proficient and efficient to give patients the care they need and deserve. Essential Procedures for Emergency, Urgent, and Primary Care Settings is a great resource to turn to for the most common procedures I perform on a regular basis. Seth Lauterbach MPAS, PA-C, CAQ-EM, SEMPA member Essential Procedures for Emergency, Urgent, and Primary Care Settings Theresa M. Campo, DNP, APRN, FAANP, FAAN, is chair of the Department of Emergency Medical Services (EMS) and the director of the Emergency Nurse Practitioner Track as well as associate clinical professor at Drexel University. Clinically, she is board certified as a family nurse practitioner and emergency nurse practitioner, and works part-time as a nurse practitioner in southern New Jersey. Dr. Campo received her Doctor of Nursing Practice from Case Western Reserve University in Cleveland, Ohio. She earned her Master of Science in Nursing, Family Nurse Practitioner, from Widener University in Chester, Pennsylvania. Theresa has over 30 years of experience in emergency medicine, including prehospital, emergency department/quick care, and trauma. Dr. Campo is a founding board member of the American Academy of Emergency Nurse Practitioners, a national organization. She is a national and international lecturer on emergency and urgent care topics. Dr. Campo is the author of Medical Imaging for the Health Care Provider: Practical Radiograph Interpretation and has authored several book chapters and peer-reviewed articles. Dr. Campo was inducted as a fellow of the American Association of Nurse Practitioners (AANP) in 2015 and Fellow of the American Academy of Nursing in 2017. She has received the alumni award for excellence from Case Western Reserve University and the state award of excellence from AANP. Keith A. Lafferty, MD, FAAEM, received his BA in biology cum laude from Holy Family University in 1989 and his MD from the Medical College of Pennsylvania in 1994. At the completion of his training, his colleagues bestowed him with the “Senior Resident Teaching” award. Following his residency in emergency medicine and a faculty fellowship in critical care, he spent 10 years in full-time academia as a medical student director and a critical care director. Dr. Lafferty currently is the codirector of emergency medicine at Gulf Coast Medical Center, director of fire-based EMS in Fort Myers, Florida, adjunct assistant professor of emergency medicine at Temple University, board member of the Holy Family University Pre-Medical Committee, and board member of the Holy Family University President’s Advisory Committee. As a physician, Dr. Lafferty specializes in emergency medicine and practices in both Philadelphia and Fort Myers, Florida. As an author, he has written numerous chapters and manuscripts, mostly having to do with critical care procedures of emergency medicine, with an emphasis on advanced airway management. He has presented many of his research papers at the local and national levels. Because of his training, practice, and teaching in both emergency and critical care medicine, he passionately advocates the hybridization of these specialties in caring for the sickest of patients. Dr. Lafferty has traveled to Haiti participating in mission expeditions after the devastating earthquake and continues to work with and educate Haitian physicians. The continuing evolution of bedside sonography has no doubt lent itself to bringing diagnostic and procedural accuracy to the most remote and vulnerable areas. Those experiences are reminiscent of his own humble beginnings growing up with his mother and sister in Philadelphia housing projects. Stemming from this, he also serves as chair of the board for both a local housing authority and a nonprofit benefiting such people. Providing medical care for the most indigent and teaching evidence-based medicine are the essence of his dedication to excellence in medicine. Thomas G. Costantino, Jr., MD, FAAEM, received his BS in anthropology–zoology from the University of Michigan, graduating magna cum laude. He received his MD from the University of Michigan as well. He completed his emergency medicine residency at the Medical College of Pennsylvania and stayed to become their first emergency ultrasound fellow. He has worked at Drexel University College of Medicine and is currently a professor of emergency medicine at Temple University School of Medicine where he is the director of the Point-of-Care Ultrasound Fellowship in Emergency Medicine. Dr. Costantino has had the privilege of receiving several awards for excellence in teaching as well as serving in different leadership positions in different national medical organizations and peer-reviewed journals. He has published numerous scholarly articles relating to the field of emergency point-of-care ultrasound. He would like to extend a special thanks to Katie for her video and photo editing assistance. Jacob W. Ufberg, MD, received his BA in the biological basis of behavior from the University of Pennsylvania, graduating magna cum laude. He received his MD from the Lewis Katz School of Medicine at Temple University. He completed his emergency medicine residency at the Medical College of Pennsylvania, and then returned to Temple to join the Department of Emergency Medicine. Dr. Ufberg is a professor of emergency medicine at Temple and has been the director of the Temple University Hospital Emergency Medicine Residency Program for more than 15 years. Dr. Ufberg also serves as the associate dean for admissions at the Lewis Katz School of Medicine at Temple University. Dr. Ufberg has published extensively in the emergency medicine literature and has lectured broadly on numerous emergency medicine topics. He has held national leadership positions related to emergency medicine education and is a past recipient of the Program Director of the Year Award from the American Academy of Emergency Medicine Resident and Student Association. Jennifer Wilbeck, DNP, APRN, FAANP, FAAN, is a professor of nursing at Vanderbilt University School of Nursing and the emergency NP (ENP) academic director. She has over 20 years of experience providing acute and emergency care in a variety of rural, suburban, and tertiary care settings. Dr. Wilbeck received her Master of Science in Nursing (acute care nurse practitioner) and postmaster’s certificate (family nurse practitioner) from Vanderbilt University and her Doctor of Nursing Practice from the Medical College of Georgia. Her efforts have promoted the emergency nurse practitioner’s (ENP) role nationally and internationally to support delivery of high-quality emergency care through education, service, practice, and advocacy. Outside of her leadership within academia, she serves as an advocate for the ENP role nationally. She was the founding board chair for the first national specialty professional organization for ENP practice, the American Academy of Emergency Nurse Practitioners, where she continues to serve in various roles. Essential Procedures for Emergency, Urgent, and Primary Care Settings A Clinical Companion Third Edition Theresa M. Campo, DNP, APRN, FAANP, FAAN Keith A. Lafferty, MD, FAAEM Editors Thomas G. Costantino, Jr., MD, FAAEM Jacob W. Ufberg, MD Jennifer Wilbeck, DNP, APRN, FAANP, FAAN Associate Editors Copyright © 2022 Springer Publishing Company, LLC All rights reserved. First Springer Publishing edition 2010; subsequent edition 2015 No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, [email protected] or on the Web at www.copyright.com. Springer Publishing Company, LLC 11 West 42nd Street, New York, NY 10036 www.springerpub.com connect.springerpub.com/ Acquisitions Editor: Elizabeth Nieginski Compositor: diacriTech Interior and Cover Illustrations: Kimberly Battista and Amanda Barnaby ISBN: 978-0-8261-4104-0 ebook ISBN: 978-0-8261-4105-7 DOI: 10.1891/9780826141057 21 22 23 24/ 5 4 3 2 1 The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. Because medical science is continually advancing, our knowledge base continues to expand. Therefore, as new information becomes available, changes in procedures become necessary. We recommend that the reader always consult current research and specific institutional policies before performing any clinical procedure or delivering any medication. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. LCCN: 2020917401 Publisher’s Note: New and used products purchased from third-party sellers are not guaranteed for quality, authenticity, or access to any included digital components. Printed in the United States of America. At every one of my encounters with patients, I know my actions are guided by the thoughts, principles, and passion of my mentors, Dr. Lynda Micikas, Dr. Robert McNamara, Dr. David Wagner, and Dr. Michael Williams. It is not only an honor to have been trained by the “best of the best,” but even more so, to be a disciple of these pioneers and their relentless desire for perfection. I only hope the students I am privileged to teach are able to sense the illumination passed down to me, in order that they may also attempt to make this greatest of arts into the greatest of sciences. I am most grateful to the faculty and residents that comprise Temple University Department of Emergency Medicine. This monograph is enriched with the excellence, precision, and detail that only can come from a place of fostering evidence-based practice such as Temple University. Special thanks to Dr. Jacob Ufberg and Dr. Tom Costantino for not only being associate editors but more so for coordinating this enormous undertaking with the precision that represents only the best of training institutions. The time, commitment, and dedication spent editing this manuscript are small in comparison to the sacrifice given by my beautiful family. Cathy, you are my love and my soulmate . I am truly a better person because of you, and I love you more every day. This text would not have come to fruition without your continued and relentless encouragement, support, and unselfishness. Karli, Koko, and Kory: Mom and Dad realize and truly appreciate the sacrifices you’ve made, especially while we worked on this third edition. “To win the respect of intelligent people and the affection of children . . . to know even one life has breathed easier because you have lived.”—Ralph Waldo Emerson. This is the true meaning of success. If you love what you do, it is not work! Daddy loves you so much and grows more proud of you every day. Always remember to equate success with the summation of one’s virtuous acts. Keith A. Lafferty No journey is taken alone. The people and experiences are what shape the journey and make it educational. I am truly blessed to have mentors, Joyce Fitzpatrick, Margaret Fitzgerald, Elda Ramirez, Sue Hoyt, Dian Evans, and Jennifer Wilbeck, who have supported me and motivated me. This book would not be possible without the hard work and dedication of all the contributing authors, associate editors, and Springer Publishing. Margaret Zuccarini, you believed in a dream I had of producing a procedural book that would complement practice. Drs. Thomas Costantino, Jacob Ufberg, and Jennifer Wilbeck—thank you for bringing this book to life with consistency, accuracy, and expertise. I am grateful for the interprofessional approach of this book with authors from all disciplines coming together for this project. I have always said that we work together providing incredible care to our patients and we should learn and grow together. Working together accomplishes amazing things! I would not be the person I am today without my father, Anthony Palmerio, and my husband, Jonathan Campo. Your unconditional love and support are amazing and I thank you from my heart and soul and dedicate this book to you both. Theresa M. Campo Contents Contributors xiii Foreword Robert McNamara, MD, MAAEM xvii Foreword K. Sue Hoyt, PhD, RN, FNP-BC, ENP-C, FAEN, FAANP, FAAN xix Preface xxi Acknowledgments xxiii List of Videos xxv Unit I. Introduction 1 1. The Basics of Patient Procedures: Standard Precautions, Infection Control, Patient Preparation, and Education 3 Leigh Anne Pickup 2. Consent, Documentation, and Reimbursement 7 Jay M. Hunter and H. Charlie Lin 3. Interprofessional Approach to Performing Procedures 13 Theresa M. Campo, Jennifer Wilbeck, Brandon Peffer, and Keith Lafferty Unit II. Introduction to Sonography 17 4. Introduction to Ultrasound and Knobology 19 James Murrett, Thomas Costantino, and Aubrey Rybyinski 5. Introduction to Diagnostic Ultrasound 31 Cara Kanter Unit III. Procedures for Airway Management 73 6. Procedures for Basic Airway Management and Foreign-Body Removal 75 Benjamin Bloom, Jennifer Repanshek, and Keith Lafferty 7. Advanced Airway Management 91 Benjamin Bloom, Jennifer Repanshek, and Keith Lafferty 8. Cricothyrotomy 127 Danielle Betz and David A. Wald Unit IV. Procedures for the Heart and Lungs 143 9. Pneumothorax 145 Kimon L.H. Ioannides, Megan Algeo, and Michael Farney vii  CCaammppoo__4411004400__PPTTRR__ii--xxxxvviiiiii__FFMM__0022--0066--2211..iinndddd 77 1155//0044//2211 99::4466 PPMM