The Proceduralist

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Who is the Proceduralist?

Martha Roberts

Welcome to The Proceduralist.

Who is the proceduralist? YOU. You are the proceduralist. You need to do that abscess drainage, that intubation, that bizarre wound care treatment, that disimpaction, that ear wax removal and that paracentesis. And you need to do it now. And you need to KNOW how to do it now. And you need to know everything about it. But don’t worry, we got you covered. We get you - because we are in your shoes too. We are here to show you how to do EM procedures and review the pearls and pitfalls around all those procedures.

But how did we get here?

It’s been a long road, a lot of degrees, a lot of courses, a ton of podcasts, writing, and publishing. Many hours in the ER. Many long days and even longer nights. You know this, you work there too.

We are Martha and Jim Roberts. We are a daughter/father duo who LOVE emergency procedures. We would like to say, that we are pretty good at a lot of them. In fact, Jim was one of the first emergency physicians in the country. His famous emergency procedures textbook entitled: Roberts & Hedges, Clinical Procedures in Emegency Medicine and Acute Care, is now in it’s 7th edition. And, we are working on the 8th. This next edition will have all new videos and images, and updated amazing procedural content.

We will you a little more about Martha and Jim in the next few blogs. We have an interesting story of growth in EM - and our APP / MD collaborative approach has helped many patients. We are proud of this and our model of care.

Jim and Martha wrote a column for years just about procedures. We had a good time. But, after almost a decade of writing, producing and engaging learners for Emergency Medicine News, we have decided to retire The Procedural Pause and proceed to the PROCEDURALIST. We are currently building a new procedural platform here, to teach and share patient cases. We have a team of experts and a party going in the background laced with pretty procedural tidbits. And, with the help of The Center for Medical Education (www.ccme.org) we have tons more up our lab coats. Check out some of the courses we teach at too.

And hey, don’t forget Jim’s “In Focus” column, that he has been writing for over 35 years for EMN. You can access that here and see his latest EVERY month, still in full fashion form: In Focus.

So, hang in there with us. We are just getting started here. We believe in the collaboration between providers and clinicians. Physicians teaching Advanced Practice Providers and Nurses teaching Doctors and Paramedics teaching Technicians. We are a team. We all have a job and a role - but our interdisciplinary team allows us all to learn from each other to be better for one single cause: The Patient.

But, but, but, what about The Procedural Pause?!

Do NOT worry. The Procedural Pause Blog will still be fully accessible online at EM-news.com in the archives (including all the fun videos and bonus content). It's been a lot of fun and the cases were memorable. The patients were kind and God bless them for sharing their stories and images so others could learn. But we have plenty more peeps waiting to get their airtime to teach you too.

Here is December, 2020's last and FINAL blog. You can check it out here: The last blog.

Can I access The Procedural Pause? Where is it?

Here are some of the topics we covered for EMNews in the last several years, check them out in the archives. Pretty proud of these babies. Lots of great images and videos. They are evergreen. But if you find an old twig, it’s ok, just let us know and we will update it and answer your questions.

2013

  • March 2013 - "My Tooth Hurts and I don't want Narcotics!" - "Feel the Felon"

  • May, 2013 - "Please Poke my Paronychium"

  • June, 2013 - "Sometimes, it's Subungal"

  • July, 2013 - "Need to Know - Patellar Dislocations"

  • August, 2013 - "Here, Fishy, Fishy"

  • October, 2013 - "Funny Bone, Serious Problem"

  • November, 2013 - "Yet Another Shoulder Dislocation"

  • December, 2013 - "The Saga Continues: Posterior Shoulder Dislocation"

2014

  • January, 2014 - "Foreign Body to the Face and Facial Laceration Repair"

  • January, 2014 - "Point Taken: Finger Dislocation"

  • February, 2014 - "Feel the Burn"

  • April, 2014 - "Feel the Burn - Heal the Burn: Wound care Management"

  • May, 2014 - "Battle of the Bulge, Olecranon Bursitis"

  • June, 2014 - "Life in the Emergency Department, Not What You Expected?" August, 2014 - "Finger Fascination"

  • September, 2014 - "Go Mental: Head and Neck Anesthesia

  • October, 2014 - "Positioning is Everything: A Series on Lumbar Puncture"

  • November, 2014 - "Lumbar Puncture: Made Simple

  • December, 2014 - "Lumbar Puncture: Golden Rules"

  • December, 2014 - "Eyebrow Laceration and Repair, if you Dare!"

2015

  • February, 2015 - "Abscess Basics Part I: The Setup and Anesthesia: A series on Incision and Drainage"

  • February, 2015 - Editorial Piece: "Making it as a Midlevel, Amongst the Wolves."

  • March, 2015 - "Abscess Control: Pilonidal Cysts"

  • April, 2015 - "Abscess Basics Part II: Incision and Drainage."

  • May, 2015 - "Tenosynovitis"

  • June, 2015 - " The Hugest of Huge Hematomas."

  • July, 2015 - "Dabbling in Dentistry, Ellis fractures and more."

  • August, 2015 - "A Procedure's Impact on Patient Comfort, Care, and Outcome."

  • September, 2015 - "Knee Pain: Part I, Can I Tap That?"

  • October, 2015 - "Knee Pain: Part II"

  • November, 2015 - "Why Fluoro Should be Your Next Go-To Part I."

  • December, 2015 - "Why Fluoro Should be Your Next Go-To Part II."

2016

  • January, 2016 - Editorial Piece: "Stick It to Me."

  • January, 2016 - "Why Fluoro Should be Your Next Go-To Part III."

  • February, 2016 - "Eye Sty with my little Eye."

  • March, 2016 - "Ultrasound, Part I: We had you at Ultrasound, part I."

  • April, 2016 - "Ultrasound, Part II: We had you at Ultrasound, part II. Foreign body removal."

  • April, 2016 - Editorial Piece: "Stop working for Mr. Business."

  • May, 2016 - "Ultrasound Part III: Ocular Ultrasound and Retinal Detachment."

  • June, 2016 - "Ultrasound Part IV: Intravenous (IV) line insertion."

  • June, 2016 - Viewpoint: "New around here."

  • July, 2016 - "Ultrasound Part V: Bedside Ultrasound using two point compression to rule out DVT."

  • July, 2016 - Editorial Piece (Viewpoint) "The Deformation of Emergency Medicine."

  • August, 2016 - Thrombosed Hemorrhoids: Tape-tactics

  • September, 2016 - Back to Basics series part I: Cocaine and Foreign Bodies in the Ear

  • October, 2016 - Back to Basics series part II: Morgan Lens No More: Eye issues resolved

  • November, 2016 Pediatric Nail Bed Lacerations - Part II

  • December, 2016 - Editorial Piece (Viewpoint) "Not So Secret Work Place Bullying"

  • December, 2016 - Pediatric Nail Bed Lacerations - Part III

2017

  • January, 2017 - "Pediatric Nail Bed Lacerations" - Part IV

  • February, 2017 - "Pediatric Nail Bed Lacerations "- Part V

  • February, 2017 - "Clinical Pearls: Pediatric Eye Trauma"

  • March, 2017 - "Superglued My Eye Shut: Pediatric Eye Trauma"

  • April, 2017 - "Thumb Dislocation- Fix me!"

  • May, 2017 - "Seriously, Let's Get Splinting: A Series" (Part I)

  • June, 2017 - "Back-to-Basics - Splinting" (Part II)

  • July, 2017 - "Back-to-Basics for Strains and Sprains: ACE Wraps, Air-cast, and Velcro" (Part III)

  • August, 2017 - "Losing Your Grip with Lateral Epicondylitis - JIM TAKES OFF HIS SHIRT" (Part IV)

  • September, 2017 - "Short and Long Posterior Splints for Leg Injuries" (Part V)

  • October, 2017 - "Case Study: Foreign Body to the Foot - Wine Glass" (weird and wild series part I)

  • November, 2017 - "Kerions and Scalp Abscess" (weird and wild series part II)

  • December, 2017 - "Taming the Tattoo" - how to fix lacerations over body art (weird and wild series part III)

2018

  • January, 2018 - "The Curse of the Keloid" (weird and wild series, part IV)

  • January, 2018 - Editorial piece, Viewpoint: "Ask Patients Flat-Out Do You Have a Problem with Pain Meds?"

  • February, 2018 - "Weird and Wild: Back Piercing and Langers' Lines"

  • March, 2018 - "Weird and Wild: Piercing Problems, Tongue Rings and TXA"

  • April, 2018 - "Compartment Syndrome, 101"

  • May, 2018 - "Ultra-sounding the hand for foreign bodies"

  • June, 2018 - "Nailed it: removing a nail in the hand"

  • July, 2018 - "The Almighty Hematoma Block for Wrist Fractures."

  • August, 2018 - "Both Bone Fractures"

  • September, 2018 - "Ring Cutter to the Rescue"

  • November, 2018: "Tono-pen, Acute Narrow Angle Closure"

  • December, 2018: "Anoscopes and Foreign Bodies in the Rectum"

2019

  • February, 2019 – “The Slit Lamp Made Simple”

  • March, 2019 – “The Essential Checklist for Ankle Dislocations”

  • April, 2019 – “Trocar in Times of Trauma”

  • May, 2019 – “Lung Sliding: Ultrasound using the handheld Butterfly IQ”

  • June, 2019 – “Punctal Plugs: Part I”

  • July, 2019 – “Punctal Plugs: Part II”

  • August, 2019 – “Toe Jam: Linear Toe Lacerations and Running Sutures”

  • September, 2019 – “Chainsaw to the Leg”

  • October, 2019 – “Figure-of-eight Sutures for Bleeding Varicose Veins”

  • November, 2019 – “Evacuating the Nefarious Subungual Hematoma”

  • December, 2019 – “Fingertip Amputations and Repair”

2020

  • January, 2020 – “Paracentesis: Fluid Wave and Physical Exam”

  • February, 2020 – “Paracentesis Part II: Using Ultrasound to Assist in your Procedure”

  • March, 2020 – “Paracentesis Part III: The Procedure”

  • April, 2020 - "Ultrasound: Arthrocentesis of the Wrist, Part I"

  • May, 2020 - "Ultrasound: Arthrocentesis of the Wrist, Part II"

  • May, 2020 – Editorial piece, Narrative Medicine, “The Worst Night Ever.”

  • June, 2020 - "Ear Wick in the ER"

  • July, 2020 - "Ankle Hematoma Block"

  • August, 2020 – “The Quigley Maneuver for Ankle Fractures”

  • September, 2020 – “Ear Wicks and more for ENT procedures”

  • October, 2020 – “Cures for Cerumen Impaction”

  • November, 2020 – “Using Nasal Endoscopy for Urgent and Complex Cases”

  • December, 2020 - “Portable Otoscope for better Visualization of the TM and canal in the ER”