About Kara Toles, MD

Senior Resident
Department of Emergency Medicine
Highland Hospital, Alameda Health System
Oakland, CA

Trick of the Trade: Extra-oral reduction technique of anterior mandible dislocation

Anterior dislocation of the mandible is a clinical scenario that is not infrequently encountered by the ED provider and requires prompt intervention. The classic technique for reduction of the mandible requires the provider to place his/her thumbs or fingers into the patient’s mouth along the lower molars and apply force inferiorly and posteriorly. However, this technique is fraught with difficulties and inefficiencies including the following:

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By Kara Toles, MD|2023-06-15T16:19:45-07:00Jan 26, 2016|ENT, Tricks of the Trade|

Trick of the Trade: Patient positioning for ultrasound-guided ulnar nerve block

Patients with 5th metacarpal fractures (commonly termed “boxer’s fracture”) are frequently treated in the emergency department (ED) with closed reduction and splinting. Obtaining analgesia and a successful closed reduction can often be challenging without procedural sedation. Severe swelling can make a hematoma block difficult, often resulting in inadequate analgesia. An ultrasound-guided ulnar nerve block provides a simple method to facilitate pain relief and allow for improved fracture site manipulation.

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By Kara Toles, MD|2018-10-28T21:25:09-07:00Jan 20, 2016|Tricks of the Trade, Ultrasound|