About Kara Toles, MD

Senior Resident
Department of Emergency Medicine
Highland Hospital, Alameda Health System
Oakland, CA
26 01, 2016

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

mandible dislocationAnterior 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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20 01, 2016

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

Ultrasound ForearmPatients 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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