Central lines come packed with a long introducer needle (pink arrow) to feed the guidewire through AND a long angiocatheter (yellow arrow). Most people cannulate the vein by using the syringe and the introducer needle. What’s the angiocatheter for?
Bell’s Palsy is an idiopathic unilateral facial nerve paralysis.
Since the 2009 Cochrane review1 showing that antivirals added no benefit to corticosteroids in Bell’s Palsy, I stopped prescribing them. The NNT.com site has concluded the same. Looking at the literature a little more, the recommendations are a little murkier. Some groups are still advocating for antivirals for severe cases, because there may be a very small but questionably positive benefit.
Adapted from [1, 2, 4]
Go to ALiEM (PV) Cards for more resources.
Thanks to Dr. Kristin Berona (UCSF-SFGH EM resident) for the idea and notes!
Emergency physicians are constantly challenged with fishing foreign bodies out of various orifices such as ears, as shown here in an earlier Trick of the Trade using a tissue adhesive.
What do you do when an overweight person presents with the cotton portion of a Q-tip lodged in his umbilicus? Skin retractors and direct probing were unsuccessful in removing the cotton.
Do you use a PICO method to answering a clinical question using the medical literature?
This two-part series provides an introduction in how to search the medical literature to answer your clinical question. This provides a concise overview of epidemiology and statistics.
Have you ever wondered why prescription eyedrops have different color bottle caps? Did you know that the American Academy of Ophthalmology (AAO) has a policy to color-code topical ocular medication bottles caps?
“The Academy’s policy on color coding of eyedrop drug caps was prompted by reports to the Academy and the National Registry of Drug-Induced Ocular Side Effects of serious adverse events resulting from patient difficulty in distinguishing between various ocular medications. With input from the pharmaceutical industry and the Food and Drug Administration (FDA), the Academy’s Committee on Drugs developed a uniform color-coding system.” — AAO policy statement
This totally makes sense. I would think the highest-risk population to mix up medications are those with vision problems. The colors help serve as an safeguard against error.
When would you obtain a CT for a pediatric patient who sustained a head injury? Watch this nice 11-minute video review by Dr. Raul Patwari, discussing the 2009 Lancet PECARN study.
An IV drug user accidentally breaks off a 25-gauge needle in his/her forearm and presents to your ED for needle foreign body removal. How can you minimize the degree of trauma to the patient? How can you minimize the number of incisions made in order to find and remove this “needle in a haystack”?