About Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

MIA 2012: Than M et al. 2-Hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial. J Am Coll Cardiol. 2012 Jun 5;59(23):2091-8.

2-hoursBottom Line 1

For ED patients presenting with undifferentiated chest pain, a TIMI score of 0, together with a non-ischemic EKG, and a negative cTnI at 0 hours and 2 hours, can identify patients at very low-risk for having a major adverse cardiac event (MACE) in 30 days.

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By |2016-11-11T18:42:29-08:00Jan 1, 2013|Cardiovascular|

Most Interesting Articles of 2012

Screen Shot 2013-06-11 at 12.11.31 AMThe following compilation of the Most Interesting Articles in 2012 is the work of the EM residents at the Jacobi/Montefiore Emergency Medicine Residency Program.

INTRODUCTION

Standing at the intersection of patient care and academics, we Emergency Medicine residents have overwhelming expectations. We’re the ones dropping NG tubes, popping abscesses, and pushing stretchers, while also expected to remain up to date with current research and trends in our field. With all these lofty expectations, not to mention the ever-present requirement of sleep and caloric intake, how does a resident pick which papers to read in this sea of literature?

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By |2018-10-28T21:34:55-07:00Jan 1, 2013|Medical Education|

PV card: Metacarpal fractures

metacarpal fracture rotationa angulationa=Patients with rotation deformities of the fingers from a metacarpal fracture should be reduced. All fingers should normally point towards the patient’s scaphoid bone.

Metacarpal (MC) fractures are common injuries, which often spark discussions about whether they should be reduced in the ED urgently.

  • What are the criteria for acceptable degrees of angulation? Are these criteria different for the MC neck versus shaft?
  • Which fractures tend to be unstable and thus require eventual operative repair?
  • How should I splint the injury?

Here’s a quick-reference card to help guide your management decisions. These recommendations may vary slightly based on what references you use. You may need to tailor your decisions based on your regional practices.

PV Card: Metacarpal Fractures


Go to ALiEM (PV) Cards for more resources.

 

Thanks to Dr. Nicole Strauss at the UCSF-SFGH Orthopaedic Trauma Institute and my go-to hand expert for her input.

By |2021-10-08T09:33:03-07:00Dec 13, 2012|ALiEM Cards, Orthopedic|
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