Trick of the Trade: Stabilizing mandibular relocations

Three weeks ago, I talked about more safely reducing mandibular dislocations. After successful completion of the procedure, how do you make sure that the patient doesn’t re-dislocate the mandible? You definitely should tell the patient to keep their jaw closed as much as possible for the next 24 hours and avoid opening the mouth widely (eg. yawning/laughing).

How do you immobilize the mandible? Especially for the chronic dislocators, presumably with more lax TMJ ligaments, you should think about immobilization. This can be done with a head bandage which goes under the chin. You can use kerlix rolls or an ACE wrap.

(more…)

By Michelle Lin, MD|2021-01-01T23:08:28-08:00May 15, 2012|ENT, Tricks of the Trade|

SAEM 2012 meeting and social media

Those of us active in social media had quite an active meeting at the Society for Academic Emergency Medicine meeting in Chicago, IL this past week.

First off, Dr. David Marcus (@EMIMDoc) from Long Island Jewish Medical Center, NY gave many of us blogs a kind shout-out.

Also, many “iReporters” were on scene to live-tweet various events. Take a look at some of the posts below. Click on #SAEM12 hashtag to see the whole Twitter feed. I remember hearing that there were over 600 tweets!

By Michelle Lin, MD|2019-01-28T22:19:32-08:00May 13, 2012|Social Media & Tech|

Trick of the Trade: Bend the IV angiocatheter

You identify a great external jugular (EJ) vein to cannulate for IV access. You are having a hard time keeping the angle of the angiocatheter aimed at a shallow angle because the mandible is in the way. This is typical of patients with chubby necks (eg. pediatric patients) or who are unable to rotate their neck.

(more…)

By Michelle Lin, MD|2019-01-28T22:19:19-08:00May 8, 2012|Tricks of the Trade|

Paucis Verbis: Genital Ulcers

A few months ago, American Family Physician published a nice review article on the diagnosis and management of genital ulcers. How do you remember the classic appearances of the lesions? I often quickly check references to confirm my suspicions.

I find the two following tables helpful to remember. The table of differential diagnoses is from AFP. The article also reviews the confirmatory diagnostic testing and treatment protocols. The table of the clinical characteristics for the main infectious causes is from “The Practitioner’s Handbook for the Management of Sexually Transmitted Disease”.

Note: Although the primary lesion from Lymphogranuloma venereum (LGV) can have a variable appearance the tender, and often suppurative lymphadenopathy (buboes) are classic.

genital ulcers

PV Card: Genital Ulcers

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Most recent 2010 CDC treatment guidelines

Reference

Roett M, Mayor M, Uduhiri K. Diagnosis and management of genital ulcers. Am Fam Physician. 2012;85(3):254-262. [PubMed]

By Michelle Lin, MD|2026-06-16T16:02:42-07:00May 4, 2012|ALiEM Cards, Genitourinary|

Trick of the Trade: Seldinger chest tube technique using bougie

A 40 year-old man presents with a traumatic hemopneumothorax. He weighs 400 pounds.

Chest tubes can sometimes be challenge, especially for those with extra redundant tissue to tunnel through before reaching the intrathoracic cavity. You want to avoid placing the chest tube mistakenly in the subcutaneous space. How can you ensure that your chest tube actually reaches the intrathoracic space?

(more…)

By Michelle Lin, MD|2019-01-28T22:18:57-08:00May 1, 2012|Social Media & Tech, Tricks of the Trade|

TED video: The happy secret to better work

If you have a few minutes, take a listen to this rather humorous and thought-provoking TED video about the “intersection of human potential, success, and happiness”. The speaker, Shawn Achor, is the CEO of Good Think Inc, a Cambridge-based consulting firm which researches positive outliers — people who are well above average, and author of “The Happiness Advantage”.

“If we study what is merely average, we will remain merely average.”

By Michelle Lin, MD|2019-01-28T22:19:41-08:00Apr 30, 2012|Medical Education|

Resuscitation 2012 conference

What are you doing the rest of this week? Hop on a plane to Las Vegas and join me at the 2012 Resuscitation conference. It looks to be a great conference. I’ll be giving a 3-hour (!) discussion session on “Tips and Tricks in Emergency Medicine” on Friday. Inevitably when I given this talk, I always come away with great ideas from the audience. I’ll be sure to write them down and share on the blog.

By Michelle Lin, MD|2019-01-28T22:22:20-08:00Apr 26, 2012|Medical Education|

About Michelle Lin, MD

Trick of the Trade: Stabilizing mandibular relocations

SAEM 2012 meeting and social media

Trick of the Trade: Bend the IV angiocatheter

Paucis Verbis: Genital Ulcers

PV Card: Genital Ulcers

Reference

Trick of the Trade: Seldinger chest tube technique using bougie

TED video: The happy secret to better work

Resuscitation 2012 conference