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About Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
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Trick of the Trade: Another magnet trick for metallic FB removal

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Last week, I talked about the use of Rare Earth Magnets for removing metallic foreign bodies. Sometimes a straight magnet though isn’t quite strong enough to grab a metallic foreign body. If only you had a small magnetic hemostat.

This week Dr. Catherine Perry (Culpepper Memorial Hospital) and Dr. Kolapo DaSilva (PGY-2 at UVA) emailed me with a creative solution. They encountered a patient with a BB pellet lodged deeply in the soft tissue. Small mosquito clamps couldn’t get around the BB. A cardiac magnet alone caused the BB to tent the skin up.

(more…)

By |2019-01-28T22:25:49-08:00Mar 6, 2012|Tricks of the Trade|
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Video: Crash course on Prezi

Dr. Rob Rogers has started a great series of videos which highlight resources and tools which medical educators may find useful and innovative. This video takes you on a guided tour through making a Prezi presentation. Although I am still torn about using Prezi as a delivery tool because of the excessive motion-based transitions, I do like such features as:

  • Really professional looking templates
  • The presentations can live online and/or on your desktop
  • Ability to easily embed videos
  • Ability to see your entire presentation on the canvas
  • Allows more flexibility in content delivery
  • It just looks cool.

You can look for more excellent videos on the Academic Emergency Medicine Education Masters site. Hey maybe you can next teach people how to use Google Reader, Evernote, Dropbox!

By |2026-06-16T16:02:53-07:00Feb 27, 2012|Social Media & Tech|
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Paucis Verbis: Anaphylaxis

Anaphylaxis Epipen in Thigh

Anaphylaxis is one of the most under-appreciated and under-treated conditions in the Emergency Department. A common misperception is that you need hypotension to diagnose it. Below is a brief summary of the diagnostic criteria and ED treatment protocol. Immediate administration of IM epinephrine is critical.

A major challenge is deciding which patients can go home and which need to be admitted, because of the risk of “rebound” or a biphasic anaphylactic response. This may occur as late as 72 hours later, but typically occur within the first 24 hours. There isn’t a good answer for this.

What’s your practice in dispositioning these patients? Personally, I admit at least those patients who present with severe hypotension, require more than 1 epinephrine dose, or have poor social support.

NOTE: Unlike the photo on the top, warn patients NOT to rest their thumb on the device because of the risk inadvertent needle puncture.

PV Card: Anaphylaxis


Adapted from [1, 2]
Go to ALiEM (PV) Cards for more resources.

References

  1. Arnold J, Williams P. Anaphylaxis: recognition and management. Am Fam Physician. 2011;84(10):1111-1118. [PubMed]
  2. Simons FER. Anaphylaxis. Journal of Allergy and Clinical Immunology. 2010;125(2):S161-S181. doi: 10.1016/j.jaci.2009.12.981
By |2021-10-10T19:17:26-07:00Feb 24, 2012|ALiEM Cards, Allergy-Immunology|
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Paucis Verbis: Pediatric fever without a source (3 mo-3 yr)

Thermometer Pediatric FeverIn part 3 of this “Pediatric Fever Without a Source” Paucis Verbis cards, we now cover febrile infants 3 months to 3 years old (PV cards for birth-28 days and 29 days-3 months old).

Notes:

  • The algorithm below is a guideline for NON-toxic patients. More ill-appearing children require a more broad workup.
  • For the under-immunized (<2 PCV immunizations) and temperature ≥39.5C, blood cultures may be falling out of favor in the near future, because the incidence of blood culture contaminants is close to exceeding the true incidence of occult bacteremia.

PV Card: Pediatric Fever Without a Source (3 Months-3 Years)


Go to ALiEM (PV) Cards for more resources.

Thanks to Dr. Hemal Kanzaria (UCSF-SFGH resident) for helping design this PV card and Dr. Christine Cho, Dr. Andi Marmor, and Dr. Ellen Laves (UCSF Pediatrics) for the content.

By |2021-10-11T15:10:11-07:00Feb 10, 2012|ALiEM Cards, Pediatrics|
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