About Michelle Lin, MD

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

Trick of the Trade: Cunningham maneuver for shoulder dislocation

ShoulderDLxray

We commonly see patients with shoulder dislocations in the Emergency Department. There are a myriad of approaches in relocating the joint, which includes scapular rotation, Snowbird, and Kocher maneuvers.

I recently stumbled upon the Cunningham technique after hearing about it from Dr. Graham Walker (of MDCalc fame) on TheCentralLine.org.

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By |2019-01-28T22:43:28-08:00Jun 22, 2011|Orthopedic, Tricks of the Trade|

Article review: Professionalism in the ED through the eyes of medical students


Professionalism
Teaching professionalism in a formal curriculum is so much different than demonstrating professionalism in the Emergency Department. So much of what students and residents learn about professionalism are from observed behaviors of the attending physicians — that is, the hidden curriculum.

In a qualitative study assessing medical student reflection essays during an EM clerkship, the authors (my friends Dr. Sally Santen and Dr. Robin Hemphill) found some startling results. The instructions to the medical students were to “think about an aspect of professionalism that has troubled you this month. Write a minimum of one half-page reflection describing what was concerning and how you might handle it.”

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By |2016-11-11T18:52:55-08:00Jun 20, 2011|Education Articles, Medical Education|

Trick of the Trade: I need more lidocaine but I have sterile gloves on!


LPkit3
How often has this happened to you —

You are in the middle of a sterile procedure (chest tube, suturing, central venous line, lumbar puncture) and you realize that you need more lidocaine to provide better topical anesthesia. You don’t have any more in your kit and you are alone in the room with the patient.

“Uh, can someone help me out there?”

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By |2016-11-11T18:52:56-08:00Jun 15, 2011|Tricks of the Trade|

Paucis Verbis: Lifetime attributable risk of cancer from CT

How great would it be if you could give patients concrete numbers when you are talking about cancer risk and CT? Well, Dr. Hans Rosenberg (Univ of Ottawa)  has come up with just such a table.

Using this table you can say that the risk is about “one in …”

PV Card: Cancer Risk from CT


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

Reference

  1. Smith-Bindman R. Radiation Dose Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer. Archives of Internal Medicine. 2009;169(22):2078. doi: 10.1001/archinternmed.2009.427
By |2021-10-13T08:43:55-07:00Jun 10, 2011|ALiEM Cards, Radiology|
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