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: Endotracheal tube lubrication

ETT_Lubricatesm-1
Does your endotracheal tube get caught up on a swollen or floppy epiglottis during insertion?

Trick of the Trade: Endotracheal tube lubrication

Occasionally the endotracheal tube may become “caught up” along the epiglottis. Because it is difficult to predict when this may happen, pre-lubricate the endotracheal tube cuff and tip with a thin layer of water-soluble lubricant, such as K-Y jelly. This lubricant can also minimize the degree of surface trauma to the trachea and tracheal rings as the tube passes the vocal cords.

By |2016-11-11T19:00:45-08:00May 26, 2010|Tricks of the Trade|

Paucis Verbis card: Ottawa knee, ankle, and foot rules

Often times, I get called to triage to help decide whether a patient should be sent to Radiology for an initial x-ray after injuring their knee, ankle, and/or foot. After teaching one of the nurses about the Ottawa rules, she taped a list of these rules on the triage wall.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews Ottawa Knee, Ankle, and Foot Rules.

(more…)

By |2019-01-28T23:40:47-08:00May 7, 2010|Orthopedic, Radiology|

Trick of the trade: Percuss the spine in low back pain

 SpineAnatomysmMany patients present to the Emergency Department for low back pain. Determining whether these patients have a red-flag diagnosis can be difficult. Red flag diagnoses include:

  • Fracture
  • Cauda equina syndrome/ spinal cord compression
  • Spinal infection
  • Vertebral malignancy

Almost all patients presenting with back pain, whether it be a muscle spasm or a spinal epidural abscess, will have back tenderness to some extent. So, how can you better differentiate benign from dangerous etiologies?

(more…)

By |2016-11-11T19:01:21-08:00May 5, 2010|Tricks of the Trade|

Poll: How do you recover from a night shift?

EmergencySignsm
There are so many amazing things that we get to see and do as emergency physicians.

  • We see sick, undifferentiated patients who need our help acutely.
  • We have cool toys, such as ultrasounds.
  • We get to do great procedures.
  • We work on a shift-based schedule.
  • We work in team-based fashion with fun nurses, technicians, and staff.

However, one major down side is that almost all of us work some night shifts.

(more…)

By |2019-09-10T14:05:52-07:00May 4, 2010|Life|

Paucis Verbis card: Vasopressors and Inotropes for Shock

IVdripsmThe treatment of shock should focus on correcting the underlying pathophysiology. With persistent hemodynamic instability, a vasopressor and/or inotrope should be selected. Reviewing receptor physiology can help you select the best-fit agent for the patient’s clinical condition. There is an especially useful table on medication selection in the reviewed 2008 EM Clinics of North America article.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews Vasopressors and Inotropes for the Treatment of Shock.

(more…)

By |2019-01-28T23:40:34-08:00Apr 30, 2010|ALiEM Cards, Cardiovascular, Tox & Medications|