Sometimes you just have to be lucky to get projects done.
In anticipation of our Vietnam trip in October to teach clinical decision software to pediatricians (KidsCareEverywhere), we are kicking preparations into high gear. One of my tasks is to create new KCE-PEMSoft training modules not only in English but also Vietnamese. And no, I do NOT speak a lick of Vietnamese.
Welcome to new superstar guest blogger, Dr. Robert Cooney! Today’s post is his first (of hopefully many).
The most common cause of stridor in pediatric patients is croup, or laryngotracheobronchitis. The distinct high-pitched, seal-like,”barky” cough can be heard from outside the patient’s room often.
Check out the YouTube clip above. Go to the 1:15 mark (near the end) to hear the barking cough. Poor but cute kid.
What is the current treatment regimen? Did you know that the traditional treatment with cool mist or humidified air have shown to be of no added benefit?
Go to ALiEM (PV) Cards for more resources.
I finally tried the Modified HAT (Hair Apposition Technique) trick for the closure of scalp lacerations. I have used the traditional HAT trick multiple times but not the modified technique.
Instead of using your fingers, the modified approach involves the use of two instrument clamps to help twist and pull the hair strands taut. It turns out that this makes a huge difference, especially for short hairs. The clamps allow you to grab the hair strands so much more securely, before instilling a tissue adhesive at the twisting points.
The nice added benefit was that my chubby fingers were now out of the procedural field. This allowed my assistant to more easily see and reach the hair twisting points with the Dermabond applicator.
Check out the finished product of this 2.5 cm laceration on the scalp vertex.
The simple addition of two instrument clamps provides significantly superior control, stronger tensile strength, and better exposure when twisting hair strands together. Try it.
Acute limb ischemia (ALI) is a true vascular emergency. It doesn’t occur as frequently as the more high-profile conditions as cerebrovascular accidents and acute myocardial infarcts, but it portends similarly high morbidity and mortality risk.
Go to ALiEM (PV) Cards for more resources.
As emergency physicians, we are experts in pain control. We frequently write opiate prescriptions for patients being discharged home. Unfortunately, an occasional patient tries to forge my prescription. At times, I get a call from pharmacy for prescriptions that were suspiciously written. For instance several years ago, I had someone try to forge 100 tablets of “Mophine”.
