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: 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?

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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.

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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.

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

Paucis Verbis card: Skipping the CT prior to LP for meningitis

LumbarPunctureWith increasing awareness of CT’s irradiation risk, I thought I would review a classic 2001 article from the New England Journal of Medicine. Head CT’s previously were commonly performed prior to all lumbar punctures (LP) to rule-out meningitis. When can you safely go straight to an LP without imaging?

Caveat: This review only applies to those patients in whom you suspect meningitis. This does not apply to those being worked up for subarachnoid hemorrhage.

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By |2019-01-28T23:41:24-08:00Apr 23, 2010|Neurology, Radiology|
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