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: Peritonsillar abscess needle aspiration

peritonsillar abscess

How do you drain a peritonsillar abscess?

When evaluating a patient with a sore throat and “hot potato voice,” peritonsillar abscess (PTA) is at the top of the differential diagnosis list. As with all abscesses, the definitive treatment involves drainage of pus. This can be done either by incision and drainage or, more commonly, by needle aspiration.

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2019-07-02T20:50:17-07:00

Trick of the Trade: Hair apposition technique (HAT trick)

Scalp lacerations over hair-bearing areas require wound closure, usually with staples. An alternative technique is the Hair Apposition Technique, also known as the HAT trick [1, 2]. This technique provides a more cost-effective, faster, and less painful approach to scalp laceration repair. Imagine the scalp hairs as suture ties already embedded in the skin.

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2019-11-29T19:02:25-08:00

TGIF: The "caffeine nap"

A common problem that emergency physicians share and struggle over is the circadian “dysrhythmia” of working random morning, afternoon, and night shifts. Shift work is the blessing and curse of our profession. I have yet to figure out the best way to adjust back to the daytime world after night shifts. Do you have any tricks?

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2019-09-10T14:06:16-07:00

What is a journal "impact factor"?

Journals use the numerical “Impact Factor” as an indirect quantitative measure of a journal’s importance in the medical field and scientific literature. Thompson Scientific calculates the impact factor scores annually. This score provides journals with bragging rights, especially when it comes to marketing. Be aware that there are ways to manipulate the numbers a little and thus brings the true value of this score into question.

How is the impact factor calculated?

The impact factor is a calculation of how frequent a journal’s articles are cited in a 2-year period. As an example, the 2009 impact factor for a journal would be:

Impact Factor = A / B

  • A = Number of times 2007-08 articles are cited from a given journal
  • B = Number of total “citable items” published in given journal during 2007-08

The ambiguous issue is how the denominator of “citable items” is determined. Basically articles which qualify as potentially citable items include original research, reviews, proceedings, and notes. These do not include such items as editorials, coresspondences, and errata. Sometimes it’s unclear which articles don’t qualify. The more articles that you exclude, the smaller your denominator and thus the higher (and better) the impact factor.

Below are impact factors of several journals, relevant to those interested in publishing in EM and medical education. In addition to impact factors, you should also consider the journal’s general focus when deciding where to submit your manuscript. If you read through several back-issues, you will get a sense of each journal’s “flavor”:

Emergency Medicine journals

  • Annals of Emergency Medicine 3.755
  • Academic Emergency Medicine 2.46
  • Emergency Medicine Journal 1.347
  • American Journal of EM 1.188
  • Journal of Emergency Medicine 0.778


Education journals

  • Academic Medicine 2.57
  • Medical Education 2.181
  • Teaching and Learning in Medicine 0.83
2019-09-10T14:06:28-07:00