Building on my theme of combating odors in the Emergency Department (see Toxic Sock Syndrome), foul-smelling pus from large abscesses has got to be one of the most nauseating smells in the ED for me.
Use a Yankauer to suction up pus
How do I keep up with the information from the myriad of Emergency Medicine websites out there? Blogs, Twitter, Journals, oh my.
Thanks to LifeInTheFastLane, you can check out all the current EM bloggers out there with their Twitter name and RSS feed links! I had no idea there were so many. I can appreciate how much time and effort it took to compile this list. Fantastic job, guys.
Atraumatic subarachnoid bleeds are most commonly caused by ruptured intracranial aneurysms.
This installment of the Paucis Verbis (In a Few Words) e-card series reviews the current management, knowledge, and challenges in aneurysmal subarachnoid hemorrhage (SAH).
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
I mentioned from an earlier post about building a “head basin” for collecting irrigation fluid prior to wound closure. This basin prevents a deluge of fluid from soaking the gurney sheets and patient.
I finally managed to capture this trick in action, while a student was irrigating an eyebrow laceration.
When cutting out a semi-circular or rectangular hole in the basin, be sure that there remains a 2-4 inch lip at the bottom to ensure that fluid can collect in the basin.
Using the slit lamp can be a challenge to learn, especially if you haven’t seen pathology before. In checking for anterior uveitis (i.e. iritis), you need to look for “cell and flare”. In theory, you know that you are looking for inflammatory cells and “flare”, which resembles a light beam being filtered through smoke.
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This is is a great look back at how SAEM Tests were developed and now used by EM clerkships across the country. Because EM does not have a National Board of Medical Examiners shelf exam, a tremendous effort was made by the authors to create a set of validated questions for clerkship directors to use.
Specifically point serial correlation coefficients (range -1 to +1) were calculated for each question. A high coefficient means a high correlation between the performance on the individual test question and the performance on the overall test. After rewriting 25% of the test questions because of poor correlation coefficients, all current test questions now have a point serial correlation coefficient >0.2. (more…)
Patients present with acute strokes to the Emergency Department. Time is of the essence to obtain a rapid neurologic exam, draw labs, get CT imaging, and consulting a neurologist especially if the patient presents within 3 hours of onset. To help the neurologist determine whether the patient should get thrombolytics, calculating a NIH Stroke Scale score is useful.w
In this installment of the Paucis Verbis (In a Few Words) e-card series, here is the NIHSS scoresheet.
| Score 0 | No stroke |
|---|---|
| Score 1-4 | Minor stroke |
| Score 5-15 | Moderate stroke |
| Score 16-20 | Moderate-severe stroke |
| Score 21+ | Severe stroke |
Go to ALiEM (PV) Cards for more resources.