Trick of the trade: Straightening the guidewire

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Did you know that a medical guidewire consists of a flexible central “ribbon wire” externally wrapped with a coil-spring wire?

J-shaped guidewires are commonly used in many medical procedures, such as central lines, arterial lines, and pigtails for pneumothoraces. Knowing more about the guidewire makes it possible to carry out a unique Trick of the Trade. For example, let’s say that the plastic introducer is missing or unusable. Using one hand to stabilize the needle in the patient, how do you use your other hand to re-insert a curved guidewire tip into the hub of a needle?

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2019-01-28T23:53:30-07:00

Trick of the Trade: Style points in pediatric orthopedics

With this hot summer season in California, kids have been running around and getting into all sorts of orthopedic troubles. Monkey bars are a common culprit. In treating pediatric patients in the ED, it’s worth spending an extra few minutes on the subtle style points.

Trick of the Trade:

Splint the buddy bear

You should consider keeping a stash of stuffed teddy bears in the ED for those patients, whom you splint or cast. It is a nice touch to have the patient go home with a teddy bear with the same “injury” and splint/cast.

BearCastAll

It’s the little touches that will make your patient’s day a little less sucky.

2019-02-04T03:00:51-07:00

Trick of the Trade: The key to pollution is dilution

Wound care mantra: “The key to pollution is dilution.”

High-pressure irrigation best reduces the patient’s risk for a wound infection. Open fractures are unique in the ED in that they require quick, high-volume irrigation before going to the operating room for more definitive wash-out. Often times a 30 mL syringe and 18-gauge angiocatheter is too cumbersome and slow for high-volume, high-pressure irrigation.

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2019-01-28T23:53:51-07:00

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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2016-10-26T17:05:42-07:00