Trick of the Trade: Dermal Avulsion Injuries 2.0

This year I published a Novel, Simple Method for Achieving Hemostasis of Fingertip Dermal Avulsion Injuries in the Journal of Emergency Medicine ¹ — a technique I’ve used in my local ED for several years. In brief, this involves achieving hemostasis over a fingertip skin avulsion by using a tourniquet followed by tissue adhesive glue. After bringing the technique to press and sharing this video, I’ve received great tips from peers and subsequently refined it with some additional ideas. Thus I present for the first time on ALiEM: Dermal Avulsion Injuries 2.0.

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By Brian Lin, MD|2016-11-11T19:39:55-08:00Nov 5, 2015|Expert Peer Reviewed (Clinical), Trauma, Tricks of the Trade|

NEXUS Chest CT Decision Instruments in Blunt Trauma

One of the five 2014 American College of Surgeons’ Choosing Wisely recommendations is to avoid routing whole-body CT imaging of trauma patents, also known as the ‘pan-CT’. Until now, no validated decision instrument existed to help guide clinicians decide whether to obtain a chest CT in the setting of blunt trauma. This month, Dr. Robert Rodriguez and the multi-institutional NEXUS Chest CT research team published a paper describing the derivation and validation of 2 decision instruments in PLOS Medicine [1].

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By Michelle Lin, MD|2019-01-28T21:43:56-08:00Oct 13, 2015|Radiology, Trauma|

60-Second Soapbox: New podcast series featuring Drs. Lin, Riddell, Shaikh

We are excited to announce our new podcast series, 60-Second Soapbox! Each episode, one lucky individual gets exactly 1 whole minute to present their rant-of-choice to the world. Any topic is on the table – clinical, academic, economic, or whatever else may interest an EM-centric audience. Don’t worry if your are microphone-shy. We will carefully remix your audio to add an extra splash of drama and excitement. Even more exciting, participants get to challenge 3 of their peers to stand on a soapbox of their own!

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By Sam Shaikh, DO|2020-04-20T19:40:02-07:00Jul 29, 2015|60-Second Soapbox, Genitourinary, Infectious Disease, Medical Education, Podcasts, Trauma|

Rib Fractures in Older Adults – What’s the Big Deal?

Blunt chest trauma from falls or motor vehicle collisions are a common reason for ED visits and a common source of rib fractures. While many patients with rib fractures can be discharged home with oral analgesics and an incentive spirometer, certain patients are at much higher risk for morbidity and mortality. This post will look at which patients are at risk, what factors predict increased mortality, and inpatient interventions that can reduce mortality, with a focus on the risks in older adults.

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By Christina Shenvi, MD, PhD, MBA|2016-11-11T19:37:08-08:00Jun 3, 2015|Geriatrics, Trauma|

A cost-effective, two-layer wound closure task trainer

Performing a two layer wound closure can be a challenging procedure in the Emergency Department for clinicians with limited wound care experience. Challenges include suture choice, suture placement, and the technique of burying the knot in the deep layer of the wound, and the availability of ready ‘volunteers’ with complex wounds willing to let novices practice on them. Commercially available suture models are expensive, and can be cumbersome to store, and difficult to obtain in a timely manner to provide the learner with opportunities to practice prior to wound repair on a patient in the department.

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By Rob Bryant MD|2016-12-19T11:02:01-08:00Apr 15, 2015|Expert Peer Reviewed (Clinical), Medical Education, Simulation, Trauma|

Diagnose on Sight: Lower extremity numbness and pain

Case: An 18 year old male presents after a single gunshot wound to his left calf. He complains of pressure-like pain near the wound and sensory numbness below his left knee. On examination, the left leg is tense. He has no dorsalis pedis pulse. Based on the history, exam, and findings in the image, which of the following is true regarding this diagnosis?

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By Jeff Riddell, MD|2016-12-22T18:49:50-08:00Mar 9, 2015|Diagnose on Sight, Orthopedic, Trauma|

Diagnose on Sight: Traumatic low back pain

Case: An 18 year old female was the restrained passenger in a motor vehicle crash moving at 65 mph. She complained of traumatic low back pain radiating to her abdomen. What is the most likely mechanism of injury, based on this video of CT images?

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By Jeff Riddell, MD|2018-01-30T01:55:28-08:00Jan 26, 2015|Diagnose on Sight, Orthopedic, Trauma|

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