Trick of the Trade: No pelvic bed? No problem

Pelvic SpeculumOften finding a pelvic examination bed for a female patient needing a speculum exam can be challenging. Without the elevated foot stirrups, the bed under the patient’s buttocks obstructs the pelvic speculum handle so that it can’t rotate completely into a 6 o’clock position.
Some people place an upside-down bed pan to elevate the patient’s buttocks slightly in order to create more space for the speculum. Not only is the position uncomfortable for the patient, it seems a waste of a perfectly good bed pan. Fortunately there is an alternative approach.
By |2019-01-28T22:00:26-08:00Mar 26, 2013|Ob/Gyn, Tricks of the Trade|

Trick of the Trade: Ambient noise and creative cognition

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For many of us in academia and medical education, we accomplish a tremendous amount of work outside of the workplace. This can be in our home office, on the public transit system, or in the library.

Interestingly, creative cognition occurs best with a moderate amount of ambient noise (not too much and not too little), according to a 2012 article from Journal of Consumer Research.

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By |2019-02-19T18:04:59-08:00Mar 12, 2013|Tricks of the Trade|

Trick of the Trade: External jugular tourniquet

Paitents can be a challenge when trying to obtain peripheral IV access. The vein may be collapsed from dehydration or scarred because of IV drug use or repeated cannulation. Before thinking about an ultrasound-guided deep vein IV or a central line, take a look at the external jugular (EJ) vein.

There are, however, a few problems that exist when trying to cannulate this site:
  • There is no tourniquet for the neck.
  • To distend the vein, you often need to put the patient in Trendelenburg, which may be uncomfortable or intolerable for some
By |2016-11-11T11:17:20-08:00Mar 5, 2013|Tricks of the Trade|

Trick of Trade: Umbilical foreign body removal

Emergency physicians are constantly challenged with fishing foreign bodies out of various orifices such as ears, as shown here in an earlier Trick of the Trade using a tissue adhesive.

What do you do when an overweight person presents with the cotton portion of a Q-tip lodged in his umbilicus? Skin retractors and direct probing were unsuccessful in removing the cotton.

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By |2016-11-11T18:40:59-08:00Feb 19, 2013|Tricks of the Trade|

Trick of the Trade: Recognizing eyedrop bottles by color

Have you ever wondered why prescription eyedrops have different color bottle caps? Did you know that the American Academy of Ophthalmology (AAO) has a policy to color-code topical ocular medication bottles caps?

Why was this needed? 

“The Academy’s policy on color coding of eyedrop drug caps was prompted by reports to the Academy and the National Registry of Drug-Induced Ocular Side Effects of serious adverse events resulting from patient difficulty in distinguishing between various ocular medications. With input from the pharmaceutical industry and the Food and Drug Administration (FDA), the Academy’s Committee on Drugs developed a uniform color-coding system.” — AAO policy statement

This totally makes sense. I would think the highest-risk population to mix up medications are those with vision problems. The colors help serve as an safeguard against error.

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By |2016-11-11T18:41:10-08:00Feb 12, 2013|Ophthalmology, Tricks of the Trade|