Trick of the Trade: Persistent paracentesis leakage

Paracentesis-1Dr. Matt Borloz (Carilion Clinic) recently emailed me his recent trick in fixing a persistently leaking paracentesis site. Read about his experience:

A patient with advanced alcoholic cirrhosis with ascitic fluid leaking from a paracentesis puncture site from a procedure done 2 days prior. Dermabond had initially been applied post-procedure, but it had come loose, and ascitic fluid had been saturating dressing after dressing.

By |2016-11-11T18:43:16-08:00Nov 6, 2012|Gastrointestinal, Tricks of the Trade|

Trick of the Trade: Universal precautions for your iPad

iPadAnatomyscreeniPads are increasingly being used in medical education in a variety of arenas, including the classroom, the bedside, and small group workshops.

I recently taught in a procedures lab with unembalmed cadavers at UCSF’s new anatomy lab (on the 13th floor of the hospital with spectacular views of San Francisco and the Golden Gate Bridge). Everyone was gowned up from head to toe using universal precautions. But wait, what about my iPad? How can I use it to teach at the “bedside” about arthrocentesis?

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By |2018-10-28T21:48:52-07:00Oct 30, 2012|Tricks of the Trade|

Top 10 medical photography tips for a camera phone

A picture is worth a thousand words.

My corollary to this statement is that a poorly framed or blurry image significantly detracts from its impactfulness. Plus, it just looks unprofessional. I have had to either retake or Photoshop-edit several photos submitted for blog posts. There have been many amazing photos which I decided not to use because of image quality.

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By |2016-11-11T18:43:22-08:00Oct 25, 2012|Tricks of the Trade|

Trick of the Trade: Avoiding a straight-needle needlestick injury

StraightNeedleYou are finishing up a successful subclavian line procedure. You insert the straight-needle suture needle through the skin to secure the line. When trying to pull it out, you accidentally poke yourself!

This is actually a common scenario for a needlestick injury. Although many central line kits now have curved suture needles, many still have straight needles. How can you avoid a needlestick?

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By |2019-01-28T22:11:48-08:00Oct 23, 2012|Tricks of the Trade|

Trick of the Trade: Don’t miss the pneumothorax in needle thoracostomy

PTXtensionA patient arrives in PEA arrest and you note that her left chest has no breath sounds or lung sliding on bedside ultrasound. You suspect a tension pneumothorax.

You insert a standard 14g angiocather in the left 2nd intercostal space (ICS). You don’t hear a rush of air. The patient’s clinical condition deteriorates to impending asystole. How sure are you that your angiocatheter actually reached the pleural space?

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By |2017-08-03T00:59:44-07:00Oct 2, 2012|Tricks of the Trade|