An essential skill of any innovative troubleshooter in the Emergency Department is the ability to recognize when one piece of equipment may be used elsewhere. For instance, what’s your go-to approach when looking for a spare guidewire? Let’s say you are trying to salvage an ultrasound-guided basilic vein IV catheterization.
Here’s where I go for guidewires:
Serotonin syndrome is caused by the excess of serotonin and presents classically as:
Fortunately, there’s a nice algorithm (Hunter’s decision rule) which helps you decide whether it is serotonin syndrome or not. I also include a table, which I adapted from a New England Journal of Medicine review article, which helps you to differentiate it from its mimickers, such as anticholinergic syndrome, neuroleptic malignant syndrome, and malignant hyperthermia.
Adapted from [1, 2]
Go to ALiEM (PV) Cards for more resources.
A video to remind you what clonus looks like:
Thanks to Dr. Steve MacDade (Univ of Florida, Jacksonville EM resident) for the idea!
As a followup to the blog on the Captain Morgan technique for hip dislocations, I’d like to throw out another similar technique that also does NOT involve climbing up on the gurney.
Scalp lacerations are apparently a hot topic these days. This is the third post now on how to apply a bandage to a scalp laceration.
Relocation of a hip joint is often quite a sight to see in the ED. A commonly taught technique is the Allis maneuver (watch the first 45 seconds of the above video from the Medical College of Georgia). It has always seemed a bit precarious to me having someone stand on the patient’s bed.
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Today’s Paucis Verbis card is a little different. This card focuses on helping you give talking points when giving feedback to a learner on shift. This could be a medical student or resident.
Dr. David Thompson (UCSF-San Francisco General Hospital) sent this great card to me and I thought it was too useful NOT to share. It’s handy on shift, which ultimately is the purpose of these Paucis Verbis cards. These are useful especially for senior residents, who are supervising medical students and junior residents.
This card can be used in many ways. For instance:
Go to ALiEM (PV) Cards for more resources.
Scalp lacerations are one of the most common injuries which present to the Emergency Department. Applying a dry bandage over the staples or sutures can be a challenge because the tape just has nothing to adhere to.
We reviewed the use of tubular cotton gauze to create a beanie hat, but what should you do if you can’t find any tubular gauze? Ever since I wrote about the beanie hat trick, people in the ED have been using the tubular gauze more and we’re always out of stock whenever I look for it!