Paucis Verbis card: Ankle fractures

Lauge-Hansen Classification of Ankle fracturesAnkle fractures are a common injury diagnosed in the Emergency Department. Being able to speak Ortho-ese (i.e. the language of orthopedists) is invaluable in consulting the orthopedist over the phone. One ankle fracture classification system that our orthopedists like to use is the Lauge-Hansen system.

PV Card: Lauge-Hansen Classification of Ankle Fractures


Go to ALiEM (PV) Cards for more resources.

By |2021-10-19T19:08:02-07:00Feb 19, 2010|ALiEM Cards, Orthopedic, Radiology|

iPhone uses in the Emergency Department

EMnewssm
Occasionally, I get a rare – “Hey congrats on the article!” comment from residents or students. It’s usually in reference to my ACEP News column that comes out every 3 months on Tricks of the Trade. However, I got about 3 shout-outs in the past 2 days. How odd.

Then I saw one of our office staff who was reading EM News. “Hey cool!” she said. Totally confused, I realized that I was quoted on the front page of this week’s publication about iPhone applications in EM. Many months ago, I had done a brief telephone interview with the writer.

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By |2016-11-11T19:01:35-08:00Feb 18, 2010|Social Media & Tech, Tricks of the Trade|

Trick of the Trade: My new penlight

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On any given day in the ED, I use my super-bright penlight 2-5 times a day. It is amazing what things I’ve almost missed without a bright LED flashlight.

  • Subtle HSV-2 labial ulcerations in a female patient with dysuria
  • Additional scalp lacerations hidden in the hair
  • Tonsillar exudates in a patient with strep pharyngitis
  • Unequal pupillary responses in a brightly lit trauma room in a head-injured patient

I wanted to revisit a prior post about the importance of changing your Tungsten penlight to a LED light.

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By |2019-01-28T23:47:58-08:00Feb 17, 2010|Tricks of the Trade|

Paucis Verbis card: Urinary tract infection

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In this installment of the Paucis Verbis (In a Few Words) e-card series, the topic is Urinary Tract Infection. UTIs are one of the most common infections that we treat in the Emergency Department.

PV Card: Urinary Tract Infection


Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

  1. Norris D, Young J. Urinary tract infections: diagnosis and management in the emergency department. Emerg Med Clin North Am. 2008;26(2):413-30, ix. [PubMed]
By |2021-10-19T19:10:04-07:00Feb 12, 2010|ALiEM Cards, Genitourinary|

Beware the hidden tibia plateau fracture

TibialPlateau2vsmFind the fracture in this patient with blunt knee trauma.

As a general rule, plain films are insensitive in ruling out orthopedic injuries. One particularly tricky area is the knee. This 2-view knee series above is normal.

Did you know that the sensitivity of picking up knee fractures is as low as 79% with a 2-view series and 85% with a 4-view series? With the advent of CT imaging, more and more subtle fractures are being found.

By |2016-11-11T19:01:36-08:00Feb 11, 2010|Orthopedic, Radiology|

Paucis Verbis card: Pediatric blunt head injury

Epidural hemorrhage blunt head traumaIn this installment of the Paucis Verbis (In a Few Words) e-card series, the topic is Pediatric Blunt Head Trauma.

This a particularly relevant topic given the recent press and discussions about CT irradiation and the cancer risk especially in pediatric patients. It’s also relevant since Dr. Nate Kuppermann (UC Davis) just gave Grand Rounds at our UCSF-SFGH EM residency program. He first-authored a landmark 2009 Lancet article on minor head injury in kids.

PV Card: Pediatric Blunt Head Trauma


Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

 

Update June 27, 2017

We collaborated with PECARN and CanadiEM to create visual PECARN’s official decision tool.

Reference

  1. Kuppermann N, Holmes J, Dayan P, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170. [PubMed]
By |2021-10-19T19:12:36-07:00Feb 5, 2010|ALiEM Cards, Pediatrics, Trauma|
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