I just wanted to revisit the Trick of using bedside ultrasonography to diagnose retinal detachments. Be sure to use plenty of ultrasound gel and use the linear tranducer.
This is the second Paucis Verbis card on cervical spine fractures. Part 1 covered C1 and C2 fractures. This card covers the lower cervical spine fractures. These two tables are part of my chapter on “Spine and Spinal Cord Injury” in the textbook Emergency Medicine by Dr. Jim Adams (Northwestern EM Chair).
Go to ALiEM (PV) Cards for more resources.
Many times, patients who we deem as “noncompliant” with medications may actually be financially unable to afford medications that we prescribe them. Thanks to Amy Kinard, I just learned about this great new website where you can find pharmacies with amazing discounts for common medications.
I’m starting to work on co-authoring the next edition of my chapter on “Spine and Spinal Cord Injury” within the textbook “Emergency Medicine” by Dr. Jim Adams (Northwestern EM Chair). There are some useful tables that I created that I thought you might find helpful. This is the first installment covering C1-C2 fractures. The next PV card will cover the lower cervical fractures.
I always forget which are stable and unstable. For instance, the above extension teardrop fracture looks innocuous but is an unstable fracture because the anterior longitudinal ligament is ruptured.
Go to ALiEM (PV) Cards for more resources.
Your next ED chart: Finger injury
The finger needs to be anesthetized.
Patient: “I have had this freezing before. The needles really hurt! Is there anything else less painful? “
It is 4 a.m. You pick up a chart. Toe pain.
Thinking this could be an easy injury, you walk over to the patient, only to discover: bilateral ingrown toenails. Your heart sinks. In your head, you are thinking: Lateral nail resection? Nail removal? This could take a while.
Is there a less invasive method for treating an ingrown toenail?
Have you been in a situation where you are the first to detect a cardiac murmur in a patient? If you are hearing it in a busy, loud Emergency Department, I find that it’s at least a grade III.
Should you order an echocardiogram for further outpatient evaluation? It depends on the grade and characteristic of the murmur, in addition to the patient’s symptoms. For instance, all diastolic murmurs require an echo. There is a useful ACC/AHA algorithm which helps you decide.
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
Thanks to Amy Kinard, an Emergency RN and aspiring Family Nurse Practitioner, for drafting this useful Paucis Verbis card for me during her studies. Keep the great ideas coming, everyone!