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Trick of the Trade: DIY Finger Traps

Fx_RadiusUlnaPadding copyDistal radius fractures are among the most commonly encountered fractures in the emergency department (ED). They have been reported to account for around 25% of pediatric fractures and up to 18% of fractures in the elderly.1 Reducing minimally displaced distal radius fractures is a procedure that can be greatly facilitated by the presence of finger traps, which help hold traction while you reduce the fracture.2 Often While working in small 5-bed, free-standing emergency department (ED), I found myself needing to perform this vital procedure and finger traps were unavailable.

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By |2024-02-22T14:29:56-08:00Jul 1, 2015|Orthopedic, Tricks of the Trade|
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Diagnose on Sight: Lower extremity numbness and pain

GSW leg XRCase: An 18 year old male presents after a single gunshot wound to his left calf. He complains of pressure-like pain near the wound and sensory numbness below his left knee. On examination, the left leg is tense. He has no dorsalis pedis pulse. Based on the history, exam, and findings in the image, which of the following is true regarding this diagnosis?

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By |2016-12-22T18:49:50-08:00Mar 9, 2015|Diagnose on Sight, Orthopedic, Trauma|
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Trick of the Trade: Knee Arthrocentesis

arthrocentesis2A patient comes into the ED and you suspect septic arthritis to the knee. As you consent the patient for arthrocentesis, you can tell s/he has reservations about a needle being inserted into their knee and left in place while you aspirate. You also think in the back of your mind how tricky it is to sometimes change syringes while keeping the needle in the correct location. Is there another way of tapping the knee without a needle?

 

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By |2019-02-19T18:42:04-08:00Jan 8, 2015|Expert Peer Reviewed (Clinical), Orthopedic, Pre Publication Critique (Clinical), Tricks of the Trade|
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High risk back pain: Spinal Epidural Abscess

epidural-abscess-282x300-modifiedSpinal epidural abscess (SEA) is a rare but potentially catastrophic cause of back pain. Classically these patients are described as having back pain, fever, and clear neurologic deficits. In reality, patients often present with less obvious symptoms which often leads to a delay in diagnosis. Missed cases of SEA are a source of significant risk to both the patient and the provider. To improve outcomes and minimize risk, providers must identify and promptly evaluate patients who are at increased risk of developing a SEA.

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By |2016-11-12T09:28:24-08:00Sep 25, 2014|Infectious Disease, Orthopedic|
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Sternoclavicular Joint Dislocations: Diagnosis and Treatment

Image obtained from healio.com

A 16-year-old football player presents to the emergency department directly from a game. He was tackled, falling onto his right shoulder. The patient is complaining of right-sided chest pain. On exam, there is tenderness over the right sternoclavicular joint (SCJ) with a prominent medial clavicle. Range of motion is limited in the right arm. What diagnostic studies need to be performed? What treatment is warranted in the emergency department?

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By |2019-02-06T20:11:22-08:00Jul 21, 2014|Orthopedic|
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