Paucis Verbis card: NIH Stroke Scale

Patients present with acute strokes to the Emergency Department. Time is of the essence to obtain a rapid neurologic exam, draw labs, get CT imaging, and consulting a neurologist especially if the patient presents within 3 hours of onset. To help the neurologist determine whether the patient should get thrombolytics, calculating a NIH Stroke Scale score is useful.w

In this installment of the Paucis Verbis (In a Few Words) e-card series, here is the NIHSS scoresheet.

Score 0	No stroke
Score 1-4	Minor stroke
Score 5-15	Moderate stroke
Score 16-20	Moderate-severe stroke
Score 21+	Severe stroke

PV Card: NIH Stroke Scale

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Go to ALiEM (PV) Cards for more resources.

By Michelle Lin, MD|2021-10-19T19:07:03-07:00Feb 26, 2010|ALiEM Cards, Neurology|

Paucis Verbis card: Ankle fractures

$Lauge-Hansen Classification of Ankle fractures$ Ankle 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 Michelle Lin, MD|2021-10-19T19:08:02-07:00Feb 19, 2010|ALiEM Cards, Orthopedic, Radiology|

Paucis Verbis card: Urinary tract infection

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

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 Michelle Lin, MD|2021-10-19T19:10:04-07:00Feb 12, 2010|ALiEM Cards, Genitourinary|

Find 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.

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

Paucis Verbis card: Pediatric blunt head injury

In 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

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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

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 Michelle Lin, MD|2021-10-19T19:12:36-07:00Feb 5, 2010|ALiEM Cards, Pediatrics, Trauma|

Article review: Long axis view for IJ line placement

As bedside ultrasonography is becoming a staple in central line placement (especially of internal jugular lines), emergency physicians now can minimize complications, such as carotid artery puncture and a pneumothorax. Traditionally, the US probe is positioned along the short-axis of the IJ during the procedure (see right).

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By Michelle Lin, MD|2016-11-11T19:01:39-08:00Feb 1, 2010|Ultrasound|

Paucis verbis card: The Red Eye

Here is another installment of the Paucis Verbis (In a Few Words) e-card series on the topic of The Red Eye from EM Clinics of North America, Here are some sample images: