Using the slit lamp can be a challenge to learn, especially if you haven’t seen pathology before. In checking for anterior uveitis (i.e. iritis), you need to look for “cell and flare”. In theory, you know that you are looking for inflammatory cells and “flare”, which resembles a light beam being filtered through smoke.
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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 |
Go to ALiEM (PV) Cards for more resources.
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.
Go to ALiEM (PV) Cards for more resources.
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.
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
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.
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.
Adapted from [1]
Go to ALiEM (PV) Cards for more resources.
We collaborated with PECARN and CanadiEM to create visual PECARN’s official decision tool.
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).