Trick of the Trade: Conveying risk for postexposure prophylaxis

NeedlesA health care worker hurried in to the ED after being poked with a needle.

‘It was an old 18G needle with dried blood’, she said. Her puncture had drawn blood. You discussed the very low risk of contacting HIV and the side effects of postexposure prophylaxis (PEP). She asked, ‘What does very low risk mean?’

Is there another way to covery risk for patients?


By |2019-02-19T18:21:27-08:00Feb 9, 2011|Infectious Disease, Tricks of the Trade|

Tricks of the Trade: Nursemaid elbow reduction

We’ve all seen it before while working in the ED. A parent brings in their child because they pulled on their arm, and now the child is not using it. Parents are thoroughly convinced that the child’s arm is either broken or dislocated. We all recognize this as radial head subluxation or “nursemaid’s elbow” and immediately attempt to reduce it. The provider takes the injured arm, supinates at the wrist and flexes at the elbow. Does the child scream? What if nothing happens?

Is there an alternative technique to reducing a nursemaid elbow?


By |2016-11-15T22:02:31-08:00Jan 19, 2011|Orthopedic, Pediatrics, Tricks of the Trade|

Tricks of the Trade: Finding the wandering contact lens

ContactLensContact lens wearers are familiar with the phenomenon of the wandering lens. What should you do if you can’t visualize the contact lens of a patient, who presents with a “lost contact lens” in the eye? You have the patient look in all directions and you evert the eyelid, but still no contact lens can be found. The patient swears that it’s there because of the painful foreign-body sensation.


By |2019-02-19T18:08:23-08:00Jan 5, 2011|Ophthalmology, Tricks of the Trade|
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