Trick of the Trade: Topical anesthetic cream for cutaneous abscess drainage in children

Abscess drainage can be painful and time consuming in the ED. Can this article help? ¹

Trick of the Trade

Apply a topical anesthetic cream on skin abscesses prior to incision and drainage (I and D).

In this press-released article in American Journal of Emergency Medicine, the authors found that application of a topical 4% lidocaine cream (LMX 4) was associated with spontaneous cutaneous abscess drainage in children.

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By Stella Yiu, MD|2019-07-10T21:29:20-07:00Mar 16, 2011|Infectious Disease, Pediatrics, Tricks of the Trade|

Trick of the Trade: Heat it up!

What is it about heat that makes everything feel better? Fireplace, hot tub, heat packs, electric blankets, and hot chocolate have got to be the best inventions EVER.

How can we apply this in Medicine?

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By Michelle Lin, MD|2026-06-16T16:03:14-07:00Mar 9, 2011|Tricks of the Trade|

Trick of the Trade: Website resource on HIV medications

At our department’s first annual UCSF High Risk Hawaii Conference 2 weeks ago, Dr. Rachel Chin taught about complications from all of the HIV drugs on the market now. It’s a virtual alphabet soup: EFV, TDF, FTC, oh my. How do you keep track of them all?

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By Michelle Lin, MD|2019-01-28T23:04:30-08:00Mar 2, 2011|Infectious Disease, Social Media & Tech, Tricks of the Trade|

Trick of the Trade: Serial lactate measurements in sepsis?

Does your Emergency Department have computerized spectrophotometric catheters to measure continuous central venous oxygen saturation (ScvO2) in early goal directed therapy (EGDT) for severe sepsis? That’s what was used in the original Rivers’ EGDT study.

I’ve never even seen one before.

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By Michelle Lin, MD|2019-01-28T23:05:12-08:00Feb 16, 2011|Infectious Disease, Tricks of the Trade|

Trick of the Trade: Conveying risk for postexposure prophylaxis

A 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?

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

Trick of the Trade: Getting an EKG on Chewbacca

Patients with a hairy chest may require little patches of hair to be shaved when applying EKG leads. This allows the leads to stick firmly to the chest. Loose leads will result in either an artifactual signal or no signal at all on the EKG machine.

How can you obtain an EKG without shaving little patches on the patient’s chest?

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By Michelle Lin, MD|2026-06-16T16:03:23-07:00Feb 2, 2011|ECG, 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?

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