Tricks of the trade: Chemical sedation options

 DilatedPupilsmYou walk into a room where a patient is screaming and thrashing about in his/her gurney from some stimulant abuse. PCP, cocaine, methamphetamine… or all of the above.

When the number of people (police officers, security guards, nurses) is greater than the patient’s pupil size, you KNOW that you’ll need some chemical sedation.

What intramuscular sedation regimen do you use?

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By |2016-11-11T19:01:31-08:00Mar 17, 2010|Tricks of the Trade|

Trick of the trade: Irrigation scalp wound photos

I mentioned from an earlier post about building a “head basin” for collecting irrigation fluid prior to wound closure. This basin prevents a deluge of fluid from soaking the gurney sheets and patient.

I finally managed to capture this trick in action, while a student was irrigating an eyebrow laceration.

Pearl

When cutting out a semi-circular or rectangular hole in the basin, be sure that there remains a 2-4 inch lip at the bottom to ensure that fluid can collect in the basin.

By |2019-02-19T18:53:55-08:00Mar 3, 2010|Tricks of the Trade|

iPhone uses in the Emergency Department

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Occasionally, I get a rare – “Hey congrats on the article!” comment from residents or students. It’s usually in reference to my ACEP News column that comes out every 3 months on Tricks of the Trade. However, I got about 3 shout-outs in the past 2 days. How odd.

Then I saw one of our office staff who was reading EM News. “Hey cool!” she said. Totally confused, I realized that I was quoted on the front page of this week’s publication about iPhone applications in EM. Many months ago, I had done a brief telephone interview with the writer.

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By |2016-11-11T19:01:35-08:00Feb 18, 2010|Social Media & Tech, Tricks of the Trade|

Trick of the Trade: My new penlight

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On any given day in the ED, I use my super-bright penlight 2-5 times a day. It is amazing what things I’ve almost missed without a bright LED flashlight.

  • Subtle HSV-2 labial ulcerations in a female patient with dysuria
  • Additional scalp lacerations hidden in the hair
  • Tonsillar exudates in a patient with strep pharyngitis
  • Unequal pupillary responses in a brightly lit trauma room in a head-injured patient

I wanted to revisit a prior post about the importance of changing your Tungsten penlight to a LED light.

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By |2019-01-28T23:47:58-08:00Feb 17, 2010|Tricks of the Trade|
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