• Broselow tape

Paucis Verbis card: Pediatric weight-based reference (5-34 kg)

By |Categories: ALiEM Cards, Pediatrics|

The foundation in any pediatric resuscitation is the length-based estimation of the patient’s lean body weight. Once determined, equipments and medications are sized and dosed, respectively, according to that weight. You can use electronic resources such as PEMSoft (Pediatric Emergency Medicine Software) or the more traditional paper-based Broselow tape. […]

  • BVM placement

Trick of the trade: Face mask ventilation in edentulous patients

By |Categories: Tricks of the Trade|Tags: |

Can you imagine trying to bag-valve-mask ventilating this patient without teeth? Edentulous patients can cause BVM problems because air tends to leak out the sides of the mouth, because the cheeks don’t contact the mask as well. You can do a jaw-thrust and/or place an oropharyngeal airway to help. What else can you do? […]

  • cervical fractures diagram

Paucis Verbis card: C3-C7 spinal fractures

By |Categories: ALiEM Cards, Orthopedic|

This is the second Paucis Verbis card on cervical spine fractures. Part 1 covered C1 and C2 fractures. This card covers the lower cervical spine fractures. These two tables are part of my chapter on “Spine and Spinal Cord Injury” in the textbook Emergency Medicine by Dr. Jim Adams (Northwestern EM Chair). […]

  • cervical fractures diagram

Paucis Verbis card: C1-C2 injuries

By |Categories: ALiEM Cards, Orthopedic|

I’m starting to work on co-authoring the next edition of my chapter on “Spine and Spinal Cord Injury” within the textbook “Emergency Medicine” by Dr. Jim Adams (Northwestern EM Chair). There are some useful tables that I created that I thought you might find helpful. This is the first installment covering C1-C2 fractures. The next PV card will cover the lower cervical fractures. I always forget which are stable and unstable. For instance, the above extension teardrop fracture looks innocuous but is an unstable fracture because the anterior longitudinal ligament is ruptured. […]

  • Ingrown Toenail Lift

Trick of the Trade: Toenail splinting for ingrown toenails

By |Categories: Tricks of the Trade|Tags: |

 It is 4 a.m. You pick up a chart. Toe pain. Thinking this could be an easy injury, you walk over to the patient, only to discover: bilateral ingrown toenails. Your heart sinks. In your head, you are thinking: Lateral nail resection? Nail removal? This could take a while. Is there a less invasive method for treating an ingrown toenail? […]

  • Cardiac Echo ultrasound

Paucis Verbis card: When murmurs need echo evaluation

By |Categories: ALiEM Cards, Cardiovascular|

Have you been in a situation where you are the first to detect a cardiac murmur in a patient? If you are hearing it in a busy, loud Emergency Department, I find that it’s at least a grade III. Should you order an echocardiogram for further outpatient evaluation? It depends on the grade and characteristic of the murmur, in addition to the patient’s symptoms. For instance, all diastolic murmurs require an echo. There is a useful ACC/AHA algorithm which helps you decide. […]

  • Tegaderm Dressing

Trick of the trade: I got ultrasound gel in my eye!

By |Categories: Tricks of the Trade, Ultrasound|

Bedside ultrasonography is increasingly being used in the ED to examine the eye. For instance, it can be used to detect a retinal detachment, vitreous hemorrhage, and high intracranial pressure. The technique involves applying ultrasound gel on the patient’s closed eyelid. A generous amount of gel should be used to minimize the amount of direct pressure applied on the patient’s eye by the ultrasound probe. Sometimes, however, no matter how careful you and the patient are, some gel accidentally contacts the eye itself. […]