• 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). PV Card: C3-C7 Fractures and Injuries  Go to ALiEM (PV) Cards for more resources.

  • Generics iphone

Trick of the trade: Discounted medications at pharmacies

By |Categories: Tox & Medications, Tricks of the Trade|

Many times, patients who we deem as “noncompliant” with medications may actually be financially unable to afford medications that we prescribe them. Thanks to Amy Kinard, I just learned about this great new website where you can find pharmacies with amazing discounts for common medications. [+]

Shuhan He, MD
  • 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. PV Card: C1 and C2 Fractures and Injuries [+]

  • 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. PV Card: When Murmurs Need Echocardiography Evaluation Adapted from [1] Go to ALiEM (PV) Cards for more resources. Thanks [+]

  • 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. [+]

  • Meth Pipe

Trick of the Trade: Burned fingertips as a clinical clue

By |Categories: Tox & Medications, Tricks of the Trade|

A patient presents to your Emergency Department with altered mental status and somnolence. You don’t smell alcohol on breath and you don’t see needle track marks. What clinical clue points you towards cocaine or methamphetamine ingestion? [+]

Shuhan He, MD

Shuhan He, MD

ALiEM Senior [+]
  • Pertussis Organism

Paucis Verbis card: Pertussis

By |Categories: ALiEM Cards, Infectious Disease, Pulmonary|

Is your Emergency Department administering Tdap immunization boosters instead of dT boosters? Patients with wounds are getting updated not only for tetanus and diphtheria, but also now for pertussis. Apparently there has been sharp rise in the national incidence of pertussis (Bordetella pertussis shown in image) in 2010. The infection has been documented in both infants (underimmunized less than 3 months old) and adolescents/adults (loss of immunity after 10 years). In fact, the CDC has issued an epidemic warning in California. How do you diagnose pertussis ? What are the classic symptoms? Better yet, how do you rule-it out clinically? You won't like [+]

Shuhan He, MD

Shuhan He, MD

ALiEM Senior Systems Engineer;
Director of Growth, Strategic Alliance Initiative, Center for Innovation and Digital Health
Massachusetts General Hospital;
Chief Scientific Officer, Conductscience.com
Shuhan He, MD