Trick of the Trade: The key to pollution is dilution
Wound care mantra: “The key to pollution is dilution.” High-pressure irrigation best reduces the patient’s risk for a wound infection. Open fractures are unique in the ED in that they require quick, high-volume irrigation before going to the operating room for more definitive wash-out. Often times a 30 mL syringe and 18-gauge angiocatheter is too cumbersome and slow for high-volume, high-pressure irrigation. [+]
Must-know toxicology website for emergency physicians
With recent discussion about the potential closing of California Poison Control Centers due to budget cuts, I suddenly became shockingly aware of how much Emergency Departments depend on these centers for assistance. They are always so knowledgeable and helpful in managing various ingestions and poisonings. [+]
Trick of the Trade: Peritonsillar abscess needle aspiration
How do you drain a peritonsillar abscess? When evaluating a patient with a sore throat and “hot potato voice,” peritonsillar abscess (PTA) is at the top of the differential diagnosis list. As with all abscesses, the definitive treatment involves drainage of pus. This can be done either by incision and drainage or, more commonly, by needle aspiration. [+]
Free videos and podcasts from "All LA Conference"
I recently discovered a little gem of a website, which houses video and podcast recordings of joint conferences by the Los Angeles EM residency programs since 2007. http://AllLAconference.com/ [+]
Director of Growth, Strategic Alliance Initiative, Center [+]
Trick of the Trade: Hair apposition technique (HAT trick)
Scalp lacerations over hair-bearing areas require wound closure, usually with staples. An alternative technique is the Hair Apposition Technique, also known as the HAT trick [1, 2]. This technique provides a more cost-effective, faster, and less painful approach to scalp laceration repair. Imagine the scalp hairs as suture ties already embedded in the skin. [+]
Work in Progress: Visual Aid Project is back on!
My poor camera is finally back from the Canon service shop. With now $211 less in my bank account, my Canon Eos Rebel XTi is back! Apparently SLR cameras don’t do well when bounced off the floor. In my defense, it was small bounce… [+]
Trick of the Trade: Reverse sugar tong splint
Distal radius fractures traditionally require a sugar tong splint to prevent the patient from ranging the wrist and elbow. The sugar tong splint essentially sandwiches the forearm with a splint, folded at the elbow. At this elbow fold, however, the splint often uncomfortably and inconveniently buckles and wrinkles when a wrap is applied. [+]
TGIF: The "caffeine nap"
A common problem that emergency physicians share and struggle over is the circadian “dysrhythmia” of working random morning, afternoon, and night shifts. Shift work is the blessing and curse of our profession. I have yet to figure out the best way to adjust back to the daytime world after night shifts. Do you have any tricks? [+]
What is a journal "impact factor"?
Journals use the numerical "Impact Factor" as an indirect quantitative measure of a journal's importance in the medical field and scientific literature. Thompson Scientific calculates the impact factor scores annually. This score provides journals with bragging rights, especially when it comes to marketing. Be aware that there are ways to manipulate the numbers a little and thus brings the true value of this score into question. How is the impact factor calculated? The impact factor is a calculation of how frequent a journal's articles are cited in a 2-year period. As an example, the 2009 impact factor for a journal [+]
Trick of the Trade: Toxic sock syndrome
The olfactory nerve of an emergency physician is exposed to a broad range of smells in the Emergency Department. I’ve learned that the stinky-feet problem is a commonality amongst ED’s around the world! I call it the “toxic sock syndrome”. There are two remedies which I’ve been told of: Nebulized oil of wintergreen Placing a open canister of coffee grounds next to the feet (I’ve never understood this. I would imagine it would smell like stinky feet in a cafe. Plus, what a waste of coffee!) [+]