Trick of the Trade: Double staple gun

ScalpLacStapleHow do you approach the repair of scalp lacerations in a child? What factors are you considering?

  • Is the wound suspicious for child abuse?
  • Procedural sedation versus local anesthesia of the wound
  • Staples versus hair apposition technique (HAT trick) for wound closure

This trick of the trade pearl addresses the stapling technique for scalp laceration repair. Perhaps the child’s hair is too short for the HAT trick.

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2019-02-19T18:33:04-08:00

Sketchcasting on What Drives Us

Drawing

I recently came across a new means of online teaching and information delivery called sketchcasting. The premise isn’t new. It combines a podcast (someone speaking) with visuals (images). In sketchcasting, the images are instead someone drawing on a virtual whiteboard in real-time to convey information.

I recently found a sketchcast with stop-motion and speed-up effects, which really made the presentation dynamic and super-engaging. This sketchcast by Dan Pink (Author of “Drive: The Surprising Truth About What Motivates Us”) was created by the Royal Society for the Arts, Manufactures and Commerce (RSA).

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2019-01-28T23:39:21-08:00

Paucis Verbis card: Septic Arthritis

Knee PainIn the workup of monoarticular arthritis, the question that emergency physicians constantly struggle over is whether the patient has a nongonococcal septic arthritis. This joint infection alarmingly damages and erodes cartilage within only a few days.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews the JAMA Rational Clinical Examination article which asks “Does this patient have septic arthritis?” Pooled sensitivities and likelihood ratios were calculated. These statistics are always helpful when trying to figure out the patients probability of having a septic joint.

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2019-01-28T23:40:11-08:00

Article Review: Conceptual Model on Learner Reflection

Reflection Reflective journals and electronic portfolios are becoming increasingly popular within undergraduate and graduate medical education. I’m starting to be a believer in this learning approach, which teaches learners about professional development and life-long learning principles. Academic Medicine just published a great qualitative paper proposing a conceptual model for reflection.

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2019-02-19T18:43:35-08:00

SAEM 2010 (June 2-6, 2010)

SAEMlogo

The Society of Academic Emergency Medicine’s (SAEM) annual meeting starts this week. Instead of my regular posts, I thought I’d try using the Twitter widget to post real-time, first-hand accounts and photos from the conference.

SAEM is a very dynamic and productive conference, where academicians in Emergency Medicine meet to pow-wow about the future of our specialty.

2016-11-11T19:00:44-08:00

PV Card: Dermatomal and Myotomal Maps

Forget
There are some things in life which I just can’t memorize and dermatomal/myotomal maps are one of them. Weird cases of peripheral neurologic symptoms have presented to the ED in the setting of trauma and no trauma. So purely for selfish reasons, I’m making my own map to have on file.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews Sensory and Motor Function Testing by Levels.

Testing Sensory Function by Level

dermatomes

Testing Motor Function by Level

  • C1-C4 Spontaneous breathing
  • C5 Shoulder abduction (deltoid)
  • C6 Wrist extension (carpi radialis longus and brevis)
  • C7 Elbow extension (triceps)
  • C8 Finger flexion (flexor digitorum superficialis/profundis, lumbricals)
  • T1 Finger adduction & abduction (dorsal/palmar interossei, abductor digiti quinti)
  • T1-T12 Intercostal and abdominal muscles
  • T12-L3 Hip flexion (iliopsoas)
  • L2-L4 Hip flexion, knee extension (quadriceps), hip adduction
  • L4 Ankle dorsiflexion and inversion (anterior tibialis)
  • L5 Big toe extension (ext hallucis longus), heel walk (ext digitorum), hip abduction (gluteus medius)
  • S1 Ankle plantarflexion and eversion (peroneus longus), toe walk (peroneus brevis), hip extension (gluteus maximus)
  • S2-S4 Rectal sphincter tone

Go to the ALiEM Cards site for more resources.
2019-01-28T23:40:22-08:00