A moderately intoxicated patient presents with a facial or scalp laceration. S/he adamantly refuses to have it repaired in the ED, because of the disbelief of that there is indeed a laceration. You want to show the patient, using a mirror, but you don’t have one.
A patient presents without a family member or friend with a possible new facial droop. The patient hasn’t noticed it, but you want to ask if his/her face appears differently. Alas– no mirror.
Tricks of the Trade
1. Take a picture. Use your cell phone or iPhone to take a picture of the patient. You can show the patient his/her laceration. Or you can show the patient how his/her face currently looks. I did this when a Neurology resident was trying to ask if a patient’s face had a subtle facial droop, which accompanied her arm and leg weakness. The resident had spent 5 minutes trying to find a small compact mirror and was shocked at how easy the solution was.
2. Use a photo ID: For asymmetric facial weakness, you can also ask to see the patient’s Driver’s license or any photo ID card. This can help you evaluate if the patient has a new deficit.