LacerationNeckAgitation5smHow long is this neck laceration?

In the Emergency Department, it is important to be able to accurately estimate the length of wounds, abscesses, and cellulitis. Additionally, billing for wound closure is directly related to the length of the laceration.

The problem for me is that I personally hate carrying too many things in my pocket on a shift. This includes a ruler. Can you imagine stopping the resuscitation and evaluation for the patient above because you want to find a ruler and measure the bleeding neck laceration?

Trick of the trade

Use your “handy” ruler

Measure parts of your hand. You now have a reasonably accurate ruler with you at all times (hopefully). For me, I know that my left hand can only reach a maximum of 20 cm. The width of my left palm is 8 cm. And my pinky DIP is 1 cm wide.


Using these landmarks, I estimated the neck laceration above as 1 palm + 3 pinkies = 8 cm + 3 cm = 11 cm.

Thanks to Sandi Ma, my Visual Aid Project photographer, who consented the patient and captured the top picture.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at Bio:
Michelle Lin, MD