Tactical Medicine News Blog

ALiEM Cards, procedure
Paucis Verbis card: Suture Materials
Suturing is a common procedure performed in the ED, but we too often forget about the nuances of different suture materials. We get set in our practice patterns. This changed...
Michelle Lin, MD | January 7, 2011
procedure, Tricks of the Trade
Trick of the Trade: Hemostasis of bleeding finger laceration using a glove
Lacerations of the finger can bleed quite profusely because of digital vascularity. This obscures the provider’s ability to perform a careful exam and can make suturing quite difficult. Simple direct...
Michelle Lin, MD | November 24, 2010
procedure, Tricks of the Trade
Trick of the Trade: Toe paronychia splinting
Ingrown toenails, or paronychias, are usually exquisitely painful and a bit gnarly when they present to you in the Emergency Department. Dr. Stella Yiu described toenail splinting techniques using steristrips...
Michelle Lin, MD | November 17, 2010
procedure, Tricks of the Trade, Ultrasound
Trick of the Trade: Ultrasound-guided supraclavicular central line
Emergency physicians are procedural experts in central venous access. The subclavian vein is the best site for such access, because it has been shown to have the lowest rate of...
Michelle Lin, MD | November 10, 2010
Orthopedic, procedure, Tricks of the Trade
Trick of the Trade: Legg Maneuever for shoulder dislocation
There are many ways to relocate a shoulder dislocation. Most of these ways require procedural sedation. What if the risks of procedural sedation outweigh the risks? What alternative maneuver can...
Michelle Lin, MD | November 3, 2010
procedure, Tricks of the Trade
Trick of the trade: Face mask ventilation in edentulous patients
Can you imagine trying to bag-valve-mask ventilating this patient without teeth? Edentulous patients can cause BVM problems because air tends to leak out the sides of the mouth, because the...
Michelle Lin, MD | October 20, 2010
procedure, Tricks of the Trade
Trick of the trade: Single digital block
Your next ED chart: Finger injury The finger needs to be anesthetized. Patient: “I have had this freezing before. The needles really hurt! Is there anything else less painful? “...
Stella Yiu, MD | September 29, 2010
procedure, Tricks of the Trade
Trick of the Trade: Toenail splinting for ingrown toenails
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...
Stella Yiu, MD | September 22, 2010
procedure, Tricks of the Trade
Trick of the Trade: Modified HAT trick revisited
I finally tried the Modified HAT (Hair Apposition Technique) trick for the closure of scalp lacerations. I have used the traditional HAT trick multiple times but not the modified technique....
Michelle Lin, MD | August 18, 2010
ALiEM Cards, procedure, Tox & Medications
Paucis Verbis card: Rapid Sequence Intubation
The key to success in performing procedures is preparation. This is especially true for endotracheal intubations in the Emergency Department where things are chaotic. Strategic planning and anticipation of obstacles...
Demian Szyld, MD EdM | July 16, 2010
ALiEM Cards, Gastrointestinal, procedure
Paucis Verbis card: Ascites assessment with paracentesis
A paracentesis procedure is often performed in the Emergency Department to rule a patient out for spontaneous bacterial peritonitis (SBP). Do you check coagulation studies before performing the procedure? How...
Michelle Lin, MD | June 25, 2010
procedure, Tricks of the Trade
Trick of the Trade: Double staple gun
How 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...
Michelle Lin, MD | June 16, 2010
procedure, Tricks of the Trade
Trick of the Trade: Finding the femoral vein by V-technique
I rarely access the femoral vein for central venous catheterization… except in medical or trauma resuscitations. Oftentimes in these resuscitations, there are too many people near the IJ or subclavian...
Michelle Lin, MD | June 9, 2010

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Tactical Medicine News Blog