V-shaped lacerations can be challenging to close.They always leave an awkward, flimsy flap that feels like it should either be stretched too tightly or cut off leaving a gaping, unwieldy chunk of skin missing. Here is a slick way to close a V-shaped laceration that gives the flap its best chance to survive.
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Is the probe backwards?
Learners get confused sometimes about which direction the probe is facing. Let’s look at how to know if you have it right or not.
Continue readingX-rays or Ultrasounds for fractures?
Bones are very echogenic, which makes their ultrasound appearance a bright white line that is often easy to see – particularly in the case of superficial long bones. That’s what makes ultrasound a great way to find fractures. Let’s look at some examples.
Continue readingBladder Ultrasound: part 3
In part 3 of our discussion about the uses of bladder ultrasound in the emergency department, we consider the case of a 70 year-old man with urinary retention in whom we were unable to place a urinary catheter.
Continue readingUltrasound Guided Needle Placement
I spent some time this week with the interns shoring up their technique for using ultrasound in vascular access. Specifically, I’m referring to an out-of-plane approach – which I recommend in most cases as it lets you see the needle in relation to any large arteries or nerves that may be around.
I think if I had one point to reinforce, it would be the fact that this a dynamic process for BOTH HANDS.
Continue readingStitches
Here is a video about some of the common mistakes we see learners make. It’s not “how to tie a knot,” but rather some of the other steps in the process. It’s not exciting. It’s a little too long. I get it, but I bet there is something in it that you didn’t know you didn’t know.
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Searcy EM 