Splinting overview video
Check out this video that I made that reviews basic splinting technique. This can be applied to any number of splints.
Quick review of deep dermal sutures
Let's take a look at some basic information on deep dermal sutures. Thanks to Cincinnati Children's Hospital Medical Center resident Drew Saylor. Before moving on to the quick hits let's take a look at an excellent video from Closing the Gap. What are the indications for a deep buried dermal suture? Large wounds that: Are in need of tension [...]
Absorbable versus nonabsorbable sutures
There are many options for wound repair. It is no secret that the face is a common location for lacerations in children. Because children, especially toddlers and preschoolers, are inclined to be scared by intimidating ED physicians many parents inquire about dissolvable sutures, so that their child will not have to be held down twice (once for placement and once [...]
Lumbar Puncture review
As a follow up to today's live demo at our morning lectures here is a lumbar puncture focused video that I recently uploaded to Vimeo.
Briefs: A table for suturing guidelines in children
There are many ways to repair a wound. Please use this table as a reference to help guide selection of materials and a guide for removal. *Consider use of Fast Absorbing Gut (5-0/6-0) on Ear, Eyelid, Eyebrow, Nose, Lip and Face if anticipated difficulty with suture removal (Note: follow up still required for wound evaluation) NOTE: If cartilage involved, strongly [...]
Fracture Fridays: Nailed it!
The Case A kid got his finger caught in a car door. It hurt. The nail is now "all cracked and mangled." Mom is worried that he'll never be a hand model. On exam you see the following: I can see why this freaked mom out You subsequently get an X-Ray: Again with the tiny arrows... and [...]
Briefs: NPO for sedation
This is a follow-up of last week's Briefs on ketamine. How long do you really need to keep a patient NPO prior to moderae/procedural sedation in the ED? Let's look at this issue form a few different angles and explore the evidence since there is such a significant degree of practice variation. Aspiration Risk Certainly the main goal of fasting [...]
Briefs: Special K is not just for breakfast
Simultaneously in your ED you encounter; A 2 year old male with a complex facial laceration A 9 year old female gymnast you decided to do a back handspring, and in the process fractured her right radius and ulna A 4 year old boy with a screw embedded in his left foot You have fentanyl, midazolam and ketamine in [...]
Quick tip: Performing the external auditory canal waxectomy
You gotta see the ear drum in a kid with fever and ear pain. It's that simple. And if you thought the screaming, kicking and thrashing was offering enough of a challenge, you also encounter a Shrek-esque accumulation of cerumen. How should you proceed? Check out the handy table below. Technique Advantages Disadvantages Potential Contraindications Irrigation Easy to do Specialized manual [...]
