@precordialthump I totally forgot about the EKG library! Awesome stuff. Keep up the great work (when do you sleep?!)
258 days ago
@emeducation Perfect, thanks for the suggestions! Turns out one is co-authored by Jeff Tabas. He already gave them all books.
258 days ago
Recommendations for an EKG resource to review bread & butter cases for senior residents? Pre-graduation panic setting in for our residents.
258 days ago
@danipedia Good point. I use the studies to convince the trauma consults NOT to get c-spine imaging on EVERYONE (citing distracting injury)!
263 days ago
@doctorflash Hi there. Just wanted to drop a note to thank you for all the extra traffic you're sending to blog. Much appreciated!!
273 days ago
Trick of the Trade: Temperomandibular (TMJ) dislocation
Posted May 04 2011 12:00am
Mandible, or TMJ, dislocations occur when the patient excessively opens the mouth, such as in a yawn. They are typically bilateral and are difficult to relocate because of masseter and medial pterygoid muscle spasm. You can relocate the condyles back into the TMJ space with gentle but firm intraoral pressure inferiorly and posteriorly. Often it requires some sedation to help relax the muscles of mastication.
Trick of the Trade:
Tire out the muscles of mastication
Thanks to Dr. Sa'ad Lahri (Cape Town, South Africa), I viewed this innovative trick in relocating a TMJ dislocation, posted by the BBC on YouTube. The basic principle is that you slightly over-exaggerate the dislocation to stretch the muscles even more. This was done using a stack of tongue blades. This constant stretch of the muscles for a few minutes will cause them to be relaxed when you remove the tongue blades. This provides a small window of time when you can relocate the mandible.
Has anyone else tried this before? I haven't and can't personally vouch for it, but I'll be trying it on the next opportunity that I have. It'd be nice not to have to sedate the patient unnecessarily.
Poor patient -- this video has gotten over 1.3 million views...
Mandible, or TMJ, dislocations occur when the patient excessively opens the mouth, such as in a yawn. They are typically bilateral and are difficult to relocate because of masseter and medial pterygoid muscle spasm. You can relocate the condyles back into the TMJ space with gentle but firm intraoral pressure inferiorly and posteriorly. Often it requires some sedation to help relax the muscles of mastication.
Trick of the Trade:
Tire out the muscles of mastication
Thanks to Dr. Sa'ad Lahri (Cape Town, South Africa), I viewed this innovative trick in relocating a TMJ dislocation, posted by the BBC on YouTube. The basic principle is that you slightly over-exaggerate the dislocation to stretch the muscles even more. This was done using a stack of tongue blades. This constant stretch of the muscles for a few minutes will cause them to be relaxed when you remove the tongue blades. This provides a small window of time when you can relocate the mandible.
Has anyone else tried this before? I haven't and can't personally vouch for it, but I'll be trying it on the next opportunity that I have. It'd be nice not to have to sedate the patient unnecessarily.
Poor patient -- this video has gotten over 1.3 million views...