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Archive for October, 2006

Medical Mac Apps

OS X
Yep: organizes all those PDF journal articles.
Sente: PubMed interface – remembers your searches.
Write Room: Distraction Free Writing.
MacStats: a website with…stats…for the…mac.

Palm
PEPID: Emergency Medicine Text and Pharmacopeiea for your Palm.
Missing Sync: Fix those Palm/OS X sync problems and more…

IBEX @ HOME
Parallels: Virtualization – have WinXP in a Window.
Boot Camp: Boot into WinXP.

Written by phil

October 25th, 2006 at 12:54 am

Q Tips

· Gloves do not replace the need for hand washing! Please be sure to wash your hands (or use Purell) before and after every patient encounter. The Infection Control department is collecting observational data as to our practices in the ED for the hospital. Please do your best to comply.

· There are new ACIP guidelines which recommend the usage of Tdap rather than Td for patients requiring tetanus prophylaxis. There has been an increased incidence of pertussis in recent years which has prompted the change in protocol. The pharmacy is now stocking Tdap. Please adjust your orders to reflect these new recommendations.

· In reviewing ED mortalities, we have found intermittent usage of D50 in the resuscitation of cardiac arrest patients. Per ACLS guidelines, there is no role for D50 in these patients.

· While resuscitating cardiac arrest patients, please remember that the new ACLS guidelines stress the importance of continuous CPR with as few & limited interruptions as possible. We are re-stressing this as there was an instance where CPR was halted for an EKG to be done during a code for VF.

· If there is any concern or suspicion of foul play in an ED death, in addition to calling the ME, please call social work to evaluate the case.

Written by phil

October 12th, 2006 at 1:45 am

Posted in Pearls

Ophthal Lecture

References:

Van Herick Angle Estimation Method Thanks Chad.

Lateral Canthotomy Video

Management of Ocular Emergencies and Urgent Eye Problems. American Family Physician 2/1/96.

The Red Eye. Davey C, British Journal of Hospital Medicine 1996 Feb 7-20;55(3):89-94.

An investigation into the mechanism of orbital blowout fractures. Waterhouse N, British Journal of Plastic Surgery 1999 Dec;52(8):607-12.

Emergency diagnosis and management of physical abuse and neglect of children. Dorfman DH, Paradise JE. Current Opinions in Pediatrics 1995 Jun;7(3):297-301.

Are retinal hemorrhages found after resuscitation attempts? A study of the eyes of 169 children. Gilliland MG, Luckenbach MW. American Journal of Forensic Medical Pathology 1993 Sep;14(3):187-92.

Retinal Findings after head trauma in infants and young children. Buys YM et al. Opthalmology 1992 Nov;99(11):1718-23.

Prophylaxis of opthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis. Chen J, Pediatr Infect Dis J 1992;11:1026-30.

Eye emergencies: Acute managemenet in the pediatric ambulatory care setting. Levin A. Pediatric Emergency Care 1991 Dec;7(6):367-77.

Ocular Emergencies. Emergency Medicine: A Comprehensive Study Guide. Tintinalli, J et. al. 5th Edition

Handbook of Ocular Disease Management. Review of Optometry Online. http://www.revoptom.com/handbook

American Association for Pediatric Opthalmology and Strabismus http://med-aapos.bu.edu

Digital Journal of Opthalmology. http://www.djo.harvard.edu

Written by phil

October 10th, 2006 at 4:31 pm

Posted in Lecture Notes

Ultrasound Documentation

Bret’s Recommendation is to simply make IBEX Macros of the following:

1. ***ULTRASOUND GUIDANCE FOR VASCULAR ACCESS*** Ultrasound was used to assess potential access sites and guide needle placement for procedure in real time. Electronic images were saved.

[Use this for central venous access and peripheral venous access]

2. ***ULTRASOUND GUIDANCE FOR NEEDLE PLACEMENT*** Ultrasound was used to assess target anatomy and guide needle placement for procedure. Electronic images were saved.

[Use this for: abscess I&D, arthrocentesis, bladder aspiration, lumbar puncture, foreign body removal, or any other procedure]

3. ***ULTRASOUND GUIDANCE FOR PERICARDIOCENTESIS*** Ultrasound was used to assess target anatomy and guide needle placement for procedure. Electronic images were saved.

Written by phil

October 8th, 2006 at 7:26 pm

Posted in ED Guidelines