Conference Notes 8/21

PEM: Orthopedic injuries and NAT- Dr. Warnick

  1. 4 types of child abuse: physical, sexual, emotional, neglect
  2. Consider developmental milestones: start to roll at 4 months, crawl at 9 months, taking steps at 12 months
  3. TEN4FACES: bruises on torso, ears, neck, angle of jaw, cheeks, eyelids, subconj hemorrhage, frenulum tear; bruises on 4 months or younger; patterned bruising
  4. Workup: trauma labs, skeletal survey (under age of 2), CT Head
    • UA > 50 RBC –> CT abd
    • ALT 3x upper limit –> CT abd
    • if low hgb –> look at context
  5. Bucket handle fracture/corner fracture = concern for abuse
  6. Posterior rib fractures
  7. Spiral fracture vs toddler’s fracture
  8. Social work, Law Enforcement, CPS report, Transfer to pediatric center

Hand injuries- Dr. Shaw

  1. Perfusion: pulses, cap refill, most distal part of hand
  2. Sensation: ulnar, median, radial, palmar/volar vs dorsal
  3. Motor: “rock, paper, scissors, ok”; FDS vs FDP
  4. Phalanx dislocation: frequently have ligamentous disruption, reduction with traction, splint with alumafoam to MCP
  5. Nail avulsion: inspect for underlying laceration, repair as needed, suture/dermabond nail back in place
  6. Fingertip avulsion injury: finger tourniquets
  7. Subungal hematoma: assox with tuft fracture, trephination, abx if open fracture
  8. Boxer’s fracture/metacarpal fracture with fight bite: closed reduction with 20-20-40 rule, hematoma block, ulnar/radial gutter splint
  9. Scaphoid fracture: assess snuffbox, prone to malunion, thumb spica, follow up outpatient
  10. Lunate dislocation: require emergent hand eval
  11. Paronychia: I&D, abx if inflammation or abscess
  12. Herpetic whitlow: topical acyclovir
  13. Sporotrichosis: itraconazole 4-6 months
  14. Felon: I&D lateral margin, bactrim
  15. Flexor tenosynovitis: kanavel signs- sausage digit, pain with percussion of flexor sheath, held in passive flexion, pain with passive extension; hand consult, IV abx, OR
  16. Water bath for ultrasound

680 thoughts on “Conference Notes 8/21

  1. Hi would you mind letting me know which webhost you’re working with? I’ve loaded your blog in 3 different browsers and I must say this blog loads a lot faster then most. Can you recommend a good web hosting provider at a fair price? Thanks a lot, I appreciate it!

  2. What i do not understood is if truth be told how you’re not actually much more well-favored than you may be now. You are very intelligent. You understand thus significantly in terms of this topic, made me in my view imagine it from numerous varied angles. Its like men and women are not fascinated until it is something to do with Girl gaga! Your individual stuffs nice. Always care for it up!

  3. Individuals who take workout supplements should not ignore the importance of a balanced diet and a consistent exercise routine.
    A personal coach or fitness app could provide them with the assist and motivation they should reach
    their fitness targets. Black pepper extract permits for greater bioavailability
    to extend the overall efficiency of the person compounds.
    Customers can take four capsules per day or earlier than going to the fitness center and experience renewed power, vigor,
    and vitality.
    It is secure for most individuals to eat as much as 2 grams (g) per
    kilogram of body weight per day. If a company is
    promoting the product as a dietary supplement, it doesn’t need to conduct checks to find out
    whether or not its products actually work. Nevertheless, if you have
    HIV, you may be more more doubtless to expertise sure symptoms or side effects associated to HIV
    infection or HIV medicines. Examples of symptoms or unwanted effects embody rash, diarrhea, fatigue, and melancholy.
    In addition, if you’re pregnant and have HIV, you
    may be extra likely to experience preterm supply and low toddler birth weight.

    Moreover, this authorized steroid helps to minimize back water retention and burn excess fats, permitting you to realize a more outlined physique.
    Are you on the lookout for the strongest legal alternatives to illegal anabolic steroids that include numerous side effects?
    Well, you do not have to sacrifice your well being for muscle growth anymore.
    Yes, it is illegal to be on anabolic steroids and not
    using a medical prescription. Both the possession and sale of anabolic steroids are
    drug offenses that can result in fines or jail time. The greatest legal steroids are much less riskier merchandise to meet your athletic objectives.

    McKinsey’s 2024 report identifies longevity, personalized vitamin, and
    preventive health as key areas of consumer-driven growth.
    There are important commercial opportunities in product improvement, personalised well being technologies,
    diagnostics, and beyond. Some examples of anabolic steroids (Karri) are Deca-Durabolin, Winstrol,
    and Clenbuterol. GenFX is tailored to stimulate the body’s
    production of HGH, which plays an important function in cell repair, metabolism, and sustaining a
    youthful feeling.
    Laxogenin, however, is a brassinosteroid, that means it boosts bulking
    whereas slowing muscle breakdown. For individuals with
    recognized (or undiagnosed) diseases, taking certain dietary supplements may be
    harmful. If you could have any allergy symptoms to specific ingredients
    or any serious medical situations, totally verify the label for potential purple flags.

    Every ingredient has its own set of advantages and potential
    unwanted effects, so understanding them offers
    you an concept of how the product can potentially work.
    With the proper complement stack, disciplined coaching,
    and correct diet, you can expertise dramatic transformations—without injections, prescriptions, or authorized points.
    Keep In Mind, consistency is essential, and
    while dietary supplements can aid in your journey,
    they can’t exchange a balanced food plan and common exercise.

    Its fundamental impact is to suppress the immune system’s pure inflammatory response.
    Some customers discover half a dose (one capsule each other day)
    helpful for managing light stress or daily pressure.
    Reviewers constantly praise this product for helping them sleep through the night, especially
    those who are most likely to get up in the
    midst of sleep cycles. It’s also used by some professionals for mid-day anxiety regulation,
    with no grogginess. BioEmblem has constructed a reputation for transparency and ingredient integrity — and
    their valerian root formulation isn’t any different.
    You’re getting a thousand mg per serving, extracted for better consistency, with zero synthetic additives.
    Do not exceed the serving without medical advice due to the melatonin content.

    We evaluated the efficiency of each ingredient within the legal steroids
    to make sure they’re effective for bodybuilding. We examined
    every ingredient’s capacity to reinforce muscle growth and strength.
    The latter is an artificial type of testosterone that medical doctors could prescribe to deal with sure hormonal
    or muscle-wasting situations. Folks typically misuse anabolic
    steroids to increase muscle mass and enhance athletic performance.
    However, these medicine might have harmful unwanted facet effects and are unlawful
    and not utilizing a prescription.
    Understanding the differences between supplements and
    steroids may help you make informed decisions about your well
    being. Anabolic steroids are artificial substances just like the male hormone testosterone.
    They are used medically to deal with situations like delayed
    puberty and diseases that trigger muscle loss. What issues is that those wishing to pursue a profession in athletics ought to probably avoid DHEA.
    Still, it is efficient and authorized, and there
    may be some non-career athletes who wish to
    discover its prospects, so we included a few DHEA-based supplements on our list.

  4. Great paintings! This is the type of information that are supposed to be shared across the web. Disgrace on Google for no longer positioning this post upper! Come on over and visit my web site . Thank you =)

Leave a Reply

Your email address will not be published. Required fields are marked *