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Chemical burns are a unique subset of burns that require specialised management due to the nature of the substances involved. The majority of acid burns cause coagulative necrosis and cytotoxicity leading to skin and mucosal changes that limit deeper injury. Keep the patient warm using force air warmers such as Bairhugger.
Hydrogel dressings are preferred for minor burns, partial- and full-thickness wounds, wounds with necrosis, and deep wounds with tunneling or sinus tracts. Photographic documentation of the wound is helpful to enhance continuity of care. They should be avoided in dry wounds (arterial ulcers) or necrotic wounds with an eschar.
One of the first documented strikes among house staff officers took place in 1974 at Howard University here in Washington, D.C., Physician burnout will burn all of us. Historically, labor unionization among health care workers is uncommon, 5 including among resident physicians, 6 and the prospect of striking even more so. Adelman LC.
Your response may range from simply documenting the event somewhere secure, so that you have a contemporaneous record of what happened and who else may have been involved to support any future decisions you might make, all the way up to formally speaking up. It is hard to speak up sometimes.
Spending day and night coding. On the one hand, my colleague was critical of these young tech people for burning the midnight oil in pursuit of their startups. A few years ago, a colleague of mine was applying for, and eventually received, a grant to study lung cancer screening in a vulnerable population. 8 of them living in a house.
Now let’s compare the two documents. If the AAP continues in this direction, they will burn through any remaining credibility. From their document. The USPSTF has issued draft guidance that emphasizes diet and exercise. The AAP champions surgery and medications. Let’s take a look at the USPSTF. This is Orwellian.
Furthermore, this type of abuse can manifest in various harmful actions, including punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other object), burning, and any other behavior that results in physical harm.
Written by Willy Frick A 46 year old man with a history of type 2 diabetes mellitus presented to urgent care with complaint of "chest burning." The documentation does not describe any additional details of the history. He described the symptom as chest burning with occasional radiation into his throat and jaw.
Click here to sign up for Queen of Hearts Access Case A 58-year-old woman presented to the ED with burning chest pain that started 2-3 hours earlier while sitting on a porch swing. The physician documented “normal sinus rhythm”. The physician documented that she was “improved” and the patient was discharged. CK MB was 1.9
Our leaders have done a terrible thing to doctors—they’ve told doctors to put their heads down and focus on billing and coding in short visits with patients, as they measure their performance by a doctor’s throughput. We have not given doctors the time or resources to study the root causes of disease.
Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.
Know your audience, and tailor your presentation to them in terms of humor, pop culture references, and dress code Err on the side of making your presentation slightly shorter than the alloted time to allow room for questions. It is better to finish early than rushing through your presentation
Document a risk and benefit discussion with the patient regarding empiric anticoagulation, perhaps even including the HAS-BLED score in the documentation [10]. Give the first dose of enoxaparin in the ED: 1 mg/kg subcutaneously for 12 hours or 1.5 mg/kg for 24 hours.
Insurance companies paying more attention to addressing social needs Medicaid: 1115 Demonstration Waivers, CalAIM in California ICD-10 code modifiers to acknowledge – and compensate—for the added complexity of social needs Additional resources/further reading: Liberman DB, Pham PK, Semple-Hess JE. Acad Pediatr. 2022 Mar;22(2):190-192.
Don’t be afraid to ask the simple questions: Where do I document? Are there distinctive sub-specialty referral pathways for your area e.g. liver, burns, surgery, neurosurgery etc. Top tip: verbally communicating your plan followed by clear documentation can help avoid confusion! Where do I prescribe? Where is the staff room?
However, the patient had known dextrocardia based on documented medical history and was confirmed with a recent chest x-ray. Burns E, Buttner R. 5 The patient’s initial left-sided EKG did not demonstrate concerning ST segment changes. Coronary Artery Disease. 2019;30(5):390-392. Right Ventricular Infarction. Life in the Fast Lane.
Who’s running codes? Vacation and time away from work is needed to prevent burn-out! If you’re at a hospital with multiple programs, who’s up first to doing them? Surgery, Internal Medicine, Anesthesia, Emergency Medicine? Is there a simulation lab on-site for practicing procedures? Social Life. How do holidays work?
This post will discuss a brief overview of hospital planning and operational setup with key elements of a disaster response from events that cause high numbers of blunt trauma, penetrating trauma, burns or crush injuries that may be seen following explosive events, mass shootings, or large scale motor vehicle collisions, to name a few.
At Shands (the level 1 trauma center admitting adults), the panel relates the impressive results that mortality fell by 58%, and unplanned codes by 47% “after the widespread implementation of patient/ family activated RRT/MET.” More health care professionals are burned out or disengaged. Societal trust has declined.
ST elevation in both anterior and inferior leads does not necessarily indicate an LAD "wraparound" lesion ( Bozbeyoğlu reference documenting this cited by Dr. Aslanger below — with Dr. Aslanger as one of the co-authors ). Smith's Blog show this same phenomenon ).
Written by Pendell Meyers, with edits by Steve Smith A man in his early 40s with history of MI s/p PCI presented with bilateral anterior chest pain described as burning and belching with no radiation since last night starting around 11pm (roughly 11 hours ago). He also described a syncopal episode just prior to onset of symptoms.
Fun fact: planes also take off heavy - with tons of fuel that will be burned prior to landing. Alternatively, you may have to fly in circles for some time to burn fuel off in planes that cannot dump. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%. Say you were to take off from London, bound for the US.
mg/kg of IBW Seek to match a patient's minute ventilation with TV and RR after intubation Intentionally match patient's intrinsic RR noted prior to intubation Note that healthy lungs can handle 8 mL/kg, based on IBW, if that is useful for compensation Secure your ETT Thomas Tube Holder is a new ETT holder on Air Care for ETT down to size 6.5
It is important to be accurate when assessing and documenting wounds as it can have medico-legal implications, should your assessment later come up in a court case. Wounds are a very common presentation to A&E and minor injuries departments. Wound management is very clinician dependent and there is a lot of variation in practice.
Recognizing the Signs of Abuse Healthcare providers must remain vigilant for signs of abuse, which can include: Physical Signs : Unexplained bruises, burns, or fractures, along with frequent hospitalizations for preventable issues. Documentation : Detailed documentation is crucial.
Common Cal/Osha Violations No formal workplace violence prevention plan Lack of staff training on de-escalation techniques Failure to report and document violent incidents Inadequate security measures in high-risk areas How to Avoid This Violation Develop a Workplace Violence Prevention Plan as required by Cal/OSHA.
There is a well-documented misunderstanding among American doctors about nicotine and cigarette substitutes. Swedish snus is vastly safer than cigarettes and the FDA recently authorized the sale of heat-not-burn tobacco (HNB), e-cigarettes/vapor, and nicotine pouches as “appropriate for the protection of the public health.”
For example, veterans with abnormal spirometry results would also need documented or presumed exposure to toxic inhalants during their service, such as burn pits or agent orange. To qualify for disability payments, veterans need a service-connected diagnosis beyond meeting abnormal spirometry criteria alone.
4,5 Of particular concern is the Sudanese conflict, which began in April 2023, and which has caused the largest internal displacement of a population in documented history. Physical injuries and burns among refugees in Lebanon: implications for programs and policies. In: CDC Yellow Book 2024. Centers for Disease Control; 2023.
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