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Carolinas Case Conference - Dr. Nichols

7/16/2015

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Picture
1) Respect the elderly, but especially in geriatric trauma!      
      -Many of these patients are beta blocked and anticoagulated
      -High risk for occult fracture, higher risk for mortality following any trauma
      -Remember to apply geriatric trauma scoring, and triage conservatively

2) Don't fear the chronic tracheostomy patient in respiratory distress
    -Remember your airway toolbox, gauge how much time you have!
    -A NG tube can be a great placeholder for trach exchange
    -Never forget you can (usually) still intubate these people from above
    -Fiberoptic nasotracheal intubation as a failsafe

3) Consider imaging of the hip in pediatric leg pain
    -SCFE can present as subacute knee pain, patients may still be able to walk!
    -Consider in both boys and girls, obese and average sized
    -Low threshold for imaging of the hips with knee or thigh pain complaints

4) Ensure you examine every trauma patient's eyes, checking for ocular trauma
   -Globe rupture requires immediate optho consultation

   -Do not perform further exams until this is ruled in or out
   -Hyphema is a collection of blood in the anterior chamber, usually traumatic
   -More anterior chamber filling associated with worse visual recovery
   -Emergent consultation with opthomology, elevate head of bed, check for coagulopathy

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​
  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • Global EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • MATCH 2022
    • Alumni
  • STUDENTS/APPLICANTS
    • Prospective Visiting Students
    • UNC/Wake Forest Students
    • Healthcare Disparities Externship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction