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Carolinas Case COnference - Dr. NIchols

9/18/2015

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Picture
Tuberculosis
-Immediately isolate any patient that you believe may have TB, and document that you have done so!
-Upper lobe pneumonia should always prompt further consideration of tuberculosis, screen with risk factors
-Patients with TB often have multiple ED visits with active disease, risk factors are often overlooked in triage
-Remember, PPD and IFN blood testing is for latent TB only and will not help you diagnose active TB
-Involve infectious disease, ensure that the health department is involved in the patient's case

Elderly Falls - Missed Femoral Neck Fracture
-95% due to falls, more than 300k admissions per year
-One year mortality in those over 65: 12-37%
-High risk of malunion, poor healing, and avascular necrosis if missed
-Surgical repair is performed as soon as medically stable for procedure
-Range all joints, low threshold to image
-Before discharge, consider home/social factors
-For a full reassessment, ambulate the patient personally or with the nurse to prevent missed injuries and assess feasibility of discharge


High Pressure Injuries
-Surgical emergency despite benign exam
-Paint/grease guns, pressure washers
-Material rapidly spreads to tissue spaces and can cause compartment syndrome
-Time Sensitive: Amputation rate 38% within 6 hours, 58% after that
-EMS transportation if transferring for ortho evaluation from OSH/Urgent Care

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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Medical Students at CMC
    • EM Acting Internship
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #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