EYES – LATERAL CANTHOTOMY (Dr Siva Gnanasekaran)
– to do in the setting of ocular compartment syndrome as a vision saving procedure
– doesn’t look hard!
– EM:RAP video on the procedure – https://www.youtube.com/watch?v=tgQaKVGynFA
– video on the use of the tonopen – https://www.youtube.com/watch?v=OJso6-m711I
– cut the SUPERIOR crus
FINGER LUMPS AND UNEXPECTED X-RAY (Dr Jess Roberts)
– review plastics presentation on hand exam – http://westerned.org/presentations/plastics-hand-injuries/
– remember to consider a broad ‘sieve’ (categories) to think about differentials when faced with an unexpected or unfamiliar finding eg. metabolic / trauma / neoplastic / vascular / inflammatory / toxin
– who remembers CREST?
PE and D-DIMER (Dr Romeo Restellini)
– read about the two-tier Well’s score for PE – https://www.ncbi.nlm.nih.gov/pubmed/16403929
– if your suspicion for PE is high, anticoagulate FIRST
– thrombolysis for submassive PE is still controversial – involve ICU and respiratory EARLY
RESPIRATORY
– suggestions from respiratory team that a regular inhaled steroid preventer improves outcomes although exact recommendation still hazy
– I am going to read the SYGMA 1 + 2 papers with interest and you should too:
– be wary of trials where significant conflict of interest exists
– We CAN however be BETTER at:
– asking about and documenting asthma frequency and severity and IMPACT – “what would you like to do but can’t, because of your asthma?”
– educating about asthma devices – patients might feel a spacer is no good because they don’t ‘feel’ the medication going in
– having multilingual resources for patient education – this is a potential PROJECT
– identifying the medication the patient is actually taking – https://www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/charts/asthma-copd-medications-chart