Morning Report: 5/10/2013

Dr. Julie presents his final Morning Report [tear] with a list of important tips he picked up along the way during his time at County.

 

Airway:

–  Have a few seconds? Review the chart

–  Tonsil Cancer

–  Chronic pts/prior procedures/lab (trend) or radiology findings

–  Always remember your Bougie

–  SUCTION

–  Tonsil

 

–  Beware the Trach

–  ENT. Suction/saline. Baby tube?

 

– Know your meds

–  Silverberg quote

– Succs: Etomidate: Roc/Vec: Ketamine: Propofol: Epi: …

Breathing:

–  LMAs save lives

–  Cric

–  Bougie??

 

–  Nasal High Flow Oxygen

–  Why not??

 

–  Consider Ketamine

–  Asthma. EDP. Kids

 

Circulation:

–  Brachial

–  Sono (not for CTA) tricks. Fem cath, peds CVC, 2’’ IVs

–  Blood draws

–  Blind sticks: Watch out for scary meds (Ca, Dextrose…)

 

–  EJ

–  Trendelenberg

–  Check the catheter

 

–  Calcium/Bicarb

–  Renal?

–  Other acidosis?

 

–  EKG/SONO

–  Effusion, arrhythmia…

 

–  Cardioversion

–  QTc issue? Mg. BP issue? Ca.

 

Extras:

–  The Odd Affect

–  Psych. Thyroid. SVT (OCP. LP with pressure).

 

–  OD

–  ASA (Tachypnea, Met acidosis/resp alkalosis). Packers. TCA (wide QRS, terminal R in aVR). Metformin? Heroin (narcan nebs)

 

–  IM Workup

–  Anemia (Retic, Iron Studies, Haptoglobin, Ferritin, LDH, T&S). AKI (urine lytes and/or urea, urine CR). Uric acid: Tumor lysis and Eclampsia. Sickle Cell (Anemia labs, hgb electophoresis, CRP HS)

 

–  The Best Medicine(s)

Valium, Zantac, Zofran, Magnesium. Smile. Acknowledge their concerns. Be honest.

The views expressed on this blog are the author's own and do not reflect the views of their employer. Please read our full disclaimer here. Any references to clinical cases refer to patients treated at a virtual hospital, Janus General Hospital.
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Jay Khadpe MD

Editor in Chief of "The Original Kings of County" Assistant Professor of Emergency Medicine Assistant Residency Director SUNY Downstate / Kings County Hospital

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