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.
Jay Khadpe MD
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