Differences

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--- resident:common_consults [2020/03/21 01:06] – jonathan
+++ resident:common_consults [2025/08/09 16:22] (current) – [Distal radius fracture] victoria
@@ Line 1: / Line 1: @@
 ==== Lower Extremity Soft Tissue Coverage ====
-Mechanism of wound\\
+  * Mechanism of wound
-Size of wound\\
+  * Size of wound
-Prior surgeries\\
+  * Prior surgeries
-Existing hardware?\\
+  * Existing hardware?
-Current dressing/vac, etc\\
+  * Current dressing/vac, etc
-Weight bearing status\\
+  * Weight bearing status
-Infection? Osteo versus soft tissue only.\\
+  * Infection? Osteo versus soft tissue only.
-Antibiotics? Follow ALL cultures; know if they are soft tissue versus bone\\
+  * Antibiotics? Follow ALL cultures; know if they are soft tissue versus bone
-CTA runoff\\
+  * Has CTA runoff been obtained?
-Needs to be on SQH 5000U TID and hold the AM dose if going to OR\\
+  * Needs to be on SQH 5000U TID and hold the AM dose if going to OR
-Follow up CBCs especially after OR with ortho. If Hct is <28, will transfuse day BEFORE surgery.\\
+  * Follow up CBCs especially after OR with ortho. If Hct is <28, will transfuse day BEFORE surgery.
-If planning for poss free flap, need to T&C 2u RBC.\\
+  * If planning for poss free flap, need to T&C 2u RBC.
-If going to surgery, need to make NPO, IVF, pre-op abx.\\
+  * If going to surgery, need to make NPO, IVF, pre-op abx.
+No nicotine patch
 Example:\\
@@ Line 23: / Line 26: @@
 [ ] Mark and consent\\
 [X] CTA runoff: L AT open to hardware, DP open. L PT open. L peroneal occluded in zone of injury.\\
-[ ] Lovenox ppx: Change to SQH TID 500U after Ortho OR\\
+[ ] Lovenox ppx: Change to SQH TID 5000U after Ortho OR\\
 [ ] F/u CBC- pending this AM (need pre-op trx?)\\
 [ ] T&C 2u RBC for OR 2/5.\\
@@ Line 29: / Line 32: @@
 - OR cx 1/29: NGTD.\\
 - Abx: none.\\
+==== Hand Pus ====
+Dr. Gordon is particularly  particular about these. You "wick" the wound, not pack it. He likes a 1/4 inch penrose drain, but he understands more practically, that a sliver of a glove is the easier option. Suture it to itself so it can't possibly fall out. ALWAYS get a culture if you would like to stay in this program. If the patient is compliant and able to care for themselves, he wants the patient to soak the hand once an hour for 10-20 minutes. If you are deciding between the OR, it's best to have inflammatory markers (WBC, ESR, CRP) and trend them.
 ==== Chest Wall Recon after sternal dehisence of sternectomy ====
@@ Line 74: / Line 82: @@
 Gather plaster roll (normally will fold into two sets 13-15 sheets each for a dorsal-volar splint, webril, a basin for warm water, bias wrap and an ACE to splint the patient after the reduction
+Call XR 88657
+Place order XR fluoro diagnostic set up less than one hour