resident:dermatology
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| resident:dermatology [2020/06/25 09:19] – melissa | resident:dermatology [2023/09/08 17:33] (current) – [Start time] jacob | ||
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| - | ====Mohs Rotation==== | + | =====Mohs Rotation===== |
| - | Attendings | + | ==== Attendings |
| - Dr. Mariah Brown - Mondays, Thursdays, some Tuesdays \\ * Background: super smart, on the board of the derm society, breast cancer survivor | - Dr. Mariah Brown - Mondays, Thursdays, some Tuesdays \\ * Background: super smart, on the board of the derm society, breast cancer survivor | ||
| - | - Dr. Misha Miller | + | - Dr. Maryam Asgari |
| + | - Dr. Fiona Zwald - Fridays \\ * Background: from Ireland, new UCH faculty currently building practice | ||
| - | Start time | + | ====Background Reading ==== |
| - | * Typically 7:45 | + | Rotation Info from Derm residents: https:// |
| - | * No “end time.” You stay until the last case is finished. Then you help write the notes. | + | |
| - | Attire | + | https:// |
| + | A practical guide to skin cancer (Hanlon) - Actinic keratosis chapter\\ | ||
| + | Facial Flap Surgery (Goldman, Dzubow, Yelverton)\\ | ||
| + | Download the MOHS AUC app. You will need to put this score in your notes. Https:// | ||
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| + | Dr. Brown' | ||
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| + | https:// | ||
| + | https:// | ||
| + | https:// | ||
| + | https:// | ||
| + | ==== Start time ==== | ||
| + | * Typically 7:30 | ||
| + | * No “end time.” You stay until the last case is finished, can range anywhere from 3: | ||
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| + | ====Attire==== | ||
| * UCH green scrubs. No need for white coat or clinic clothes. | * UCH green scrubs. No need for white coat or clinic clothes. | ||
| * They wear loupes for everything. I would only wear them for the closures. | * They wear loupes for everything. I would only wear them for the closures. | ||
| - | General workflow | + | ====General workflow==== |
| * You will not follow single patients. Basically everyone divides and conquers to get the work done. | * You will not follow single patients. Basically everyone divides and conquers to get the work done. | ||
| * Check the Mohs white board across from the nurse triage room to get a sense of patient flow/ | * Check the Mohs white board across from the nurse triage room to get a sense of patient flow/ | ||
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| - Label the photo “Mohs # **** preop” | - Label the photo “Mohs # **** preop” | ||
| - Will need to take profile, side, and swimmer’s views for nose cases and profile side and postauricular for ear cases. | - Will need to take profile, side, and swimmer’s views for nose cases and profile side and postauricular for ear cases. | ||
| + | - Will need at least 4 photos per encounter: preop, defect, closure, and a picture of the MOHS map sheet | ||
| * Extras: | * Extras: | ||
| - EYE CASES: For cases close to eyelid margin/eye itself, make the following are ordered 1)Tetracaine drops 2) Erythromycin 0.5% ointment ordered | - EYE CASES: For cases close to eyelid margin/eye itself, make the following are ordered 1)Tetracaine drops 2) Erythromycin 0.5% ointment ordered | ||
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| * Once patient is back on the table, numb the area again with lido and let the attg know they’re ready for another stage | * Once patient is back on the table, numb the area again with lido and let the attg know they’re ready for another stage | ||
| - | Reconstruction | + | ====Reconstruction==== |
| * Once path is negative, let the MA know get the patient ready for closing | * Once path is negative, let the MA know get the patient ready for closing | ||
| * Take a picture of the defect in Haiku. Label it: “Mohs #****, defect” | * Take a picture of the defect in Haiku. Label it: “Mohs #****, defect” | ||
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| * Put in any dermatopath orders if biopsies were taken (Diagnosis is typically “neoplasm of uncertain behavior of skin of ____” | * Put in any dermatopath orders if biopsies were taken (Diagnosis is typically “neoplasm of uncertain behavior of skin of ____” | ||
| - | Charting | + | ====Charting |
| * Typically done at the end of the day, but if you can knock some out throughout the day, that’s really helpful | * Typically done at the end of the day, but if you can knock some out throughout the day, that’s really helpful | ||
| * You divide and conquer the notes with the fellow | * You divide and conquer the notes with the fellow | ||
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| * Regardless of the type of patient, you need to put in a visit diagnosis under the plan tab and print the AVS when done. | * Regardless of the type of patient, you need to put in a visit diagnosis under the plan tab and print the AVS when done. | ||
| - | Intralesional chemotherapy | + | For the pathology request, order " |
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| + | ====Intralesional chemotherapy==== | ||
| * Used for patients who are not surgical candidates or who have skin cancers on sites with poor surgical/ | * Used for patients who are not surgical candidates or who have skin cancers on sites with poor surgical/ | ||
| * Do not order medication prior to seeing the patient. Sometimes the skin cancer has resolved making an injection unnecessary or a different agent is needed due to treatment failure. | * Do not order medication prior to seeing the patient. Sometimes the skin cancer has resolved making an injection unnecessary or a different agent is needed due to treatment failure. | ||
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| - Triamcinolone 40mg/mL | - Triamcinolone 40mg/mL | ||
| - | Example yellow sheet: | + | ====Example yellow sheet==== |
| {{: | {{: | ||
resident/dermatology.1593091192.txt.gz · Last modified: 2020/06/25 09:19 by melissa