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resident:matt_iorio [2022/12/19 08:08] – [Operative Reports] taylorresident:matt_iorio [2024/12/20 11:14] (current) jerry
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 It's busy. Between 40-60 patients on Tuesdays for Hand.\\ It's busy. Between 40-60 patients on Tuesdays for Hand.\\
 You need to be extremely concise. "55 yo RHD woman with CTS. I want to order an EMG."\\ You need to be extremely concise. "55 yo RHD woman with CTS. I want to order an EMG."\\
-Ask the Janessa or Dan to pull meds for injections. He uses 1 cc dex and 1 cc lidocaine mixture for everything.\\+Ask Kayla or Dan to pull meds for injections. He uses 1 cc dex and 1 cc lidocaine mixture for everything.\\
 You could potentially ask for pyxis access to do it yourself.\\ You could potentially ask for pyxis access to do it yourself.\\
 \\ \\
 How to roll a Dr. Iorio Bulky Jones:\\ How to roll a Dr. Iorio Bulky Jones:\\
-These are usually for lower extremity free flaps. Make sure you glue to vioptix down with dermabond. He holds it down and then cuts the tips of his gloves off. Roll the 1lb of cotton on. No need to break it in half. Next get the webril and use it to keep the cotton on. Now get the bias. Start at the heal. Once you get a roll around the heal, place a folded ABD under the heal for extra padding. Roll up the bias all the way up. Guess where the doppler stitch is and make a hole. Use the 1 slice of medipore tape to re-enforce the wall of the hole. Prop the heal up on blankets and pillows transversely at the foot of the bed. There should be no pressure under the popliteal fossa (the inflow).+These are usually for lower extremity free flaps. Make sure you glue to vioptix down with dermabond. He holds it down and then cuts the tips of his gloves off. Roll the 1lb of cotton on. No need to break it in half. Next get the webril and use it to keep the cotton on. Now get the bias. Start at the heal. Once you get a roll around the heal, place a folded ABD under the heal for extra padding. Roll up the bias all the way up. Guess where the doppler stitch is and make a hole. Use the 1 slice of medipore tape to re-enforce the wall of the hole. Prop the heal up on blankets and pillows transversely at the foot of the bed. There should be no pressure under the popliteal fossa (the inflow).:\\ 
 + 
 +Stoma Revision Protocol (as of 3/20/23).\\ 
 +- Biopsy culture stoma (bx for colonization data) "label screening culture" (Hayden/Damioli will work with lab to work up and grow to ID and susceptibility).\\ 
 +- Vanc/tobra intra op around stoma (1 vial vanc/1 vial tobra).\\ 
 +- Augmentin 875/125 PO BID x14 days.\\ 
 +- If PCN allergy, the Bactrim DS 800/160 PO BID and Flagyl 500 PO BID x 14 days.\\ 
 +\\ 
 + 
 +OI soft tissue stoma superficial infection:.\\ 
 +- Linezolid 600mg PO BID x10 days.\\ 
 +- Cipro PO BIX x 10 days.\\ 
 + 
 +Order pain buster orderset:\\ 
 +Use Pain Buster order set. - In hospital use CADD pump set at 0.2 Ropivicaine dose, the day of leaving hospital need order the pain ball(400cc) and talk with pharmacy to set rate at 6cc/hr\\ 
 + 
 +Do not ever use Keesler method for tendon repair. Use cruciate method (4-strands, 1 knot)
 ===== Operative Reports ===== ===== Operative Reports =====
  
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 Attending Pearls (Learning points/Pimp Questions):\\ Attending Pearls (Learning points/Pimp Questions):\\
-OR tips: Local w/ sedation. Upper arm tourniquet w/ webrill, tourniquet, 1000 drape. Close w/ 4-0 Nylon, xeroform/adaptiq, 4x4, webrill 2” ace. \\+OR tips: Local w/ sedation (inject into the tunnel, along the incision, and across volar wrist). Upper arm tourniquet w/ webrill, tourniquet, foam tape. Uses scalpel only for entire CTR operation (no Freer, no scissors). Close w/ 4-0 Nylon, xeroform/adaptiq, 4x4, webrill 2” ace. \\
 </WRAP> </WRAP>
 </WRAP> </WRAP>
resident/matt_iorio.1671455310.txt.gz · Last modified: 2022/12/19 08:08 by taylor

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