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How to Manage a Knocked-Out Tooth
Have you ever had your tooth knocked out?
If you answered yes, you are not alone and probably know what to do. But if you have not, you will be someone’s hero in knowing how to manage a knocked out tooth.
[Read more…] about How to Manage a Knocked-Out ToothNon-traumatic Foreign Bodies of the HEENT and Esophagus
People often present to an emergency room, or urgent care setting with a foreign body lodged in an orifice. When the patient presents they will have a sense of urgency, and feel that it needs to “come out now”. This may or may not be the case. In order of most to least common, non-traumatic foreign bodies can become lodged in the throat, ears, nose, vagina, rectum and urethra. Patients may be adult or pediatric. Kids will often stick beads or buttons in their ears or nose, and will swallow just about anything. Adults may have an insect in their ear, esophageal food impaction, or engage in foreign body insertions during sexual practices. In this blog we will talk about HEENT/Esophageal foreign bodies.
[Read more…] about Non-traumatic Foreign Bodies of the HEENT and EsophagusVentilator Management
The Police, an 80’s English rock band, had it right in there song ‘Every Breath You Take’ when they said:
- Every breath you take
- Every move you make
- Every bond you break
- Every step you take
- I’ll be watching you
Fluid Administration
Utilizing the 4 D’s to exercise fluid stewardship
“Poison is in everything, and no thing is without poison. The dosage makes it either a poison or a remedy.” -Paracelsus, date unknown
For patients in septic shock or those that are dehydrated, administration of fluid is top priority to restore adequate intravascular volume, increasing cardiac output, augment oxygen delivery, and improving tissue oxygenation.
[Read more…] about Fluid AdministrationCreating your own happiness
Medicine has changed a lot since I began practicing 15 years ago. There were no MIPS measures, no sepsis protocols, no door to provider times; in fact, the term provider was not even a ‘thing’. Medicine wasn’t perfect, but the stress level was exponentially lower. Back in the early 2000’s, the biggest concern was malpractice. Now? We have times and measures and protocols and numbers and metrics AND malpractice. Add to this the government-mandated Electronic Medical Record (EMR), which can make documentation exponentially more cumbersome.
[Read more…] about Creating your own happinessPrimary Care: Should we throw away the clonidine?
Rachel Beatty, ARNP
Typical Scenario
Let’s discuss a common scenario. You have a 50 year old male who has not been seen by a PCP in two years. His past medical history includes arthritis and hypertension. He does not smoke and has an occasional beer on the weekend. He has been off his medications for his hypertension for over a year. His BP in office is 182/110, HR 70, Temp 97.6, Respirations 16, 02 saturation 98%. His physical exam is unremarkable and he is asymptomatic. Your medical assistant asks you if you would like her to give him clonidine and do an EKG. She then asks if we will be sending him to the emergency room. The patient is now anxious and is wondering if he is going to have a stroke. What would you do?
[Read more…] about Primary Care: Should we throw away the clonidine?