Wednesday, March 16, 2022

Ortho HO must know

 Clerking key points:

- age/ race/gender

- chief complain

- presenting history (how it happens-where they fall, how, why; pain-what kind of pain-location, intensity, relieving factors) 

- other related signs and symptoms: LOC(loss of consciousness), headache, N&V(nausea and vomiting)

- treated by any other hospital?

- past medical history: underlying disease? DM/HPT? well controlled?

- Social hostory: ADL, who he is staying with?

- P/E- relevant and related: Observe, palpate, motor: Range of movement of limbs, sensitivity, neurological

- report any X-ray or CT scan done


Review pt in the morning. 

- the header is S/B Dr. XXX or <AM review> 

format:

- age/race/gender

- Post operation Day/ Day admission, what kind of surgery, 

- pt condition: oral and toiletry, SOB, fever, cough/flu, pain(pain score), 

- vital signs: BP, Pulse, T

- P/E: dressing, wound/condition

- Plan: continue previous meds, change dressing, physio referral, feeding, pain medication


Must know: (for ortho)

- how to read the spine X-ray/ any xray

    - check alignment

    - body: vertabral body, spinous process, antevertebral body, 4 lines of X-ray, 

    - any burst /compression fracture

    - to determine via TLCIS if the person with thoracolumbar injury needs surgery or not. 

- physical examination

    - motor, sensory and neurological: any abnormalities, know what is it testing for 

- differences between Upper Motor neuron and Lower Motor Neuron, 

    - Cauda Equina 

    - end of UMN is L2

COMMON TO DO LIST

  • TO do ABG, use the blue needle and syringe to extrct the blood
  • to do line, use pink needle, find the vein on pt hand, feel and put it in. 
  • to do slap, need a friend to help with releasing the water from the back slap(10 layers)
  • to do skin traction: prepare the cover and weight(10% of pt body weight)
  • to be prepared always for mo who is coming for pt. 


No comments:

Post a Comment