Author jacobi Posted on August 11, 2017August 11, 2017Format AsideCategories announcement, SMRTags ,

SMR FAQ

As an SMR you will often have many questions that will come up; these are some of the more frequent questions that we ran into when we were SMRs and we hope that the answers will help guide you. Q1: I am not sure about my team distribution, what should I do ? Q2: When should I call chiefs for potential back-up residents ? Q3: What is the cutoff time to assign/inform teams about day float admissions ? Q4: Which … Continue reading “SMR FAQ”

Author jacobi Posted on August 11, 2017August 11, 2017Format AsideCategories announcement, Weekend CoverageTags

Weekend Coverage 8/12 – 8/13

Announcement Off service notes: 8/16 will be intern switch day for ACS, Pulm and Neuro teams. Residents – please advise your interns to use the updated off-service-note template (click here to download). You can also find it in the Resident Share drive:\\[2017-2018] Note Template & Samples\[2017-2018] Off Service Note – Template.docxWe appreciate your feedback from our last group meeting and have edited the template so that it blends together the information that should be in a daily progress note, but with additional details that … Continue reading “Weekend Coverage 8/12 – 8/13”

Author jacobi Posted on August 10, 2017August 10, 2017Format AsideCategories Education, TidbitsTags , ,

Malaria Prophylaxis

  Falciparum Ovale Vivax Malarie Age of RBCs infected All Young Young Old Size of cell NL Big Big NL % of Parasitemia >5% <5% <5% <5% Liver stage no yes yes no Common prophylaxis drugs (eg, chloroquine, mefloquine and doxycycline) target blood stage of parasite (blood schizonticides). Malaria with liver stage (Ovale, Vivax) should treated with tissue schizoticides (eg, atovaquone/proguanil).   If one person travel to chloroquine-resistant P falciparum (Sub-Saharan Africa, Southern & Southeast Asia),  prophylaxis with Atorvaquone-proguanil, Doxycycline, … Continue reading “Malaria Prophylaxis”

Author jacobi Posted on August 3, 2017Format AsideCategories Tidbits, Weekend CoverageTags ,

Neurological emergency

Hydrocephalus: if you see hydrocephalus in a patient with consistent severe headaches, this could be a sign of impending herniation. Patient will need emergent relief of intracranial pressure.   Botulism: Rapidly progressive paralysis with blurry vision, sluggish pupils and diplopia. This condition is caused by an irreversible toxin and the antitoxin should be given as soon as possible, so needs high clinical suspicion. The diagnosis is by injecting patient’s serum in mice to see if it causes paralysis (takes a … Continue reading “Neurological emergency”

Author jacobi Posted on August 3, 2017August 11, 2017Format AsideCategories announcement, Weekend CoverageTags

Weekend Coverage 8/5-6

Important Announcements Qmed downtime 8/4 – 5 ​Please ​note that there will be a Qmed upgrade overnight from 8/4 @ 11:45 PM to 8/5 @ 07:45 AM (hopefully will be done by 06:15 AM) . During the Qmed downtime house staff will be UNABLE to review charts or place orders in Qmed. For chart/lab review: Please use the Qmed downtime system (review these instructions) For ordering labs/medications: Unfortunately, all orders will need to be WRITTEN (order sheets are available at nursing stations on all the … Continue reading “Weekend Coverage 8/5-6”

Author jacobi Posted on July 24, 2017July 24, 2017Format AsideCategories TidbitsTags , , , , ,

NOACs

Antidote:  Dabigatran = Idarucizumab (Praxabind)  Idarucizumab for Dabigatran Reversal  N Engl J Med 2015; 373:511-520 Factor Xa (Apixaban, Rivaroxaban) are POTENTIALLY reversible by Andexanet alfa (study was done in healthy human subjects, Andexanet reverses effect while infusion is running but rebounds on completion, further data will be available later)  ANNEXA-4 trial   N Engl J Med 2016;375:1131-41. Aripazine (PER977) is a medication currently on trial and can potentially reverse Factor Xa, dabigatran AND heparin, LMWH  Use of PER977 to Reverse the Anticoagulant Effect of Edoxaban  N Engl J … Continue reading “NOACs”

Author jacobi Posted on July 20, 2017Format AsideCategories TidbitsTags , ,

Brugada syndrome

Brugada Syndrome is an ECG abnormality with a high incidence of sudden death in patients with structurally normal hearts. It is due to a mutation in the cardiac sodium channel gene. This is often referred to as a sodium channelopathy. The 3 common types: TYPE I VERY SCARY – refer to arrhythmia team for ICD!