Medical Malpractice Insurance for orthopaedic surgeons

MAO Inhibitors

– See:       – Isocarboxazid/Marplan       – Tranylcypromine/Parnate       – Phenelzine/Nardil – Discussion:     – can potentiate the depressive effects of narcotics;     – can cause fever and seizures when administered to a patient receiving MAOI;     – the pressor effect of indirectly acting agents such … Read more

Mannitol

– Discussion:     – for reduction of intracranial or intraocular pressure;     – for osmotic diuresis, cerebral edema, ?oliguria, ?anuria, ?myoglobinuria;     – serves as rapid volumeexpander;     – adult: test dose:             – 0.2gm/kg/dose IV over 3-5 min;             – … Read more

Manifestations of Hypokalemia

 – See:  – Rx Allgorithm  – Diff Dx:  – EKG changes  – T wave flattening  – U waves –  ST segment depression  – PAC  – PVC  – Digoxin sensitivity  – Neuromuscular:  – Weakness, Depressed Deep Tendon Reflexes  – Paresthesias, Ileus;  – Misc:  – Nephrogenic Diabetes Insipidus;  – metabolic alkalosis;  – Worsening of Hepatic Encephalopathy

Manifestations of Hypercalcemia

– Cardiovascular:       – dysrhythmia       – EKG Changes       – digoxin sensitivity       – hypertension; – Gastro Intestinal:       – anorexia       – nausea / vomiting;       – constipation       – abdominal pain,       – pancreatitis … Read more

Mangled Extremity Severity Score (MESS)

                                                                           – from Johansen, et al. (1990) Skeletal / soft-tissue injury      Low energy (stab; simple fracture; pistol gunshot wound): 1      Medium energy (open or multiple fractures, dislocation): 2      High energy (high speed MVA or rifle GSW): 3      Very high energy (high speed trauma + gross contamination): 4 Limb ischemia     … Read more

Mangal Parihar MD

Dr. Mangal Parihar Hon. Asst. Professor, Orthopedics, GMC & JJ group of Hospitals Mangal-Anand Hospital 48, Swastik Park, Sion Trombay Road Chembur, Bombay 400 071 Tel: (022) 5227539 / 4845 / 0499 Fax: (022) 523 5416 Email: mangalparihar@parihar.net Web: http://www.ilizarov.in Essays on the Web: – Post Operative Ilizarov Care:

Management of Vascular Injuries in Knee Dislocation

– See:         – Arteriography         – Arterial Trauma         – Compartment Syndrome         – Knee Dislocation         – Popliteal Artery         – Reperfusion Injury – Discussion:      – note that the worst error to make is to underestimate the need to … Read more

Management of the DKA patient once stabilized

 – serum glucose qhr  – if there is not a 10% drop in serum glucose after 2 hrs:  – double Insulin dose qhr until a response occurs  – after glucose falls below 250 mg/dl, begin D5W  – avoid Hypoglycemia  – bicarbonate if pH < 7.1; max < 100 mEq/hr;  – check serum K+ qhr, anticipate … Read more