Medical Malpractice Insurance for orthopaedic surgeons

Management of Tension at Nerve Site Repair

– Discussion:     – tension at the nerve site repair will lead to poor results;     – gap of 4 cm can be bridged by local immobilization of the nerve ends;     – it appears that a gap of 4 cm can be bridged by local immobilization of nerve ends;     – … Read more

Management of Severe Hyperglycemia / DKA

– See:  – Stable HyperGly  – Sliding Scale  – Management of Stable DKA Patient   – Management:     – correct volume depletion;     – give 500 ml NS IV “wide open.” then continue as needed;     – caution with CHF;     – begin insulin; – give 5-10 units of IV regular insulin as single dose by … Read more

Management of Pulmonary Embolism

– See: – deep venous thrombosis / respiratory failure – Discussion:     – time range of diagnosis of PE following discharge:  14-68 days (JR Lieberman et al);           – ref: Early pulmonary embolism after injury: A different clinical entity?     – in the report by Lawton RL and Morrey BF (1999), the authors advise that patients … Read more

Management of Pre-renal Oliguria

   – Urine Studies    – Check: Urea, Cr    – d/c all K supplements `til diuresis occurs    – Ensure adequate Volume Replacement:       * If Hypovolemic then IV NS;    – If CHF is present, then Diuretics are required;    – Differential Dx:        – Fluid and Electrolyte depletion   … Read more

Management of Pneumonia

References for Pneumonia: Concepts in Emergency and Critical Care: Ventilator-Associated Pneumonia. A Multivariate Analysis. Increased incidence of nosocomial pneumonia in mechanically ventilated patients with subclinical aspiration. Role of gastric colonization in the development of pneumonia in critically ill trauma patients: results of a prospective randomized trial. Continuous lateral rotational therapy and nosocomial pneumonia. Enteral hyperalimentation as a source of … Read more