Medical Malpractice Insurance for orthopaedic surgeons

Triazolam/Halcion

for insomnia, sedative, hypnotic; short acting benzodiazepine: Initially .125mg (elderly)– 0.25mg (Adult) at hs; usual dose range:.25-.5mg PO hs prn; decrease dose in the elderly or debilitated patients;  Note that pyschic and or physical dependence may occur; additive CNS depression with ETOH and other depressants; hallucinations may occur in the elderly;  Contraindicated with hypersensitivity to … Read more

Treatment of Tuberculosis Infection

– Management:     – preventive therapy with Insoniazid given for 6-12 months is effective in decreasing the risk of future tuberculosis;     – persons for whom preventitive therapy is indicated include: household members and other close contacts of potentially infectious persons;     – newly infected persons; persons with past Tuberculosis or with a significant … Read more

Trauma Management:

– Advanced Cardiac Life Support (ACLS)     – ACLS     – Iowa Family Practice Handbook     – AHCPR Guidelines     – eMedicine Online Text – Advanced Trauma Life Support (ATLS)       – Assessment of Perfusion/Shock: damage control orthopaedics               – blood pressure (systolic), heart rate, urine output (30 mL/hr) body temperature;               – labs: … Read more

Trauma Workup

I. Combat/Disaster Injuries II. Battlefield/Austere Environment Trauma Systems III. Extremity Soft Tissue Care and Amputation in an Austere Environment – ATLS Assessment:  (General Approach to Trauma) – ref: Evolution and Development of the Advanced Trauma Life Support (ATLS) Protocol: A Historical Perspective – airway protection: – anesthesia menu:  virtual anesthesia textbook / intubation menu – anesthesia consideration for … Read more

Tobramycin

– See: aminoglycosides and addition of aminoglyocides to cement – Discussion:     – adult dose w/ normal renal F(x) & serious infection: 1mg/kg q8hr;     – peds: 7.5 mb/kg/day q8hr (Levels: trough <2; peak: 4-8 hr)     – for life threatening infection may use 1.66mg/kg q8hr (reduce dose as soon as possible); … Read more

Toe Nail Fungus (Onychomycosis)

– Discussion:     – most often caused by dermatophytes (Trichophyton rubrum and Trichophyton interdigitale);     – affects 3-5% of younger patients, but effects up to half of the elderly population;     – Treatment:     – medicated nail polish:             – indicated if there is only one … Read more

Toe Walking:

Discussion main causes of toe walking are idiopathic toe walking and cerebral palsy history may include continuous toe walking vs normal gait followed by delayed toe walking by age 2 yrs; idiopathic toe walking is often caused by a congenitally short heelcord or an overactive calf muscle; heel cord lengthening may be an option after … Read more