A new letter to the editor reports an association between acquired osteomalacia and autoantibodies against PHEX (phosphate-regulating endopeptidase X-linked), which may be termed autoimmune osteomalacia. Read the full letter: nej.md/40RtS7j

#MedSky #Oncology

Confirmation of ET tube in correct position

1. Chest Expansion & movements
2. Misting of tube
3. 5 point auscultation
4. Capnography
5. Imaging (X Ray)

Post Embolectomy Care

1. Monitor Distal Pulse, Limb movements and Sensation

2. Limb Elevation

3. Reperfusion effects

4. Continue Heparin infusion

5. Warfarin

Management of Acute Limb Ischaemia

1. Recognize

2. IV UFH 75-100 IU/kg followed by 18 IU/kg/hr infusion

3. Pain Mx

4. Inform Vascular Surgeon, Anaesthetist, Theatre

5. 2 x Fogarty catheters in 2 different sizes

6. Fasting

7. Consent (Embolectomy/ Fasciotomy)

8. Embolectomy

6P's 🥜

1. Pain
2. Pallor
3. Perishing cold
4. Pulselessness
5. Paresis(Paralysis)
6. Parasthesia(Anaesthesia)

2 Clinical Signs of a dead limb,
Paralysis & Anaesthesia

Acute Limb Ischaemia

Sudden interruption of vascular perfusion leading to a threat to the viability of the limb.

Causes,
Extra Mural/ Mural/ Intra Mural

1. Extra Mural
Compartment Xn, Tight cast/bandage, Circumferencial burn

2. Mural
Thrombosis, Dissection, Trauma

3. Intramural
Embolus

Key things to be addressed in Patient Management

1. Find the cause
2. Treat the cause
3. Assess complications
4. Prevention
5. Screening

Assessment of Daily Status of a patient

1. Subjective
2. Objective
3. Assessment
4. Plan

S.O.A.P

Components of the analysis of "presenting complaint" of a surgical case.
AKA History of PC.

1. Anatomy
2. Pathology
3. Aetiology
4. Complications
5. Severity
6. Disability

Objectives of History Taking

1. To arrive at a diagnosis

2. To identify Co-morbidities and complications

3. To assess fitness for Surgery (if applicable)

"4 Limb Threatening Injuries"

1. Arterial Injuries
2. Compartment Syndrome
3. Open Fracture
4. Dislocation of a joint

Bladder Catheterization. Why? Let's look at the "principles"

1. Bypass the urethra

2. Decompress bladder (Ex- Neurogenic Bladder, Acute retention)

3. Bladder outflow obstruction

4. Irrigation

5. Diagnostic (Ex- Cystometry)

Central Line "check list"

1. Number of Days

2. Signs of Local Infection

3. Line sutures in place/ Dressings changed or not

4. Blood aspiration & Functioning

5. Type of Infusion