Isbar
This presentation is the property of its rightful owner.
Sponsored Links
1 / 11

ISBAR PowerPoint PPT Presentation


  • 174 Views
  • Uploaded on
  • Presentation posted in: General

ISBAR. I - Yo ENT surgeon, I’m Alex, a GP. S – I have a 34 year old male with a three week history of hoarse voice. Patient has right cervical and left axillary lymphadenopathy . B – He is usually well, no significant medical history, none smoker, and no medication.

Download Presentation

ISBAR

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Isbar

ISBAR

  • I - Yo ENT surgeon, I’m Alex, a GP.

  • S – I have a 34 year old male with a three week history of hoarse voice. Patient has right cervical and left axillarylymphadenopathy.

  • B – He is usually well, no significant medical history, none smoker, and no medication.

  • A - Vocal cord paralysis seems possible.

  • R – Please examine.


Isbar

  • There does not seem to be any lectures or resources relating to this.

  • EBM

  • Decisions trees, algorithms.

  • Lots of holes.

  • Has anyone actually seen EBM in action in the hospital?

  • How many people in this course are really capable of using statistics….


Isbar

ECG

  • One particular program in correctly picking up MIs from an ECG

    • Cardiologists – 680/820 correct

    • Computer – 738/820 correct


Isbar

  • Apparently previous years exam question…

  • New introduced robot doctor, what can’t it do?


True story from a book

True story… from a book…

  • You are a senior surgical resident in the ED.

  • Just finished admitting someone with a gallbladder infection.

  • It is 2 pm, you have been in the ED since 9 pm the previous night.

  • An ER physician stops you on your way to finally get some food with a case.


Isbar

  • Red, swollen leg, 23 yo female.

  • The ER physician tells you that it is a bad case of cellulitis, already started on IV antibiotics.

  • The ER physician wanted to make sure there wasn’t anything surgical going on…

  • What do you want to ask her?


Isbar

  • You get her story.

  • Blister on big toes two days ago. Foot began getting painful, redness spread.

  • During the night had a fever and chills.

  • Saw her GP who got an X-ray to rule out involvement of the bone, gave her IV antibiotics, and antibiotic pills to take home.

  • The redness continued to spread. Went to hospital. No more fevers since that initial fever.

  • DDx. Go.


Isbar

  • You remember that three weeks ago you had another patient with what was thought to be cellulitis, but he didn’t get better.

  • He went into shock, and eventually died.

  • Necrotising fasciitis.


Isbar

  • In the US about

    • 1000 cases of necrotising fasciitis a year.

    • Over 3 million cases of cellulitis.

  • Necrotising fasciitis

    • Kills 70% of the people who have it.

    • Often requires amputation, next step would be biopsy.

  • How likely it is that this is necrotising fasciitis?


Isbar

  • Realistically, the biopsy shouldn’t happen, the chances of it being necrotising fasciitis are just way too low.

  • Something in your gut tells you that you should biopsy.


  • Login