Category: TJ Tidbits

TJ Tidbits

Thoracotomy in the ED

Criteria:  Most use the EAST Recommendations  1) Follow your ATLS protocol first!   - This means this patient should be intubated, have had bilateral chest tubes/thoracostomies,  and adequate/appropriate volume resuscitation first   - If the patient still remains hypotensive and there is still active bleeding and they fit the EAST  criteria, may proceed with thoracotomy   2) Tool kit (simplified ED)  A. Finochietto Retractor (crank handle must be opposite side of spreader handle, bar always 

by Tejeshwer Jaswal, DO
TJ Tidbits

Nail Trauma

Nail Trauma Brief Anatomy Overview: Topics to discuss:-Acrylic Nail Injury-Subungual Hematoma management -Nail Bed Injuries and management - cosmetic importance, prevent infection, enhance tactile sensation, enhancement of picking up objects, protects digits from mechanical injuries Why Should we care? 1) Acrylic Nail Injury 21 year old female presents to ED with “broken nail.” Patient had acrylic nails placed 2 weeks ago and accidentally slammed her right thumb into car door 2 hours ago, and heard a crack. She noticed bleeding at the sit

by Tejeshwer Jaswal, DO
TJ Tidbits

A note on ARVD

Hey so after some reading just thought I’d share some info on ARVD. This can be tricky to diagnose for many reasons. 1) What does it stand for? Arrhythmogenic Right Ventricular Dysplasia (common to replace Dysplasia with Cardiomyopathy). It’s the second most common death in young people <35yo with males more common than females (up to 20% of SCD in young).  (Bonus points: what’s the most common death in young people?) Interns..? 2) Two types: autosomal dominant (most common we see) and autosomal recessive (Naxos Disease, watch out for people with Itali

by Tejeshwer Jaswal, DO
Sunday Scaries, TJ Tidbits

Ovarian Torsion

So it’s a busy weekday at Coney Island Hospital. You get an upgrade and it’s for a 41 year old woman with severe RLQ abdominal pain. You see she’s writhing in bed, crying and guarding. Vitals are normal but she is slightly tachycardic. What do you do next?  History! History!  The patient is not fully cooperating with your questioning because of the pain but tells you it started 2 hours ago and that the pain is sharp, 10/10 constant and nonradiating. She woke up with this pain and had 2 episodes of vomiting and is still nauseous.  You press on her abdom

by Tejeshwer Jaswal, DO