Tamingthesru
Annals of B-Pod: Winter 2016 Issue
Caring for #thewholepatient
Patients typically present to the Emergency Department with one complaint. The chart says “Headache” or “Abdominal Pain” but B-pod implores us to look closer. B-pod teaches us that it is our job to sit down, take a few extra minutes, and look at the entire patient in front of us...
Annals of B-Pod: Mastering Minor Care
Under Pressure: A Tonopen Tutorial
Prepare
1. Find your Tonopen. At our shop the Tonopen lives in the cabinet in the attending office.
2. Adequate corneal analgesia is key. Instill tetracaine in both eyes prior to using the Tonopen.
3. If you are assessing the patient for corneal abrasions, perform the fluorescein exam prior to using the Tonopen as the Tonopen may inadvertently cause small abrasions.
4. Place a cover over the tip. It slides on like a condom and then roll the ridge into the grove.
Annals of B-Pod: Quick Hit Case
Open Globe and a Discussion about Traumatic Hyphema
The patient is a male in his 40s who presents after sustaining an injury to his right eye with a fishing hook. He states that a three-barbed hook pierced his eye while fishing with his friend. On gross inspection, the hook was noted to have pierced the inferior eyelid causing an obvious right open globe and there was a large hyphema. While he was initially able to count fingers at four feet in his superior visual field, his visual acuity quickly deteriorated to light perception only. Extraocular movements were intact and caused movement of the hook. Ophthalmology was consulted and a CT was obtained. The patient was then taken to the OR for anterior chamber washout, open globe repair, and removal of the fish hook. He was discharged following the surgery with next day follow-up with ophthalmology.