Browsed by
Category: Critical Thinking

HOW TO DIAGNOSE SEPTIC ARTHRITIS

HOW TO DIAGNOSE SEPTIC ARTHRITIS

The biggest challenge in diagnosing septic arthritis is to think of it. Once you think of it, there is a diagnostic process that you activate. The second biggest challenge is that that diagnostic process we learn in training is flawed. We have no alternatives right now, so I will share with you my thoughts on how we should use our judgment as clinicians.   Triggers to consider septic arthritis essentially are the same triggers as infection anywhere. Celsus’ cardinal signs…

Read More Read More

DON’T CALL IT A SEIZURE…

DON’T CALL IT A SEIZURE…

Anecdote 1:Don’t call it a seizure, start CPR Resident: Hey, remember that patient in room 7 with the heart attack? Now he’s having a seizure! You: That is not a seizure, let’s start CPR! (the patient survives, and receives emergent catheterization opening a blocked vessel)   Cardiac arrest is often accompanied by jerking movements. The cartoons of the 1940s understood this. Bugs Bunny would typically do a few good jerking leg kicks prior to faking death with Elmer Fudd, Yosemite…

Read More Read More

REAL TIME CHARTING IS REAL TIME THINKING

REAL TIME CHARTING IS REAL TIME THINKING

We speak of physical diagnosis as if the sign and the suggested diagnosis always match. Often they do, for example when we see acromial step off and suspect anterior shoulder dislocation.   But more often there is ambiguity. Most bedside information is non-specific. For example, tachycardia can mean a lot of different things. Later when we look at everything at once, there is the chance to “put it all together.”   But when will you do that? It is necessary…

Read More Read More