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Exam Room Odors

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1. Exam Room Odors

Exam Room Odors Exam Room Odors Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Exam Room Odors Exam Room Odors Aka: Exam Room Odors (...) II. Technique Nebulized masking substances (nebulizer on low flow, hung in room) Mint essence goo Mouthwash Coffee Double mask, with masking substances between layers paste Shaving cream Benzoin Liniment III. References Orman and Swaminathan in Herbert (2017) EM:Rap 17(6): 1 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Exam Room Odors." Click on the image (or right click) to open the source website in a new browser window

2018 FP Notebook

2. Exam Room Odors

Exam Room Odors Exam Room Odors Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Exam Room Odors Exam Room Odors Aka: Exam Room Odors (...) II. Technique Nebulized masking substances (nebulizer on low flow, hung in room) Mint essence goo Mouthwash Coffee Double mask, with masking substances between layers paste Shaving cream Benzoin Liniment III. References Orman and Swaminathan in Herbert (2017) EM:Rap 17(6): 1 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Exam Room Odors." Click on the image (or right click) to open the source website in a new browser window

2017 FP Notebook

3. Tales of Survival: Physical Exam

at the brink of life. Mental Status Exam Patient awake and alert, but severely cognitively impaired. Completely nonverbal and does not repeat or respond to commands. He looks observers in the eye, but he does not recognize faces and generally remains expressionless. On occasion, though, he spontaneously breaks into a beaming, ear-to-ear toothless smile that always surprises me, and at which I cannot help but sheepishly smile back. The entire room seems to light up, if only briefly, and even the doctors (...) is extremely malodorous, enough to make me pause and catch my breath before I lean forward. As I draw his blood, a worry emerges from the back of my mind that the odor might cling to me for the rest of the day, that it will follow me as I meet with my classmates and instructors. This concern is so obviously superficial in nature that it is appalling. Soon I have a difficult time deciding which is more offensive, the smell in the patient’s room or this absent-minded preoccupation. Extremities Examination

2011 Clinical Correlations

5. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Update by the Infectious Diseases Society of America and the American Society for Microbiology (Full text)

container, RT, 2 h Abbreviations: AFB, acid-fast bacilli; CDC, Centers for Disease Control and Prevention; EDTA, ethylenediaminetetraacetic acid; NAAT, nucleic acid amplification test; RT, room temperature. a Contact the microbiology laboratory regarding appropriate collection and transport devices and procedures as transport media such as Cary-Blair or parasite preservative transport for stool specimens, boric acid for urines, and specialized containers for Mycobacterium tuberculosis are often critical (...) container, RT, 2 h Abbreviations: AFB, acid-fast bacilli; CDC, Centers for Disease Control and Prevention; EDTA, ethylenediaminetetraacetic acid; NAAT, nucleic acid amplification test; RT, room temperature. a Contact the microbiology laboratory regarding appropriate collection and transport devices and procedures as transport media such as Cary-Blair or parasite preservative transport for stool specimens, boric acid for urines, and specialized containers for Mycobacterium tuberculosis are often critical

2018 Infectious Diseases Society of America PubMed

6. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease

in a warm room to prevent arterial vasoconstriction in response to the cold. TcPO 2 measurements are performed with a standardized protocol and are taken at multiple sites. 117 The likelihood of wound healing decreases with toe pressure 30 mm Hg has been used to predict ulcer healing. 118 SPP =30 to 50 mm Hg is associated with increased likelihood of wound healing. 113 TcPO 2 and SPP can be used in angiosome-targeted assessment for revascularization. 119 Additional perfusion assessment may also

2017 American Heart Association

8. Newborn Nursing Care Pathway

and as defined by the woman) is encouraged to support and participate in all aspects of newborn care • While in hospital (whenever possible), assessments and procedures should be performed in the mother’s room (to ensure mother-infant togetherness and to provide anticipatory guidance and information) Introduction3 Newborn Guideline 13: Newborn Nursing Care Pathway • Prior to, during, and following procedures that may cause newborn discomfort/pain, mothers should be encouraged to comfort their newborns (...) differentiates pleasant from unpleasant odors • Nares patent • Milia present on nose Parent education/ Anticipatory Guidance • Sneezing common Variance • Nasal congestion Intervention • Nursing assessment • Refer to PHCP prn Norm and Normal Variations • Refer to POS Parent education/ Anticipatory Guidance • Refer to POS Variance • Refer to POS Intervention • Refer to POS Norm and Normal Variations • Refer to POS Parent education/ Anticipatory Guidance • Refer to POS Variance • Refer to POS Intervention

2015 British Columbia Perinatal Health Program

9. Telehealth Services for the Treatment of Psychiatric Issues

standard telephones with or without some type of voice-recording technology, and written information via the internet. 5 Telepsychiatry has been performed at several sites including hospitals, emergency rooms, community mental health centers, clinics, physician offices, nursing homes, assisted living facilities, prisons, schools, and patients’ homes. 1,2,5,6 Care provided through telepsychiatry includes pre-hospitalization assessment, in-hospital care, assessment post-hospital follow-up care, scheduled (...) specific psychiatric diagnoses, treatments, or populations. 4,5,7 Disadvantages of telepsychiatry include the fact that some areas do not have the necessary telecommunication connectivity, and diagnostic assessment may be liable to variations according to technical issues including devices characteristics, bandwidth and resolution, and even room setup where the patient receives the care. 1,3,4 Although many studies and reviews have been published on telepsychiatry and telemental health care, the area

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

10. Patient Dignity (Formerly: Patient Modesty): Volume 93

have had those procedures w/o sedation, I was allowed to keep my pants and underwear on for an upper endoscopy and a T.E.E., both procedures for which having nothing on but a gown is standard protocol, and when I had a little dust up with Dermatology over not wanting a female scribe and LPN in the room for my exam, Patient Relations went to bat for me and effected a policy change in large part because of the manner in which I presented my complaint. I overheard the Patient Relations person (...) 56 of "Patient Modesty". ( Photograph from obtained through Google Images. ) Now that we are focusing on patient dignity, it would be of interest to compare dignity vs modesty as applied to a patient fully asleep under anesthesia within the operating room. Might I suggest that modesty is no longer a matter of ethical concern when the patients body is uncovered but the issue becomes the preservation of dignity. Modesty requires awareness . Anyone want to discuss this conclusion related

2019 Bioethics Discussion Blog

11. Nutrition in Cancer Care (PDQ®): Health Professional Version

sections comprising 17 data points evaluating weight/weight history, food intake, symptoms, and activities/function. The remainder of the PG-SGA is completed by a health care practitioner, accounting for information about disease and metabolic demand and the completion of a physical exam. The abPG-SGA and PG-SGAsf use only the section completed by the patient. Responses are then scored and, on the basis of the score, patients are stratified into four nutrition triage categories:[ , ] No intervention (...) . Education by registered dietitian or other clinician. Intervention by registered dietitian. Critical need for improved symptom management. The drawback is that the PG-SGA takes more time to administer and requires a trained health care practitioner to complete the physical assessment portion. With validation of the short form, the need for physical exam is eliminated, and the practitioner’s administration time is reduced. The benefit of the PG-SGA (PG-SGAsf) is that it collects clinical information

2017 PDQ - NCI's Comprehensive Cancer Database

13. Screening Pelvic Examination in Adult Women (Full text)

Talenti Unaffiliated July 1, 2014 Really? I'm not sure what the impetus for this study was, but it appears to follow from the societal conditioning that women's bodies are inherently more private than men's. We do back flips trying to find a female chaperone for pelvic exams, but don't seem to care who is in the room for male GU exams, rectal exams, or Foley insertions. Even for symptomatic patients, we treat women differently. For the woman with UTI symptoms, do you do a pelvic? Most do (...) prospective observational study (269 participants) compared the Amsel criteria for screening for bacterial vaginosis with the reference standard of Gram staining. According to the Amsel criteria, a diagnosis of bacterial vaginosis can be made if vaginal secretions obtained by swab during the pelvic examination contain 3 of the 4 following characteristics: thin, homogeneous consistency; pH greater than 4.5; presence of clue cells on microscopic evaluation; and release of amine odor after the addition

2014 American College of Physicians PubMed

14. Life as a doctor is selfless and selfish at the same time

Coumadin clinic, where his INR was checked biweekly and blood thinner dose adjusted appropriately. According to the primary team, the lab called his cell phone and instructed him to come to the hospital immediately for an INR level of 17. On questioning him, they found that he had been taking twice the prescribed dose of Coumadin. I went to the patient’s room to do a full history and physical exam. Roy was a 78-year-old gentleman with scraggly hair and pockmarked skin. He was probably five-foot-seven (...) odor. I was apathetic, overtaken by a weariness I vowed as a medical student never to have. Morning rounds passed without incident. All our CABG patients were more or less stable. I collected each patient’s overnight events, vital signs, laboratory values, daily chest X-ray, EKG, fluid balance and wound status. With my attending’s blessings, I titrated their blood pressure drips to protect their blood vessels, kept them sedated and paralyzed if they were mechanically ventilated, fed them

2018 KevinMD blog

15. Patient Modesty: Volume 88 (Full text)

/rectal exams, the physician later fired that NP just because people online were stating that she bad mouthed all clients (patients) after leaving the exam room – he never gave a crap that she was abusing male clients and never reported her to the BON! She has no place even in the mak’emsick industry! But, because that physician was a coward who feared only for his own scrawny hide, she is free to continue abusing! This ugly scenario is so typical of the industry! For a physician to not report abuse (...) by seeing the exam unfold from a picture mirror located in the exam room. Very odd case. Lastly, this is a case of which I cannot validate but was a post by a male patient in regards to an incident by a female nurse taking a cell phone pic of her male patient’s genitals. The poster states that he had to have a cystogram, that he was told that he would be awake for this cystogram. Now he stated previously that his first cystogram he was given conscious sedation but this time he would be awake. He went

2018 Bioethics Discussion Blog PubMed

16. Patient Modesty: Volume 90

by a dietitian. Because a lot of patients are diabetic, so it’s important. Billy bob is brought by ambulance to the hospital and admitted and he is found to have a high blood sugar of over 600. Technically, he should be in a coma. Billy bob dosen’t like the hospital food cause it tastes bland so Billy Bob orders a pizza from the local Pizza Hut and has it delivered to his room, his favorite, anchovies, pepporini, double cheese and mushrooms. But Billy Bob is non-compliant with the physicians orders regarding (...) to interact with a patient as in year 1 they learn how to take vital signs, abdominal exam, neurologic exam, mental status exam and ophthalmic exam. I will have 2 or 3 female students in my group of 6. Do I teach differently based on the gender of my student and reflecting on the gender of their patient? If you were teaching what would you say to those 3 male and 3 female students? Here is the chance for those visitors to this blog thread to contribute something to my education and possibly

2018 Bioethics Discussion Blog

17. AAWC Pressure Ulcer Guidelines

, treatment, procedure or falls (Manesse et al., 1994): time spent immobile, room temperature, pressure reducing surfaces used and repositioning considerations if appropriate to patient for all settings a. Acute care , including Emergency Department (Schoonhoven et al, 2006; Langemo et al 2006; Linares et al., 1987 Lyder et al 2001) Association for the Advancement of Wound Care Guideline of Pressure Ulcer Guidelines Legend: Bold: Evidence Level A. Italics = Level B, Normal = Level C; Underlined if cost (...) analysis was performed. Each recommendation has Content Validity > 0.75 based on 31 multidisciplinary independent survey respondents. © Association for the Advancement of Wound Care 2010 October 1, 2010 Page 3 of 14 b. Long term care (Bergstrom & Braden 1992; Bergstrom, Braden, Kemp et al., 1998) c. Operating room and post-anesthesia care unit (Schoonhoven et al, 2006; Aronovich 2007) d. Procedural lab; e.g. for oncology, radiological or catheter-related procedures such as dialysis (Reed et al., 2003

2011 Association for the Advancement of Wound Care

18. Patient Modesty: Volume 79

Doctors" thread, and I don't relate to it at all. Perhaps the difference is that I don't expect doctor's to be all-knowing and perfect. As a child I paid dearly for a missed emergency room diagnosis and so I know the downside of medicine. We say the art of medicine rather than the science of medicine. We use the term medical practice, not medical perfect. There are often going to be multiple possible diagnoses, and the wrong one is sometimes going to be chosen. Get a second opinion if your belly (...) to avoid spectators for my intimate care. BTW, I'd like to repeat my "plug" for folks to try commenting on the following articles: This one relates to the issue of men's gender preferences in health care: https://insight.athenahealth.com/new-data-suggests-male-patients-less-likely-return-women-doctors This one is an abstract for a presentation advocating for a universal law requiring "chaperones" for intimate exams. The speaker (who has "MD" after her name) makes the ridiculous claim that required

2017 Bioethics Discussion Blog

19. Solving the telephone problem in primary care

night, when we were cleaning up a mess we discovered in an exam room in the practice, I looked at the product warning label (in English and French!) on the bottle of “odor eliminator” (air freshener) that is provided to our practice to use. It says, “In case of eye or skin contact, flush immediately with water for 15 minutes. Seek medical attention if necessary.” Note that it doesn’t say put down the bottle and called 911. It gives the person using this noxious chemical a little bit of leeway

2017 KevinMD blog

20. Obese patients are among our most vulnerable

— an intravenous catheter to infuse fluids or medications — takes more time. A physical exam is more difficult and invariably less precise: heartbeats and breath sounds are muffled by the layers of fat; palpating abdominal organs is practically impossible. When the nurse went into the patient’s room to draw labs, she couldn’t get an intravenous line in. She called a fellow nurse, who tried a few times. She, too, failed. Thus, the doctor was called to put in a femoral line. When arms and hands fail, we go (...) the reason the patient is the way she is, perhaps we should instead recognize these patients for what they are — among the most vulnerable of all. Sure, we felt frustrated by the extra work our patient’s body habitus put us through. But it was not her choice to be in that room with layers of fat lifted by a stranger, causing that smell to emanate from her skin. She didn’t put that on us — we put that on her . If having witnesses to your body’s odors isn’t uncomfortable, then what is? In the ED, we only

2017 KevinMD blog

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