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Family Practice Notebook Updates 2016

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81. Tick Bite

and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) , inflammation and in some cases necrosis ( species) Woodchuck Tick (Ixodes cookei) Powassan XI. Prevention See See XII. Resources CDC Tickborne Diseases XIII. References Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Tick Bite." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Tick-Borne Diseases

2018 FP Notebook

82. Kaolin Mineral Dressing

. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 11/4/2016 and last published on 3/3/2019 . Contact 2019 Family Practice (...) prefer on wounds not amenable to (e.g. high femoral wound) V. References Mason, Spangler and Nichols (2016) EM:Rap 16(11): 10-11 Kheirabadi (2011) US Army Med Dep J p. 25-37 Swaminathan and van de Leuv (2013) Crit Dec in Emerg Med 27(8): 11-17 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Kaolin Mineral Dressing." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip

2018 FP Notebook

83. Smoke Inhalation Injury

specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 4/4/2016 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | |

2018 FP Notebook

84. Chitosan Dressing

and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 11/4/2016

2018 FP Notebook

85. Thrombin Hemostatic

revised on 11/4/2016 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | |

2018 FP Notebook

86. Aluminum Chloride

published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) are a random sampling from a Bing search on the term "Aluminum Chloride." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Cost: Medications xerac (on 7/20/2016 at ) XERAC AC 6.25% SOLUTION Generic OTC $0.17 per ml FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans

2018 FP Notebook

87. Topical Hemostatic Agent

/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) concentration at wound sites via water absorption Efficacy Slower control of bleeding Significantly increased survival in animal models Advantages Available as gauze rolls (3 inch wide, 4 yard long) that are now primary hemostatic agent used on battlefield XVI. References Berry in Schrage (2013) Topical Hemostatic Agents, Medscape Emedicine Kheirabadi (2011) US Army Med Dep J p. 25-37 Mason, Spangler and Nichols (2016) EM:Rap 16(11): 10-11 Peralta in Sanfrey (2013) Overview of Topical Hemostatic Agents

2018 FP Notebook

88. BIPAP

literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 4/12/2018 and last published on 3/2/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) ( ) Hypoxic (Oxygenation failure) BIPAP is in practice typically used instead of Exacerbation or Severe Hypercarbic ( y Failure) Bridge to or from (e.g. or ) Do-not-intubate status III. Contraindications See See Indications (requires intubation) with increased aspiration risk IV. Mechanism Noninvasive Similar to except offers two pressure levels instead of one continuous pressure Preset inspiratory airway pressure (IPAP) Preset expiratory airway pressure (EPAP) is increased by expiratory pressure (EPAP

2018 FP Notebook

89. Medication Compliance

found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 3/2/2018 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) , updated medication list at each visit (part of after visit summary) Employ reminder systems to take medications Use pill boxes Time medication delivery with daily activities Consider alarms or phone applications to issue reminders Consider mobile applications (e.g. Medisafe, Dosecast) Involve pharmacists Consider pharmacy consultants to review medications with patients May help to eliminate compliance barriers (e.g. cost, adverse effects) Patients should share their medication lists

2018 FP Notebook

90. Medical Cognitive Error

is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 10/3/2018 and last published on 3/2/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) making is a combination of thin and Thick Slicing Thin Slicing (fast and intuitive) Formulate initial patient plan based on limited information, gestalt, pattern recognition and intuition Allows for rapid emergency decision making Often accurate, especially in more expert clinicians (but risky in medical trainees) Pitfalls Requires experience, training and practice, with constant exposure to cases, simulations, peer review Risk of anchor bias and Confirmation Bias Processing occurs in the prefrontal

2018 FP Notebook

91. Hydrocodone

Practice Notebook, LLC. | | | | (...) Generic $2.01 each HYDROCODONE-IBUPROFEN 7.5-200 Generic $0.31 each vicodin (on 3/22/2017 at ) VICODIN 5-300 MG TABLET Generic $0.96 each VICODIN ES 7.5-300 MG TABLET Generic $1.11 each lortab (on 12/21/2016 at ) LORTAB 10 MG-300 MG/15 ML ELXR $0.37 per ml zohydro (on 3/22/2017 at ) ZOHYDRO ER 10 MG CAPSULE $7.61 each ZOHYDRO ER 15 MG CAPSULE $8.19 each ZOHYDRO ER 20 MG CAPSULE $8.38 each ZOHYDRO ER 30 MG CAPSULE $8.62 each ZOHYDRO ER 40 MG CAPSULE $8.93 each ZOHYDRO ER 50 MG CAPSULE $9.30 each

2018 FP Notebook

92. Violence in the Hospital

revised on 3/8/2016 and last published on 12/2/2018 . Contact 2018 Family Practice Notebook, LLC. | | | | (...) harbor the mentally ill for long periods while arranging disposition are often cared for in emergency departments (escape attempts are common) Family members of patients with medical adverse events may target health workers as revenge III. Management: General Maintain constant awareness of surroundings and disruptions Plan for violent events in the hospital Pre-planned strategy offers best chance of survival Active Shooter situations are a rapidly developing "fight for your life" Survival relies

2018 FP Notebook

93. Venous Blood Gas

contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 12/5/2016 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | |

2018 FP Notebook

94. Hyperlipidemia in Diabetes Mellitus

and last published on 3/2/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) medical reference for primary care and emergency clinicians. Started in 1995, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 12/5/2016

2018 FP Notebook

95. Orbital Ultrasound

to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 9/4/2016 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) VIII. Precautions Avoid any pressure to the eye if is suspected (risk of vitreous loss) IX. References Frasure (2014) Crit Dec Emerg Med 28(8): 2-9 Laudenbach (2016) Ocular Ultrasound,Stabroom.com online video, accessed 4/1/2016 Noble (2011) Manual Emergency and Critical Care , Cambridge University Press, p. 203-11 Reardon (2011) Pocket Atlas of Emergency , McGraw-Hill, p. 259-69 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term

2018 FP Notebook

96. Enoxaparin

is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 7/19/2016 and last published on 3/2/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See for financial assistance information. Ontology: Enoxaparin (C0206460) Definition (NCI_NCI-GLOSS) A drug used to prevent blood clots. It belongs to the family of drugs called anticoagulants. Definition (NCI) A low molecular weight, synthetic heparin

2018 FP Notebook

97. Bladder Ultrasound

, this collection now contains 6656 interlinked topic pages divided into a tree of 31 specialty books and 728 chapters. Content is with systematic literature reviews and conferences. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 4/1/2016 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | |

2018 FP Notebook

98. FAST Exam

. Although access to this website is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians. This page was written by , last revised on 11/5/2018 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) FAST Exam Subcostal (Dr. Mandavia, Sonosite) Right Upper quadrant FAST Exam RUQ (Dr. Mandavia, Sonosite) FAST Exam RUQ -Normal (Dr. Mandavia, Sonosite) FAST Exam RUQ - (Dr. Mandavia, SonoSite) Left Upper quadrant Left upper quadrant FAST Exam LUQ (Dr. Mandavia, Sonosite) Suprapubic FAST Exam Suprapubic (Dr. Mandavia,SonoSite) FAST Exam Female (Dr. Mandavia, SonoSite) Fast Exam (Dr. Mandavia, SonoSite) FAST Exam - (SonoSite) (Dr. Perera, SonoSite) VIII. References Reardon (2016) , Stabroom.com

2018 FP Notebook

99. Oxycodone

concerns with their physicians. This page was written by , last revised on 7/10/2018 and last published on 3/3/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) , 40, 60 mg, 80 mg sustained release formulations ric in U.S. as of 2016 Precautions Start with short acting Oxycodone and convert to long acting based on pattern of requirements Titrate slowly: 80 mg is very high dose and only for tolerant patients Do not break or chew sustained release product (risk of ) Sustained release product is intended only for scheduled use (not prn) Oxycontin true duration of action approaches 6 hours (instead of 12 hours) in many patients Oxycontin may offer no duration

2018 FP Notebook

100. Vasopressor

/2019 . Contact 2019 Family Practice Notebook, LLC. | | | | (...) Immediately (even if skin site has not yet whitened) Dilute Phentolamine vial (5 mg/ml) in 9 ml Inject diluted phentolamine 0.1 to 0.2 mg/kg (up to 10 mg) SQ into extravasation site Second dose may be needed Consult plastic surgery References Orman and Weingart (2016) EM:Rap 16(5): 12-3 V. Preparations: Push Dose Pressors (Bolus Dose Pressors) Indications Temporizing measure in severe (MAP <60 mmHg) Bolus pressors typically via peripheral IV (prior to central access) ral Used initially prior to central

2018 FP Notebook

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