Takotsubo Cardiomyopathy POD

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TAKOTSUBO CARDIOMYOPATHYWHAT IS IT?

  • Weakening of the left ventricle after an emotional stress

  • Aka Broken Heart

PRESENTATION

  • Classically in postmenopausal women after an emotional stress

  • Chest pain and SOB

  • ECG resembles a STEMI

  • Rapid but small rise in troponin (actual STEMI troponin takes longer to rise but has higher peak)

  • NEGATIVE angiogram

  • ECHO- ballooning of LV

HOW DID IT GET ITS NAME?

Takotsubo= a pot used to catch octopi—resembles the LV apical ballooning that occurs

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ED MANAGEMENT: STEMI alert

** only way to differentiate from a STEMI is a negative angiogram.

PROGNOSIS: much better than STEMI.

  • Most patient’s fully recover in 2 months

  • In hospital mortality= 4%

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Trauma Tuesday POD- Hare Traction Splint

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What is a Hare Traction Splint?

When to Use a Hare Traction Splint?—Midshaft femur fracture when there is no evidence of pelvic or lower leg injury.

How to apply a Hare Traction Splint?

  1. Expose the injured limb.

  2. Measure distance of splint on uninjured leg- Should be 6-8inches past ankle.

    1. Measure on opposite leg of fracture as femur fracture side can be shortened

    2. Apply ankle hitch

    3. Slide splint under injured leg.

    4. Fasten the ischial strap.

    5. Connect loop of ankle hitch to splint

    6. Tighten the ratchet so the splint holds the traction

    7. Apply the rest of the straps- avoiding the fracture site.

    8. Assess neurovascular function

Here is a link to a video to see how it is applied!

https://youtu.be/498SydRP4jg

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Trauma Tuesday POD- BOWING FRACTURE

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BOWING FRACTURES  

What is it?

  • Incomplete fracture of tubular long bones pediatric patients.

    • Commonly radius and ulna

Presentation:

  • Fall on outstretched hand. Child presenting with pain and swelling of forearm

How does it happen?

  • Pediatric bones bend because the cortex is thinner than adult bones.

Management

  • Depends on degree of angulation

    • <20degrees= splint

    • >20 degrees= reduction of bowing (call orthopedics)

      • during the reduction they are very prone to fracturing

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