Please read this and ADVISE... Tension Pneumothorax !!!

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Posted by Medicine Man from IP 173.215.214.72 on October 02, 2010 at 19:20:02:

I'm a little confuse with the SEQUENCING for the CCS. I have been doing usmleconsult and reading premier review CCS.It seems that PR approach is easier and UC is more complete ( but take too much steps to get to the same point).

In a Office senario you receive the patient, do physical, then order work-up, then make an appointment when all the results area available, evaluate exam results and finally give treatment. WELL, UC teach you to much steps, and frankly confuse me

Check this Tensional Pneumothorax cases:

Premier Review style.
1. Order: O2, Pulse Ox,Cardiac Monitor, IV access
2. Examination
3. Order:Needle Thoracostomy
4. Order: Chest tube insertion
5. Move the clock for chest tube insertion
6. Order: CXR, CBC, BMP, Coagulation profile
7. Vital signs
8. Pertinent physical
9. Interval history
10. Find all results
11. Transfer to Ward
12. Round next day
DONE!!!!!!

USMLE Consult style
1. Order: Pulse ox, Blood pressure monitor, Cardiac Monitor, O2, IV access, Normal saline, 0.9% NaCl, Elevate foot of bed.
2. Exam
3. Needle thoracentesis, ventilation, consult surgery, consult anesthesiology.
4. Advance clock to next available exam
5. Order: Vitals, Pulse O2, Cardiac monitor
6. Exam
7. Order: Thoracostomy, BMP,CBC,PT/PTT, Type and cross,Urinalysis,Morphine.
8. Advance to next available results
9. CXR
10. Exam
11.Advance to next available results
12. Admit to ICU
13. Advance to next available results
14. CXR, Cefoxian.
DONE ! ! ! !

Someone please give your opinion and ADVISE !!!!!
Should I continue with UC or try other material?????

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