From: Scott Morris (swm@emanon.com)
Date: Fri Aug 22 2003 - 13:43:09 GMT-3
#11 is a little vague. Should we ask the attending for more
clarification on that?
Also, #2 is a bit harsh. In the real world we'd likely use an IV push,
but perhaps that's the difference between these silly lab exams and the
real world, huh?
For #5, would you recommend going with a vertical or horizontal
incision? I know both give me the same result in the end, but I'm
really not sure what people are looking for here. And with these
auto-grading systems it's not just about the patient still living in the
end!
-----Original Message-----
From: nobody@groupstudy.com [mailto:nobody@groupstudy.com] On Behalf Of
Howard C. Berkowitz
Sent: Friday, August 22, 2003 11:39 AM
To: CCIE Lab group
Subject: Re: Friday humor: New to Medicine
At 10:38 AM -0400 8/22/03, Charles Church wrote:
>Variation on a theme :)
>
>
>Hi I am new to the medical field I have a quick question for you
>doctors. What book should I read to be a surgeon? I read a book and
>now I am veterinarian. I want to continue my learning and become a
>smart medical guy. How can I get to the six figure plus salaries the
>fastest? I have very little medical experience except using drugs and
>a complete mastery of Milton-Bradley's 'Operation' board game but I can
>really scalpel around to get this stuff working. I think brain surgeon
>is the next logical step. Also I was reading about appendectomy and
>forceps, does anybody have any good explanations of how these thingies
>work?
Appendectomy? Assuming an open rather than laparoscopic procedure
1. Diagnose appendicitis. This is often the hard part.
2. Put patient to sleep or at least use a spinal anesthetic.
3. Using a #10 blade, incise the skin and subcutaneous fat, directing
the incision laterally and inferiorly through MacBurney's point
4. Changing to a clean scalpel, incise the four muscle planes and
retract,
with appropriate hemostasis.
5. With a new scalpel, incise the omentum and peritoneum.
6. Locate the appendix and double-clamp the stump. If there is
peritonitis,
call for help.
7. With a Metzenbaum scissors, cut between the clamps.
8. Rinse the area, suction, and suture the stump. Send appendix to
pathology so they can tell you what you removed. If you removed
the
assistant surgeon's finger, you probably already know that.
9. Repair the incisions.
10. Wake up the patient.
11. Bill somebody.
Was that clear?
(begin standard rant about L3 switch), you have to realize the
boundary between forceps and clamps is sort of like the boundary
between routers and L3 switches. There is much more variability
within forceps and clamps than among Cisco products. Offhand, clamps
I've used include Kelly, Mayo, mosquito, Crile and Ochsner styles,
with straight and bent tips, traumatic and atraumatic tip finishes,
and an assortment of lengths.
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