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Stroke got you thinking of freestyle & butterfly? Do you avoid people w/ focal neuro deficits? Let’s channel our inner Michael Phelps as we swim thru this #POPCoRNtweetorial adapted by @robertdaulton on our way to mastering the Stroke/TIA work-up #POPCoRNet #COVIDPOPCoRN 1/
Ischemic: occlusion from thrombus/embolus/hypoperfusion
-Large vessel atheroscler./small vessel dz/cardioemboli
Hemorrhagic: intracerebral/subarachnoid hem from intracranial vessels
-HTN, aneurysm rupture, cerebral amyloid angiopathy, vasc malform #POPCoRNtweetorial 2/
-Large vessel atheroscler./small vessel dz/cardioemboli
Hemorrhagic: intracerebral/subarachnoid hem from intracranial vessels
-HTN, aneurysm rupture, cerebral amyloid angiopathy, vasc malform #POPCoRNtweetorial 2/
DDx: TIA (transient, no CT findings, resolves in 24 hrs), complex/hemiplegic migraine (slow spread of symps), venous sinus thrombus
Now for the work-up:
1. Est timeline, last known well (LKW)
2. POC Glucose
3. Neuro Exam: NIHSS (mdcalc.com/nih-stroke-sca…) #POPCoRNtweetorial 3/
Now for the work-up:
1. Est timeline, last known well (LKW)
2. POC Glucose
3. Neuro Exam: NIHSS (mdcalc.com/nih-stroke-sca…) #POPCoRNtweetorial 3/
Like a proud parent, there comes a time when we must release our patients into the real world, one free from heparin shots, catheters, & miralax (maybe). When your adult patients are ready for discharge, refer to this #POPCoRNtweetorial for a few tips. #POPCoRNet #COVIDPOPCoRN 1/
et’s get them home. Does OT/PT/Speech need to see them? Does the pt have appropriate care at home per recs? Are they going home/assisted living facility, home with services (visiting nurse/OT/PT), SNF, Inpatient Rehab (IRF), LTACH, or another hospital? #POPCoRNtweetorial 2/
Considerations for meds:
Pt education on lovenox/insulin/nebs/inhlaers
Can they afford meds? Refills?
Confirm pharmacy & send 1mo supply (non-opiates)
Pill pack? Let the pharmacy know so they can prep
Going to SNF/IRF on Fri/wknd? Send 3 day supply of controlled substances 3/
Pt education on lovenox/insulin/nebs/inhlaers
Can they afford meds? Refills?
Confirm pharmacy & send 1mo supply (non-opiates)
Pill pack? Let the pharmacy know so they can prep
Going to SNF/IRF on Fri/wknd? Send 3 day supply of controlled substances 3/
Are you a peds provider caring for adult pts in a COVID-19 world? Last admitted an adult as a 3rd year med student? In this #POPCoRNtweetorial, we will lay the groundwork for how to get this admission started off on the right foot. #POPCoRNet #COVIDPOPCoRN 1/
You can’t ask EVERYTHING in your Hx, but definitely ask this:
Substance use: frequency, duration, last use (esp. EtOH & Benzos)
Functional status: who lives at home, help with ADLs or meds?
Code status, advanced directives, healthcare proxy or POA
#POPCoRNtweetorial 2/
Substance use: frequency, duration, last use (esp. EtOH & Benzos)
Functional status: who lives at home, help with ADLs or meds?
Code status, advanced directives, healthcare proxy or POA
#POPCoRNtweetorial 2/
What can your pt order on Door Dash?
DM: diabetic diet
CAD: low chol & sat fats
(pre)HTN: Na <2g/day
CHF: Na <2g/day + <2L fluids
ESRD: low phos, 60mEQ K
ESLD: low protein, Na <2g/day +/- <2L fluids
EtOH: multivit, folate, B12, aspiration risk?
#POPCoRNtweetorial 3/
DM: diabetic diet
CAD: low chol & sat fats
(pre)HTN: Na <2g/day
CHF: Na <2g/day + <2L fluids
ESRD: low phos, 60mEQ K
ESLD: low protein, Na <2g/day +/- <2L fluids
EtOH: multivit, folate, B12, aspiration risk?
#POPCoRNtweetorial 3/
