Week 1


Surgery

posted Jul 10, 2014, 2:18 PM by Unknown user   [ updated Aug 4, 2014, 4:15 PM ]

The first week of our clinical immersion has passed, and boy do I have a lot to share. I didn't think I would have seen this much right away and in such a short period of time. On our second day, we were already changing into scrubs and observing surgery in the OR. One procedure that I found really interesting and also had a really good view of was the total knee replacement. I didn't get any actual pictures in the OR, but this picture (below) from the company OrthAlign is pretty close to what I saw. The vendor from OrthAlign was actually in the OR as well, where he essentially walked the surgeons through which equipment to use. The surgeons wore body exhaust systems or "space suits" which include helmets with battery operated fans (also pictured below). After the operation, the vendor showed us how his device, KneeAlign, works. The device utilizes accelerometers for both tibal and femoral alignment.

When we weren't in the OR, we were shadowing Dr. Gonzalez as he saw patients in the clinic. Dr. Gonzalez specialized in hand, hip, and knee replacements. The system at the clinic was very organized, especially considering how hectic things can get. Dr. Gonzalez told us he typically sees around 90 patients a day! The process begins by the nurse first bringing in a patient to a room and putting up a green flag outside the door (to inform the residents the patient is ready to be seen). A resident or med student then comes in (raising both red and green flags) to meet with the patient and gather information, which he or she then bring to the attending physician (Dr. Gonzalez) to be further assessed. The attending goes back to see the patient and gives his final consultation. In some cases, a red flag is then raised meaning the patient needs further assistance. For example, a knee brace or cast. One concern I noticed while observing in the clinic is the doctor's office is fairly small and can get really crowded and difficult to maneuver around.

Femoral Navigation http://www.orthalign.com/videos/

First Day

posted Jul 10, 2014, 1:31 PM by Unknown user   [ updated Aug 4, 2014, 4:18 PM ]

To begin, my experience at the Orthopedic Clinic was a very brief but eventful first day. When we arrived at the clinic we were introduced to Dr. Chmell, who was constantly being bombarded with questions by med students. We proceeded to shadow Dr. Chmell as he saw patients and watch as new residents gave knee injections. We even had the opportunity in assisting in putting a knee brace on a patient (pictured below). The doctor's office was always very busy and crowded, with doctors coming in and out to view X-rays and assess patients. In the hall, red and green flags hung outside each patient door. If a green flag was raised up, it meant the patient needed to be seen. If both green and red flags were raised, then the patient was in the process of being seen. Lastly, a raised red flag meant the patient had already been seen and was awaiting further assistance (such as putting on a knee brace). One important thing to take away from this experience is the importance of hand hygiene, as evident from the various signs hanging around the office reminding doctors to wash their hands and the hand sanitizer dispensers located in the halls.

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