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(212) 234-1999

Medilex: The Experts on Medical Experts

About
Medical-Legal Triage
Services
Services and Procedures
Medical Expert Fields
Types of Cases
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Resources
A Spoonful of Medicine
Tales from Telephone Triage
Thought Leadership
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(212) 234-1999
michael lavinger
December 27, 2022
A Spoonful of Medicine

Nursing Responsibilities Regarding Temperature Instability

michael lavinger
December 27, 2022
A Spoonful of Medicine
Nursing Responsibilities Regarding Temperature Instability

Nurses are responsible to realize that subtle changes in temperature instability can be the first signs of a life-threatening infection.

Tagged: 9

michael lavinger
December 27, 2022
A Spoonful of Medicine

Risk Factors for Deep Venous Thrombosis

michael lavinger
December 27, 2022
A Spoonful of Medicine
Risk Factors for Deep Venous Thrombosis

The most important factors predisposing to DVT are immobility of the extremity and the presence of a hypercoagulable condition.

Tagged: 9

michael lavinger
December 27, 2022
A Spoonful of Medicine

Dialysis Clotting

michael lavinger
December 27, 2022
A Spoonful of Medicine
Dialysis Clotting

When a patient’s dialysis access is clotted, a dialysis center is required to contact a surgical service to arrange for declotting. That said, clotting is a very common occurrence and not an emergency. 

Tagged: 9

michael lavinger
December 27, 2022
A Spoonful of Medicine

Bowel Ischemia

michael lavinger
December 27, 2022
A Spoonful of Medicine
Bowel Ischemia

If bowel ischemia is not recognized and treated, the muscle layer of the bowel between the mucosa and serosa starts to die.  Soon, the serosa becomes ischemic and starts to die. 

Tagged: 9

michael lavinger
December 27, 2022
A Spoonful of Medicine

Acute Thrombosis of the Superior Mesenteric Artery

michael lavinger
December 27, 2022
A Spoonful of Medicine
Acute Thrombosis of the Superior Mesenteric Artery

Acute thrombosis of the SMA and/or its branches is a catastrophic event that can lead to ischemia and death of most of the small intestine and the right colon if not recognized and surgically treated. 

Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

Sepsis

michael lavinger
December 26, 2022
A Spoonful of Medicine
Sepsis

Sepsis is defined as life-threatening organ dysfunction secondary to an infection. The clinical spectrum of sepsis includes SIRS (systemic inflammatory response syndrome)…

Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

CT Angiogram (CTA)

michael lavinger
December 26, 2022
A Spoonful of Medicine
CT Angiogram (CTA)

A CTA shows vasculature in detail and is the test of choice when the vasculature is what needs to be evaluated. If the intent is to evaluate for vessel occlusion or blockage…


Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

Acute/Surgical Abdomen

michael lavinger
December 26, 2022
A Spoonful of Medicine
Acute/Surgical Abdomen

Acute abdomen is a clinical scenario marked by severe abdominal pain of acute onset, typically within 24 hours. The differential diagnosis is broad and includes the following…

Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

Elevated Lactic Acid Levels

michael lavinger
December 26, 2022
A Spoonful of Medicine
Elevated Lactic Acid Levels

An elevated lactic acid level can be caused by several entities including select medications, intense exercise, recent seizures, decreased clearance by the liver, and any clinical state marked by hypoperfusion or a low flow state.

Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

Acquired Versus Inherited Risk Factors for Deep Venous Thrombosis

michael lavinger
December 26, 2022
A Spoonful of Medicine
Acquired Versus Inherited Risk Factors for Deep Venous Thrombosis

Risk factors for DVT include any problem that alters the clotting system or alters blood flow in the deep veins.  These are broadly classified between acquired risk factors that enhance clotting and inherited thrombophilias.


Tagged: 9

michael lavinger
December 26, 2022
A Spoonful of Medicine

Treatment of Incarcerated Patients

michael lavinger
December 26, 2022
A Spoonful of Medicine
Treatment of Incarcerated Patients

Incarceration makes a patient’s post op management more complex.  Care of an inmate must take into consideration limitations on postoperative care.


Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Hammertoes, K-Wires, Nonunions, Pin Migration, and Pin Removal

michael lavinger
December 21, 2022
A Spoonful of Medicine
Hammertoes, K-Wires, Nonunions, Pin Migration, and Pin Removal

Hammertoes are the most common lesser toe deformity.  They make up nearly 50% of all forefoot surgeries.


Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Stroke, Intravenous tPA, and Last Known Well (LKW) Time

michael lavinger
December 21, 2022
A Spoonful of Medicine
Stroke, Intravenous tPA, and Last Known Well (LKW) Time

Intravenous tPA is the only FDA-approved (since 1996) medication for the management of acute ischemic stroke. tPA is a thrombolytic agent that breaks down the fibrin that binds clots together. When administered to a patient having an acute ischemic stroke, tPA has been demonstrated to reduce long-term disability.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Hippocampus Anoxia

michael lavinger
December 21, 2022
A Spoonful of Medicine
Hippocampus Anoxia

The hippocampus is the most oxygen-sensitive part of the brain. It is well-known that severe anoxia results in profound neuronal cell death.  Generalized and/or focal brain atrophy most frequently occurs in the hippocampus, the most oxygen-sensitive region of the brain.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Medication Errors in the Emergency Department

michael lavinger
December 21, 2022
A Spoonful of Medicine
Medication Errors in the Emergency Department

A medication error is a preventable event that can cause patient harm. ED medication errors are derived from prescribing, transcribing, preparation, and dispensing.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Chemical Exposures and Rheumatologic Diagnoses

michael lavinger
December 21, 2022
A Spoonful of Medicine
Chemical Exposures and Rheumatologic Diagnoses

Speaking generally, when chemical exposures cause medical sequelae, the duration of the claimed exposure is a factor (along with the quantitative extent of exposure and route of absorption) that may be determinative of whether a causal link exists.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Automated Dispensing Cabinets

michael lavinger
December 21, 2022
A Spoonful of Medicine
Automated Dispensing Cabinets

Automated dispensing cabinets [ADCs], such as Pyxis systems, are the most widely used medication safety technology.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Emergency Department Boarding

michael lavinger
December 21, 2022
A Spoonful of Medicine
Emergency Department Boarding

When patients are admitted to an inpatient service from the ED and no inpatient beds are immediately available for the patient, the patient may spend hours in the ED waiting for the inpatient bed. This is termed ED boarding.

Tagged: 8

michael lavinger
December 21, 2022
A Spoonful of Medicine

Patient Monitoring in the Emergency Department

michael lavinger
December 21, 2022
A Spoonful of Medicine
Patient Monitoring in the Emergency Department

In the ED, appropriate monitoring of seriously ill patients is of utmost importance.

Tagged: 9

michael lavinger
December 21, 2022
A Spoonful of Medicine

Ketamine Administration in the Emergency Department

michael lavinger
December 21, 2022
A Spoonful of Medicine
Ketamine Administration in the Emergency Department

Ketamine is a general anesthetic medication that is used both in the operating room for patients requiring general anesthesia to undergo surgery as well in the ED for sedation for painful procedures.

Tagged: 9

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