RT3-AM evaluation summary

Summary of evaluation

Present materials: two H&Ps, ten pharm cards and one article

In site evaluation, I present a patient with boxer’s fracture. Patient is a 28 years old male with no significant past medical history complaints of pain of right hand a fight. No wrist pain, fight bite, decreased sensation, loss of sensation, numbness, or tingling. Physical examination show swelling, bruising, tenderness to palpation along 4th and 5th metacarpals, capillary refills < 2 seconds, no neurovascular compromised. This case allows me to explore splinting skills and review different splinting as well. For this case, patient needs ulnar gutter. I also find an article which compare the outcomes of soft wrap and buddy taping and reduction and cast in boxer’s fracture, the result showing soft wrap is not inferior to casting. My patient is a lawyer, cast is inconvenient for him to runs his office. And he prefers soft wrap if the evidence shows no inferior to casting.

For the second case, I write up for suspected testicular torsion. Patient is a 24 years old male with no significant past medical history complaints of left testicular pain, tenderness, elevated testicle and intermittent left lower abdominal pain for 2 weeks. Denies fever, chills, nausea, vomiting, diarrhea, rectal bleeding, blood in stool, or urinary symptoms. Physical examination findings with left cremasteric reflex diminished, left testicle tender to palpation, elevated lie noted. Patient was sent to emergency room for ultrasound.

Feedback received

Prof. Sadat gave feedback for my H&Ps. In the management part for urgent care, should document patient’s presentations after procedure, for example, patient tolerate procedure well, in no acute distress.

Need to improve:

  • Will need to work on plan part, documentation on the procedure, and make decision about when to send the patent to ER
  • Whether to order diagnosis imaging according to patient’s presentations
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