Weeks 54 & 55: Change Is Coming

I cut a long piece of cloth, resembling the texture and shape of a sock. I asked my ‘patient’ (a classmate) to hold her arm still as I slid the cloth over her hand and halfway up her arm. I then wrapped several layers of a cotton-like material over the “sock” on my patient’s arm, and prepared for the application of her arm splint (similar to a cast, but not encircling the entire limb). I then stacked eight sheets of plaster, which resembled the same size and shape of a piece of printing paper, and dipped the stacked sheets of plaster into a bucket of warm water. Placing the dampened plaster over the right side of my patient’s right arm, I molded the plaster splint around her forearm and thumb (since I was treating her for a lower thumb fracture). After several minutes, the plaster began to solidify, and I applied a few final layers of coverage (elastic bandages). Just like that, I had splinted by first (imaginary) fracture!

As is apparent, this week in Clinical Skills we learned how to splint a variety of bone fractures. Applying a splint is actually much easier and quicker than I expected it to be, only taking about ten minutes. From finger, wrist, and forearm fractures, to ankle sprains and lower leg dislocations, we practiced a good amount of splinting on one another. I splinted one arm and one leg of my partner, and she did similar forms of splints on my limbs as well. Something tells me this process will be a bit more difficult to perform on patients with actual fractures…those who I can’t tell to lift their arm or to keep their hand straight throughout the procedure, as we were able to say to one another during these practice runs.

The past two weeks have been gratefully manageable. In Emergency Medicine, we have been focusing on treatment of patients who present to the ED with endocrine emergencies, like diabetic (high/low blood sugar levels), thyroid, and adrenal gland emergencies. In Family Practice, we reviewed/learned how to work-up patients who present with fatigue, urinary tract infections, tick-borne diseases (Lyme disease), sexually transmitted infections, and infections of the skin (MRSA and fungal infections). Pathology has shifted focus to the study of the causes, manifestations, and microscopic appearances of a variety of gastrointestinal tract diseases, including diseases of the liver, gallbladder, and pancreas. Finally, in Pediatrics, we have started focusing on the diagnosis and treatment of HEENT (head, eyes, ears, nose, and throat) conditions in children. Since many of these conditions manifest similarly in adulthood, the past couple of weeks have been a great review of what we have covered over the past three semesters.

This semester is flying by! Only five weeks of classes stand between me and the completion of this first phase of PA school, and I am getting so anxious for the change that’s about to come. The next couple of weeks will get a bit crazy, mainly because I’ll have two eight hour days to endure this coming weekend, for a Radiology (x-rays, CT scans) review course on Saturday, and my clinical year orientation on Sunday. It’s never a good thing to lose a whole weekend, especially when it’s the only time available to catch up with the previous week’s material…but, too little time left to start complaining now!

Question of the week: Your patient presents to the emergency department with a dislocated forearm bone. When should you take an x-ray of your patient’s forearm? Before splinting, halfway into the splinting process, or after splinting (more than one choice may apply).

Last week’s (midterm) answers: True; Motor vehicle accidents; Subcutaneously; False; Endocrinology

Clinical Phase Countdown: 57 days, 1 hour, 35 minutes

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