During my shadowing shift I got the opportunity to see X-rays of a tibia fracture and of an ulna fracture. The resident I was with taught me to splint the tibia and ulna and let me assist him. First the resident measured the plaster on the patient and then I counted out and folded 10 layers of the plaster. From there the medical student soaked the plaster in warm water and then it was ready to place on the patient.The split done for the tibia fracture was a posterior ankle and stirrup splint and for the ulna we did a sugar tong splint. Dr. Chhabra explained that splints are usually done in the ED in order to allow blood flow and inflammation which would otherwise be restricted with a cast. In both cases the patients were coming back to the ortho clinic and most likely will not need surgery.

Another patient we saw was a diabetic with a swollen finger draining pus. The resident performed a paronychia which required a lidocaine nerve block on the patients middle finger in order to numb. After waiting about a minute the resident took his blade and went in under the nail bed. Immediately after the pus began to drain along with some blood. This patient happened to be diabetic and had a blood sugar level of 500+ which was concerning to the resident so he order labs on him and also started an IV. The resident was concerned that he could go into diabetic ketoacidosis which is a condition where the body does not have enough insulin and produces excess ketones.

Lastly, Dr. Chhabra took me to see one of his patients that was diabetic and came in because of a nail puncture on the bottom of his foot. They ordered him a tetanus shot immediately. Then Dr. Chhabra showed me two places on the foot where he could take the pulse as well as the red swollen area that was warm to the touch. This patients case of cellulitis was not too bad but he was put on two different antibiotics which should help him recover. The concerning factor was if he were to get a fever or if the area of redness and inflammation grew bigger. The patient was discharged with antibiotics and should be doing better over the next couple days.