Soldier's Manual and Trainer's Guide
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Telemedicine Management of Musculoskeletal Issues Nicole T
Telemedicine Management of Musculoskeletal Issues Nicole T. Yedlinsky, MD, University of Kansas Medical Center, Kansas City, Kansas Rebecca L. Peebles, DO, Ehrling Bergquist Family Medicine Residency Program, Offutt Air Force Base, Nebraska; Uniformed Services University of the Health Sciences, Bethesda, Maryland Telemedicine can provide patients with cost-effective, quality care. The coronavirus disease 2019 pandemic has highlighted the need for alternative methods of delivering health care. Family physi- cians can benefit from using a standardized approach to evaluate and diagnose musculoskeletal issues via telemedicine visits. Previsit planning establishes appropriate use of telemedicine and ensures that the patient and physician have functional telehealth equipment. Specific instructions to patients regard- ing ideal setting, camera angles, body positioning, and attire enhance virtual visits. Physicians can obtain a thorough history and perform a structured musculoskel- etal examination via telemedicine. The use of common household items allows physicians to replicate in-person clinical examination maneuvers. Home care instructions and online rehabilitation resources are available for ini- tial management. Patients should be scheduled for an in-person visit when the diagnosis or management plan is in question. Patients with a possible deformity or neuro- vascular compromise should be referred for urgent evaluation. Follow-up can be done virtually if the patient’s condition is improving as expected. If the condition is worsening or not improving, the patient should have an in-office assessment, with consideration for referral to formal physical therapy or spe- cialty services when appropriate. (Am Fam Physician. 2021;103:online. Copyright © 2021 American Academy of Family Physicians.) Illustration by Jennifer Fairman by Jennifer Illustration Published online January 12, 2021. -
Coding for Musculoskeletal System and Connective Tissue Diseases
Chapter 11 Coding for Musculoskeletal System and Connective Tissue Diseases Chapter Outline Objectives Musculoskeletal Disorders . Describe the pathology of common Arthritic Disorders musculoskeletal and connective tissue diseases. Chronic Versus Traumatic Joint Derangements . Recognize the typical manifestations, Pathologic Versus Traumatic Bone Fractures complications, and treatments of common Osteomyelitis musculoskeletal and connective tissue diseases in Necrotizing Fasciitis terms of their implications for coding. Costochondritis . Correctly code common musculoskeletal and Back and Spine Disorders connective tissue diseases by using the ICD-9-CM Connective Tissue Diseases and medical reports. Systemic Lupus Erythematosus Systemic Sclerosis Testing Your Comprehension Coding Practice I: Chapter Review Exercises Coding Practice II: Medical Record Case Studies Musculoskeletal and connective tissue diseases are classified in code section 710 to 739 of chapter 13 of the Disease Tabular of the ICD-9-CM, which includes diseases of the bones, muscles, joints, soft tissues, ligaments, tendons, and cartilage. To assist in your understanding, Table 11.1 reviews word parts and meanings of medical terms related to common musculoskeletal and connective tissue diseases. 283 284 Part II: Coding for Specific Diseases and Disorders Table 11.1 Word Parts and Meanings of Musculoskeletal and Connective Tissue Terms Word Part Meaning Example Definition of Example arthr/o joint arthritis Inflammation of a joint oste/o bone osteoarthritis Inflammation of -
Knee Examination (ACL Tear) (Please Tick)
Year 4 Formative OSCE (September) 2018 Station 3 Year 4 Formative OSCE (September) 2018 Reading for Station 3 Candidate Instructions Clinical Scenario You are an ED intern at the Gold Coast University Hospital. Alex Jones, 20-years-old, was brought into the hospital by ambulance. Alex presents with knee pain following an injury playing soccer a few hours ago. Alex has already been sent for an X-ray. The registrar has asked you to examine Alex. Task In the first six (6) minutes: • Perform an appropriate physical examination of Alex and explain what you are doing to the registrar as you go. In the last two (2) minutes, you will be given Alex’s X-ray and will be prompted to: • Interpret the radiograph • Provide a provisional diagnosis to the registrar • Provide a management plan to the registrar You do not need to take a history. The examiner will assume the role of the registrar. Year 4 Formative OSCE (September) 2018 Station 3 Simulated Patient Information The candidate has the following scenario and task Clinical Scenario You are an ED intern at the Gold Coast University Hospital. Alex Jones, 20-years-old, was brought into the hospital by ambulance. Alex presents with knee pain following an injury playing soccer a few hours ago. Alex has already been sent for an X-ray. The registrar has asked you to examine Alex. Task In the first six (6) minutes: • Perform an appropriate physical examination of Alex and explain what you are doing to the registrar as you go. In the last two (2) minutes, you will be given Alex’s X-ray and will be prompted to: • Interpret the radiograph • Provide a provisional diagnosis to the registrar • Provide a management plan to the registrar You do not need to take a history. -
Practice Description –Institutional Setting (Hsc) – Internal Medicine
NOTE: REMEMBER TO HIGHLIGHT CHANGES YOU MAKE TO THIS DOCUMENT IN BLUE SCHEDULE A PRACTICE DESCRIPTION –INSTITUTIONAL SETTING (HSC) – INTERNAL MEDICINE AREAS HIGHLIGHTED IN GREEN ARE FOR GUIDANCE IN COMPLETING THIS DOCUMENT. THESE AREAS WILL BE DELETED WHEN THE DOCUMENT IS IN ITS FINAL FORM. AMEND/MODIFY AREAS HIGHLIGHTED IN YELLOW AS APPROPRIATE – ENSURE ALL CONTENT YOU ADD IS HIGHLIGHTED IN BLUE SO THE REGISTRAR CAN EASILY IDENTIFY CHANGES DO NOT CHANGE OR DELETE CONTENT THAT IS NOT HIGHLIGHTED WITHOUT PRIOR WRITTEN APPROVAL FROM CPSM Clinical Assistant: INSERT NAME (hereinafter “Clinical Assistant”) Designated Primary Supervisor: INSERT NAME Date Practice Description approved by Registrar: [Insert date] Practice Location(s): INSERT LOCATION(S) Contents 1. Overview of the Practice Setting ......................................................................................... 2 2. Professional Practice of Clinical Assistant ............................................................................ 2 3. Prescribing and medications .............................................................................................. 22 4. Education and training ....................................................................................................... 23 5. Evaluation and assessment of performance ..................................................................... 24 6. College Reporting Requirements ....................................................................................... 29 Be advised that nothing in this document -
BASIC Approach to the Acutely Ill and Injured and Ill Acutely the to Approach
PARTICIPANT WORKBOOK PARTICIPANT BASIC EMERGENCY CARE: Approach to the acutely ill and injured APPROACH TO THE ACUTELY ILL AND INJURED BASIC EMERGENCY CARE APPROACH TO THE ACUTELY ILL AND INJURED Basic emergency care: approach to the acutely ill and injured ISBN (WHO) 978–92–4-151308–1 ISBN (ICRC) 978–2-940396–58–0 © World Health Organization (WHO) and the International Committee of the Red Cross (ICRC), 2018. Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO or the International Committee of the Red Cross logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO) or the International Committee of the Red Cross (ICRC). WHO and ICRC are not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization (http://www.wipo.int/amc/en/ mediation/rules). -
Podcast to Teach Clinical Reasoning to First
Brown S, Wood E, McCollum D, Pelletier A, Rose J, Wallach P MedEdPublish https://doi.org/10.15694/mep.2018.0000132.1 Description of a new education method or tool Open Access “Doctors’ Lounge” podcast to teach clinical reasoning to first-year medical students Shilpa Brown[1], Elena Wood[2], Daniel McCollum[3], Allen Pelletier[4], Jennifer Rose[5], Paul Wallach[6] Corresponding author: Dr Shilpa Brown [email protected] Institution: 1. Medical College of Georgia at Augusta University, 2. Medical College of Georgia at Augusta University, 3. Medical College of Georgia at Augusta University, 4. Medical College of Georgia at Augusta University, 5. Augusta University, 6. Indiana University School of Medicine Categories: Educational Strategies, Students/Trainees, Teaching and Learning Received: 06/06/2018 Published: 14/06/2018 Abstract In the first year of medical school, our students have a comprehensive course in history taking, physical examination skills, clinical reasoning, and patient-centered care. We have observed that first year students struggle to conduct a focused history and perform a focused physical examination on a given chief complaint. We developed an innovative program to address this concern in our Essentials of Medicine- Physical Diagnosis course. We created an online outline and audio podcast for students to review illustrating the key elements of the history of presenting illness, review of systems, other historical patient information, and focused physical examination for 3 specific chief complaints to assist them in their approach to these patients. This resource also included the discussion of the work up and treatment plans and was created in collaboration of Internal, Family, and Emergency Medicine to account for the various approaches to the same chief complaint within the various specialites of medicine. -
Open Wide – Mouth Is the Window to the Body. HEENT to HEENOT
Open Wide –Mouth is the window to the body. HEENT to HEENOT Dr. Vinod Miriyala BDS, MPH, CAGS, DDS Dr. Anna Novais DMD Objectives Make the case that oral health is an essential component of primary care. Present a practical framework for how to deliver preventive oral healthcare as a component of routine medical care. Share resources and information about existing practice in the state to implement this in your health center. Understanding the problem Lack of access to basic dental services contributes to profound and enduring oral health disparities in the United States. Millions of children and adults do not receive needed clinical and preventive dental services. In 2011, 6.1 percent of children and 16.4 percent of adults under the age of 65, did not receive needed dental care because their families could not afford it. Children are only one of the many vulnerable and underserved populations that face persistent, systemic barriers to accessing oral health care. Understanding the Problem Dental caries (cavities) and periodontal disease (gum disease) are largely preventable. Yet nationwide, among all ages, incomes, and life experiences, we have an unacceptably high burden of these chronic diseases. We’ve seen little improvement in oral health status over the past 20 years, and pervasive disparities remain: Poor and near‐ poor 5‐year‐olds are more than two times as likely to have tooth decay than their middle‐income peers. The Burden of Oral Disease: Children Decay: Tooth decay is the most common chronic disease of childhood. • Pain and infection can result in impaired nutrition and growth. -
JP 4-02.2 JTTP for Patient Movement in Joint Operations, 30 Dec 1996
Joint Pub 4-02.2 Joint Tactics, Techniques and Procedures for Patient Movement in Joint Operations 30 December 1996 PREFACE 1. Scope restrict the authority of the joint force commander (JFC) from organizing the force a. This publication delineates requirements and executing the mission in a manner the JFC and considerations for joint patient movement deems most appropriate to ensure unity of in the Health Service Support (HSS) system effort in the accomplishment of the overall as well as HSS aspects of joint patient mission. movement planning, special operations, and military operations other than war. The 3. Application doctrine described applies to the exercise of command and control by joint force a. Doctrine and selected tactics, commanders engaged in all types of techniques, and procedures and guidance operations and exercises. established in this publication apply to the commanders of combatant commands, b. Where specific tactics, techniques, and subunified commands, joint task forces, and procedures for HSS are not addressed in this subordinate components of these commands. publication, they can be found in Service HSS These principles and guidance also may apply documents. when significant forces of one Service are attached to forces of another Service or when 2. Purpose significant forces of one Service support forces of another Service. This publication has been prepared under the direction of the Chairman of the Joint b. The guidance in this publication is Chiefs of Staff. It sets forth doctrine and authoritative; as such, this doctrine will be selected joint tactics, techniques, and followed except when, in the judgment of the procedures (JTTP) to govern the joint commander, exceptional circumstances activities and performance of the Armed dictate otherwise. -
Musculoskeletal Clinical Vignettes a Case Based Text
Leading the world to better health MUSCULOSKELETAL CLINICAL VIGNETTES A CASE BASED TEXT Department of Orthopaedic Surgery, RCSI Department of General Practice, RCSI Department of Rheumatology, Beaumont Hospital O’Byrne J, Downey R, Feeley R, Kelly M, Tiedt L, O’Byrne J, Murphy M, Stuart E, Kearns G. (2019) Musculoskeletal clinical vignettes: a case based text. Dublin, Ireland: RCSI. ISBN: 978-0-9926911-8-9 Image attribution: istock.com/mashuk CC Licence by NC-SA MUSCULOSKELETAL CLINICAL VIGNETTES Incorporating history, examination, investigations and management of commonly presenting musculoskeletal conditions 1131 Department of Orthopaedic Surgery, RCSI Prof. John O'Byrne Department of Orthopaedic Surgery, RCSI Dr. Richie Downey Prof. John O'Byrne Mr. Iain Feeley Dr. Richie Downey Dr. Martin Kelly Mr. Iain Feeley Dr. Lauren Tiedt Dr. Martin Kelly Department of General Practice, RCSI Dr. Lauren Tiedt Dr. Mark Murphy Department of General Practice, RCSI Dr Ellen Stuart Dr. Mark Murphy Department of Rheumatology, Beaumont Hospital Dr Ellen Stuart Dr Grainne Kearns Department of Rheumatology, Beaumont Hospital Dr Grainne Kearns 2 2 Department of Orthopaedic Surgery, RCSI Prof. John O'Byrne Department of Orthopaedic Surgery, RCSI Dr. Richie Downey TABLE OF CONTENTS Prof. John O'Byrne Mr. Iain Feeley Introduction ............................................................. 5 Dr. Richie Downey Dr. Martin Kelly General guidelines for musculoskeletal physical Mr. Iain Feeley examination of all joints .................................................. 6 Dr. Lauren Tiedt Dr. Martin Kelly Upper limb ............................................................. 10 Department of General Practice, RCSI Example of an upper limb joint examination ................. 11 Dr. Lauren Tiedt Shoulder osteoarthritis ................................................. 13 Dr. Mark Murphy Adhesive capsulitis (frozen shoulder) ............................ 16 Department of General Practice, RCSI Dr Ellen Stuart Shoulder rotator cuff pathology ................................... -
Mcmaster Musculoskeletal Clinical Skills Manual 1E
McMaster Musculoskeletal Clinical Skills Manual Authors Samyuktha Adiga Dr. Raj Carmona, MBBS, FRCPC Illustrator Jenna Rebelo Editors Caitlin Lees Dr. Raj Carmona, MBBS, FRCPC In association with the Medical Education Interest Group Narendra Singh and Jacqueline Ho (co-chairs) FOREWORD AND ACKNOWLEDGEMENTS The McMaster Musculoskeletal Clinical Skills Manual was produced by members of the Medical Education Interest Group (co-chairs Jacqueline Ho and Narendra Singh), and Dr. Raj Carmona, Assistant Professor of Medicine at McMaster University. Samyuktha Adiga and Dr. Carmona wrote the manual. Illustrations were done by Jenna Rebelo. Editing was performed by Caitlin Lees and Dr. Carmona. The Manual, completed in August 2012, is a supplement to the McMaster MSK Examination Video Series created by Dr. Carmona, and closely follows the format and content of these videos. The videos are available on Medportal (McMaster students), and also publicly accessible at RheumTutor.com and fhs.mcmaster.ca/medicine/rheumatology. McMaster Musculoskeletal Clinical Skills Manual S. Adiga, J. Rebelo, C. Lees, R. Carmona McMaster Musculoskeletal Clinical Skills Manual TABLE OF CONTENTS General Guide 1 Hip Examination 3 Knee Examination 6 Ankle and Foot Examination 12 Examination of the Back 15 Shoulder Examination 19 Elbow Examination 24 Hand and Wrist Examination 26 Appendix: Neurological Assessment 29 1 GENERAL GUIDE (Please see videos for detailed demonstration of examinations) Always wash your hands and then introduce yourself to the patient. As with any other exam, ensure adequate exposure while respecting patient's modesty. Remember to assess gait whenever doing an examination of the back or any part of the lower limbs. Inspection follows the format: ● S welling ● E rythema ● A trophy ● D eformities ● S cars, skin changes, etc. -
Command Sergeant Major John F. Sampa Command Sergeant Major Army National Guard
BIOGRAPHY General Carter F. Ham, U.S. Army, Retired General Ham is the president and chief executive officer of the Association of the United States Army. He is an experienced leader who has led at every level from platoon to geographic combatant command. He is also a member of a very small group of Army senior leaders who have risen from private to four-star general. General Ham served as an enlisted infantryman in the 82nd Airborne Division before attending John Carroll University in Cleveland, Ohio. Graduating in 1976 as a distinguished military graduate, his service has taken him to Italy, Germany, Kuwait, Saudi Arabia, Macedonia, Qatar, Iraq and, uniquely among Army leaders, to over 40 African countries in addition to a number of diverse assignments within the United States. He commanded the First Infantry Division, the legendary Big Red One, before assuming duties as director for operations on the Joint Staff at the Pentagon where he oversaw all global operations. His first four-star command was as commanding general, U.S. Army Europe. Then in 2011, he became just the second commander of United States Africa Command where he led all U.S. military activities on the African continent ranging from combat operations in Libya to hostage rescue operations in Somalia as well as training and security assistance activities across 54 complex and diverse African nations. General Ham retired in June of 2013 after nearly 38 years of service. Immediately prior to joining the staff at AUSA, he served as the chairman of the National Commission on the Future of the Army, an eight-member panel tasked by the Congress with making recommendations on the size, force structure and capabilities of the Total Army. -
Mos Specific Requirements
IOWA ARMY NATIONAL GUARD NON STANDARD VACANCY ANNOUNCEMENT POSITION VACANCY NUMBER: 21-019 CLOSING DATE: Indefinite UNIT/DUTY LOCATION: HHB 194th FA / Fort Dodge MINIMUM RANK TO APPLY: SSG DUTY MOS: 68W4O DUTY POSITION: Platoon Sergeant FULL-TIME STAFF POC: SFC Dana Preuschl PHONE: (515) 576-3761 LEADERSHIP POSITION/TYPE: Yes / Platoon Sergeant ELIGIBILITY REQUIREMENTS TO BE CONSIDERED FOR THIS POSITION GENERAL REQUIREMENTS: 1. Not currently “Flagged from Favorable Personnel Actions” or under a “Bar to Reenlistment.” 2. Must be or be able to complete 68W MOSQ within 12 months of assignment. 3. Must be able to meet the required service obligation (minimum of 12 months from course completion). 4. A Soldier who has a remaining contractual service obligation due to an incentive contract for a specific MOS or UIC may apply for non-standard vacancies, but will lose remaining incentive payments with the possibility of recoupment, as applicable. 5. Must not be currently stagnant on NCOES/PME. (to include DLC requirements). 6. Soldiers command removed or self-removed from promotion consideration are not eligible to apply. MOS SPECIFIC REQUIREMENTS: 1. A physical demands rating of Significant (Gray). 2. PULHES: 111121. 3. No aversion to blood. 4. Must possess finger dexterity in both hands. 5. A security eligibility of SECRET is required for the initial award and to maintain the MOS. 6. A minimum score of 105 in aptitude area ST and 110 in aptitude area GT in Armed Services Vocational Aptitude Battery (ASVAB) tests administered prior to 2 January 2002. 7. A minimum score of 102 in aptitude area ST and 110 in aptitude area GT on ASVAB tests administered on and after 2 January 2002 and prior to 1 July 2004.