Orthopedics for the General Medical Officer
Main Topics for Discussion
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First hand experience as a GMO
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Resources available to you
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Orthopedic Emergencies
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Basic ortho injuries from neck to toe
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When (and how) to refer
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What your orthopedic consultant can (and can’t offer)
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Recommended texts
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Casting and splinting
My Experience
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I served as a Diving Medical Officer for 2 years
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Dive site injuries at waterfront versus remote sites
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Useful tools to have at your disposal
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Digital Camera, Jump Drive, Internet access
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Casting/splinting materials
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Local anesthetics (without epinephrine)
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A comprehensive phone list
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Resources
Orthopedics, Naval Medical Center San Diego
The castroom number is (619)532-5342 or 532-8439
Multiple Subspecialists available
Your closest Navy orthopedics department
Make contact with your go-to orthopods early and establish a
good working relationship
Wheeless’s Ortho Textbook Online
www.wheelessonline.com
Know exactly what you want and make that clear
Physical/Occupational Therapy
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These departments can be a huge help
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OT works with the UE from the elbow down. They make custom
splints, provide therapy protocols, utilize modalities
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PT works with the shoulder, back, and lower extremities. Consider
them for back school, ankle proprioception, post-injury pre-op
rehab, etc.
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If you do not have these on your ship or nearby, protocols are
often available on-line, in texts, or from a civilian provider in
town.
The Role of the Operational Navy Corpsman
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The operational corpsman is a very active and hands-on part of the
healthcare team.
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They often know more than you do about common problems.
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Make sure you get them OJT in nearby castrooms, pt depts, etc.
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Ingrown toenail removal, blister care, splinting, crutch sizing - these
are just a few of the things they can help you with.
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If you have the good fortune to have an experienced IDC, you’re living
the good life
Orthopedic Emergencies
Aka "Fire up the helicopters…"
Cauda Equina Syndrome
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Bilateral buttock/le pain
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Urinary retention
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Bowel incontinence
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Saddle anesthesia
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Decrease in LE strength/sensation
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This can be rapidly progressive. Loss of bowel, bladder, or erectile
function may be irreversible!
Continue to PowerPoint® Lecture...
Lecture by
LCDR Eric Harris, MD
Surface Warfare Medicine Institute
2006 Surface Warfare Medical Officer Indoctrination Course
Naval Operational Medicine Institute
340 Huise Road
Pensacola FL 32508-1092
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