المحتوى المقدم من Dr. Adam Rosen. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرة بواسطة Dr. Adam Rosen أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.
Player FM - تطبيق بودكاست انتقل إلى وضع عدم الاتصال باستخدام تطبيق Player FM !
In this insightful episode of The Innovators & Investors Podcast, host Kristian Marquez sits down with Jay Crone, Managing Director and Venture Capitalist at Deloitte Ventures, to explore the firm’s strategic approach to corporate venture capital. Jay shares Deloitte Ventures’ investment thesis, focusing on supporting innovative Canadian startups at Series A and B stages across key sectors like cybersecurity, climate tech, fintech, future of work, health tech, and AI. Listeners will gain an inside look at how Deloitte leverages its vast network of 1,500 partners and 15,000 employees to source deals and add value beyond capital by helping startups navigate Deloitte’s complex ecosystem and access enterprise clients. Jay also discusses his diverse career journey—from government and investment banking to entrepreneurship and corporate VC—and how those experiences shape his investment philosophy. The episode delves into Deloitte’s due diligence process, the importance of founder relationships, and the firm’s strategic role as a co-investor. Jay highlights emerging trends, particularly the promise of vertical AI tailored to industry-specific needs, and shares his bullish outlook on fintech innovations like stablecoins and cross-border payments. He offers candid advice for entrepreneurs on risk-taking and aligning business vision with funding goals. This episode is a must-listen for founders, investors, and anyone interested in the evolving landscape of corporate venture capital and innovation in Canada. Learn more about Jay's work at https://www.deloitte.com/ca/en/services/program/ventures.html Connect with Jay on LinkedIn at https://www.linkedin.com/in/jaycrone/ Think you'd be a great guest on the show? Apply at https://finstratmgmt.com/innovators-investors-podcast/ Want to learn more about Kristian Marquez's work? Check out his website at https://finstratmgmt.com…
المحتوى المقدم من Dr. Adam Rosen. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرة بواسطة Dr. Adam Rosen أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.
Dr. Adam Rosen is an orthopedic surgeon who specializes in total joint replacement. He created this podcast which is aimed at interns, residents, fellows, and general orthopedists who are looking to dive into the details of total knee replacements. I do not claim that my way is the best way or the only way. My personal approach to my patients, total knee replacement surgery and the ever important post-operative recovery has been developed over the years. My protocols are ever changing based on scientific evidence and personal experience.I know many of you will want to jump right ahead to the operative step episodes - and that is okay. The first few episodes are not as exciting but they do contain important information in my opinion. If you jump ahead just be sure to come back and listen to the first few episodes.I will attempt to offer you my brain and the algorithm within it. Here I will share my thoughts and my approach to caring for total knee replacement patients. I hope that you learn something from this podcast. I hope that my thought process stimulates your thinking and approach. Most importantly I hope that I can offer one or more tips or pearls that may benefit your patients. If you like the information and have a friend or colleague that you think would benefit from the material please be sure to share this podcast with them. (Disclaimer: This is my opinion. Any information gathered is not medical education. Practitioners need to use their education and experience to determine how to treat their own patients.)
المحتوى المقدم من Dr. Adam Rosen. يتم تحميل جميع محتويات البودكاست بما في ذلك الحلقات والرسومات وأوصاف البودكاست وتقديمها مباشرة بواسطة Dr. Adam Rosen أو شريك منصة البودكاست الخاص بهم. إذا كنت تعتقد أن شخصًا ما يستخدم عملك المحمي بحقوق الطبع والنشر دون إذنك، فيمكنك اتباع العملية الموضحة هنا https://ar.player.fm/legal.
Dr. Adam Rosen is an orthopedic surgeon who specializes in total joint replacement. He created this podcast which is aimed at interns, residents, fellows, and general orthopedists who are looking to dive into the details of total knee replacements. I do not claim that my way is the best way or the only way. My personal approach to my patients, total knee replacement surgery and the ever important post-operative recovery has been developed over the years. My protocols are ever changing based on scientific evidence and personal experience.I know many of you will want to jump right ahead to the operative step episodes - and that is okay. The first few episodes are not as exciting but they do contain important information in my opinion. If you jump ahead just be sure to come back and listen to the first few episodes.I will attempt to offer you my brain and the algorithm within it. Here I will share my thoughts and my approach to caring for total knee replacement patients. I hope that you learn something from this podcast. I hope that my thought process stimulates your thinking and approach. Most importantly I hope that I can offer one or more tips or pearls that may benefit your patients. If you like the information and have a friend or colleague that you think would benefit from the material please be sure to share this podcast with them. (Disclaimer: This is my opinion. Any information gathered is not medical education. Practitioners need to use their education and experience to determine how to treat their own patients.)
I am going to cover some of the things I consider when approaching Uni's Please take the time to leave a review and subscribe. Stay safe. Support the show
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
This is an important episode because we are all at risk. If you are in trouble or suffering ask for help, get help, seek help and ask for help again. If you see a colleague or friend who is having trouble ask how you can help and be sure to check in with them or seek help from your attending or other supervisors. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
This is the 100th Episode of the Total Knee Tips & Pearls Podcast Some techy stuff on TKA Recommended Distal Femoral Resections 8mm - Stryker Triathlon 9mm - DePuy Attune 9.5mm - Smith & Nephew 10mm - Zimmer Persona, DJO, Microport Anterior Flange Angle to Prevent Notching 3 degrees - S&N, Zimmer 5 degrees - DJO, DePuy 6 degrees - Microport 7 degrees - Stryker Recommended Tibial Slope 0 degrees - Stryker PS, Aesculap 3 degrees - Stryker CR, Aesculap, Persona PS, Attune PS, Microport, S&N 5 degrees - Attune CR 7 degrees - Attune CR, Persona CR 1 mm Poly Options Stryker, Zimmer, Depuy, S&N Metal Sensitive Option S&N Oxinium Zimmer Ti-Nidium Microport NitrX DJO ArmourCoat Aesculap Advanced Surface Technology TJO Aurum Narrow Options Zimmer, DePuy, S&N, Aesculap Smallest - Zimmer 1 Narrow (55.5 mm M/L, 48.1 mm AP) Biggest - Aesculap F8 (82 MM M/L, 80.5 mm AP) Lots of stuff! Check with your reps and always refer to the technique manual, this is just a brief review but does not take the place of training and education. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Two studies have shown that essential amino acids (EAA) can help function, and suppress atrophy of the rectus after TKA. Dreyer et al. J Clinc Invest. 2013;123(11):4654-4666. Essential amino acid supplementation in patients following total knee arthroplasty. Ueyama et al. The Bone & Joint Journal Vol 102-B, No. 6, Supp A. Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty. The two brands I recommend to patients are Thorne ( https://amzn.to/3KPuC2i ) and Pure Encapsulations ( https://amzn.to/3ObJj1U ) Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Do not take my word for it but do your research and verify everything. Here I'll review the four common cups many of us use Zimmer G7 - ream under by 1 mm, 36 mm ID options at 50 with 10 degree and +5 lat offset Stryker Trident II Tritanium - ream line to line, 36 neutral option at 48 and 36 mm options with lip and offset at 52 mm DePuy Pinnacle - under by 1 mm, 2mm or line to line, 36 mm ID options at 52 mm Smith and Nephew - under by 1 mm or line to line, 36 mm ID option at 52 mm If you are a 40 mm fan, you can get 40 mm with Zimmer at 54 mm, Stryker at 52 mm, Depuy and Smith and Nephew at 56 mm Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Here I share with some some tips and tricks on what I look for and what I do when caring for the 50 and older patient with knee pain that does not have severe arthritis and does have a meniscus tear. I also share some tips on what to do during boards collections to make sure you have copies of the intra-op photos and how I discuss the surgical findings with my patients in the office. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Here is my take on the three new broach only collared hip stems Depuy Actis 130 degree neck shaft angle sizes 0-12 high offset 6mm (sizes 0-3) and 8 mm (sizes 4-12) Zimmer Avenier 135 neck shaft angle sizes 0-9 high offset 6mm collared and non-collared options coxa vara neck 126.5 degrees Stryker Insignia 130 degress neck shaft angle sizes 0-11 high offset 5 mm Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
LLD is a real issue. Here I will go over a number of things that can cause or lead to a LLD. I will share things I look for and how I talk to patients about LLD and what things you can do at the time of surgery to control for LLD. Support the show
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
What you are looking for in a fellowship is a personal decision. I covered this topic before but we are in the middle of fellowship applications and most applicants have the same questions. Here I discuss volume, autonomy, approaches, implants, technology, clinic, revisions and finding a job. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I used nav in 2005 and was looking forward to robotics when they came on the scene. First it was Mako and now Rosa and Velys. Unfortunately, the powers that be have not allowed them in our system yet. I think it is important for residents and fellows to be trained with robots. It is a part of education today. Robotic training will help you land a job. Robotics may help you attract patients. Augmented reality may offer some of the same information because that technology is advancing quickly. But, you need to know how to do a manual total knee well. A robot may not be available. Software may be corrupt or fail. Garbage in, garbage out. If it doesn't look right or feel right do not just believe what you see on. a screen or a heads-up display. You need reps on manual total knees so you have a bailout if things don't work with the technology. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I am happy to share my new book THE KNEE BOOK - A GUIDE TO THE AGING KNEE It was written for patients and it is written to patients in easy to understand language. The book is a perfect recommendation for patients with knee pain that have questions. I believe it is also a great resource for residents and young surgeons. In it I review the algorithm for treating patients with knee pain from the most conservative up to knee replacement. What I think is the best benefit for young surgeons is all of the analogies I use to explain things to my patients. You can pick these up by reading the book so that you can better explain things to your patients. It is also a great read for non-orthopedic doctors, PA's or NP's. Anyone that treats knee pain patients. It explains why we need weight bearing x-rays and not MRI's and more. You can download the ebook at Amazon here: https://www.amazon.com/Knee-Book-Guide-Aging-ebook/dp/B09NLL58LG/ref=tmm_kin_swatch_0?_encoding=UTF8&qid=1639946441&sr=8-2 You can get the paperback here: https://www.amazon.com/Knee-Book-Guide-Aging/dp/B09NKWMYFN/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1639946441&sr=8-2 Available at Barnes and Noble as a Nook here: https://www.barnesandnoble.com/w/the-knee-book-a-guide-to-the-aging-knee-adam-rosen/1140795276?ean=2940161052846 Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I still do this every Friday (sooner if it is a complicated revision) Check the patient, age, BMI, nasal swab, dvt proph. Check the x-rays and make sure the implants are ordered. Review the labs and any clearances that are needed. Double check everything necessary with the patient the day of surgery. Make sure the room is set up with everything you need prior to the patient coming into the room. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Whether you are doing a hemi or total, cementing the femoral component takes some skill. Here I will share with you my tips on how to get a good cement mantle. A link to the episode on cement grading: https://www.buzzsprout.com/725061/episodes/7501843 Support the show
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
SSI is the number one reason for unplanned admission after TJA. Biofilm can form within minutes and be mature within 24 hours. Biofilm contains approximately 80% ECM and 20% bacteria. Check out this lecture by Next Science that was given at AAOS 2021 https://www.youtube.com/watch?v=5WPZ02t8hEs&list=PL226EPMMG9vYS9F1oDCU9SvOOBIqjJXze&index=6 And this two part series: https://www.youtube.com/watch?v=cG3iOT4vZlA&list=PL226EPMMG9vYWosH11BTZh1_2g02R-M92&index=7&t=31s https://www.youtube.com/watch?v=ZDXZFbCEilw&list=PL226EPMMG9vYWosH11BTZh1_2g02R-M92&index=8 Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I discussed varus knees previously, here is my two cents on what I look for and how I approach the valgus deformity when performing a TKA Krackow I - min valgus II - deformity > 10 degree, medial soft tissue stretching III - severe, incompetent medial soft tissues, have constrained/hinge avail Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I had the chance to sit down for the second time with Dr. Colwell. In this episode we cover teaching fellows, running two rooms, bilateral total joints and more. If you haven't listen to the first episode you can listen here: https://podcasts.apple.com/us/podcast/interview-with-dr-colwell/id1507691532?i=1000536512016 Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Know if it is fixed or correctable Assess the amount of osteophytes Release MCL around to semimembranous Assess PCL if using CR Consider downsizing tibial and removing additional medial bone Further Reading: Master Techniques Knee Arthroplasty - Lotke and Lonner Chapter 7 by Scuderi and Insall Advanced Reconstruction of the Knee AAOS Chapter 27 - Varus Knee - Windsor and Choi JAAOS Article Dr. Mihalko - http://upload.orthobullets.com/journalclub/free_pdf/19948701_19948701.pdf Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I first met Dr. Colwell when I came west to interview for a fellowship at Scripps Clinic. I had the pleasure to sit down and ask him some questions about orthopedics and his career. We talked for an hour and a half and I could have spent all day listening to his stories. We didn't have time to get to every question that I had for him so I hope we can sit down again soon for a second Dr. Colwell interview. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
References: Ng et al. Preoperative Risk Stratification and Risk Reduction for Total Joint Reconstruction. AAOS 2013 Aram et al. Estimating an Individual's Probability of Revision Surgery After Knee Replacement. Am J of Epid 2018 Gronbeck et at. Risk stratification in primary total joint arthroplasty. Arthroplasty Today 2019 Florschutz et al. Estimating patient specific mortality after joint replacement. Osteoarthritis and Cartilage 2019 Ziebma-Davis et al. Outpatient Joint Arthroplasty. J Arthoplasty 2019 National Joint Registry online Risk Assessment tool. jointcalc.shef.ac.uk Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
I find this topic a more difficult topic to teach than knee balancing. Everything is important to get a stable hip. You need a good approach, pre-op planning, implant positioning and the restoration of length and offset. You need to be aware of balancing and how to address anatomic on anatomic impingement, implant on anatomic and implant on implant impingement. Impingement with total hip replacement by Malik JBJBm 2007 - https://pubmed.ncbi.nlm.nih.gov/17671025/ Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
These two tips can be used when performing a hemiarthroplasty for a hip fracture. You may also consider it even if doing a THA for a fracture or a THA for arthritis in certain patients such as parkinson's disease. Check out my other episode on a more detailed explanation of how I do my posterior approach to the hip. - https://www.buzzsprout.com/725061/episodes/4250591 Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Its good to have an algorithm that works for you when describing an x-ray. Here I will go through my thought process to make sure that you cover everything and not miss things. Support the show
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
The kinematics of the knee are so complex. You can not overlook the PFJ. We are taught early on about medializing the button and lateralize the femur and make sure your femoral rotation is correct. If not you are taught to do a lateral release. The balancing of the PFJ is so important. Overstuff it and you have pain and limited range of motion. Too loose and you lose efficiency of the extensor mechanism. Here I will share some tips and my thoughts on what I look for when I do a TKA specifically focusing on the PFJ. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
A Comparison of Four Models of Total Knee Replacement Prostheses John Insall, Chitranjan Ranawat, Paolo Aglietti, John Shine JBJS 1976 Support the show
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Roentgenographic Analysis of Patellofemoral Congruence Alan Merchant, Richard Mercer, Richard Jacobsen, Charles Cool JBJS 1974 Merchant View - patient is supine on the x-ray table. The knees are flexed 45 degrees and the legs are strapped. The beam to femur angle is 30 degrees and the plate is positioned against the shins. Sulcus Angle of Brattstrom - angle formed by the highest points on the medial and lateral femoral condyles and the lowest point of the sulcus Congruence Angle - sulcus angle is bisected to establish the reference line. Another line is drawn from the apex of the sulcus to the lowest point on the patellar articular surface. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
The Forty-five-Degree Posteroanterior Flexion Weight-Bearing Radiograph of the Knee Thomas Rosenberg, Lonnie Paulos, Richard Parker, David Coward, Steven Scott JBJS 1988 PA x-ray with the knee in 45 degrees of flexion and the patella touching the cassette. The beam is aimed at the inferior pole of the patella and aimed 10 degrees caudad, 55 patients in 1981-1982 (age 19-70) Major narrowing in the medial compartment AP xray - 25% Rosenberg - 85% Major narrowing in the lateral compartment AP xray - 30% Rosenberg - 80% Additional advantage of identifying osteophytes in the notch, loose bodies, OCD and SONK Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Current Concepts Review Impingement with Total Hip Replacement JBJB 2007 Aamer Malik, MD, Aditya Maheshwari, MD, and Lawrence Dorr, MD For hip stability: Evaluate the x-rays and template Be wary of hypermobile patients and spine patients Know your implants (head options, neck options, etc) Check patients supine and again lateral (for posterior approach) Meticulous approach Proper reaming and cup placement and remove osteophytes Proper broaching and remove osteophytes Check Ranawat sign 1. 45 degrees for females 2. 20 - 30 degrees for males How I test stability 1. leg length 2. capsular tension and palpate offset 3. extension and rectus tension 4. extension and external rotation 5. position of sleep 6. full flexion in neutral 7. 90 degrees, slight adduction and internal rotation 8. assess intraoperative x-rays Then make changes based on stability. Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Hopefully your system does not go down but when it does here is your cheat sheet. 1. ALWAYS DATE AND TIME 2. SIGN and print your name and/or doctor number, pager number, etc 3. Make sure the patients name and medical record number or DOB is on the page A- Admit D - Diagnosis C - Condition and Code Status V - Vitals A - Allergies A - Activity N- Nursing D - Diet I - IVF M - Medications L - Labs and Tests S - Special - PT, OT, Case Management And DATE AND TIME IT Common Meds after TKA - always check the medication, dose and frequency and the safety profile for the patient. Abx - Ancef 1 gm q8 (occ Vanco or other) VTE Prevention - Asa 81 mg BID (or 325mg or eliquis, xarelto, warfarin, enoxaparin, etc) Scheduled Pain Meds 1. acetaminophen 1000 mg PO q8 2. celebrex 200 mg PO BID 3. sometimes: gabapentin 100 mg PO q8 Breakthru Pain Meds 1. Tramadol 50 mg PO q6 prn mild pain (level 1-5) 2. Oxycodone IR 5 mg PO q6 prn moderate pain (level 6-9) 3. Oxycodone IR 10 mg PO q6 prn severe pain (level 10) 4. sometimes: IV breakthru medications Bowel - colace 100 mg PO BID GI - pepcid 20 mg PO BID Puritis - claritin 10 mg PO q day prn itching Nausea - zofran 4 mg IV q 6 prn nausea HOME MEDS! if diabetic don't forget sliding scale insulin and DATE AND TIME the orders Support the show…
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Total Knee Tips & Pearls From Dr. Adam Rosen (A Virtual Total Knee Fellowship Podcast)
Radiological Demarcation of Cemented Sockets in Total Hip Replacement Jesse DeLee and John Charnley CORR 1976 3 Types/Zones Zone 1 - Superior lateral Zone 2 - Central or Medial Zone 3 - Inferior medial Support the show
مرحبًا بك في مشغل أف ام!
يقوم برنامج مشغل أف أم بمسح الويب للحصول على بودكاست عالية الجودة لتستمتع بها الآن. إنه أفضل تطبيق بودكاست ويعمل على أجهزة اندرويد والأيفون والويب. قم بالتسجيل لمزامنة الاشتراكات عبر الأجهزة.