SMS Texting is Not HIPAA Compliant

Just wanted to share a great article on texting and HIPAA ComplianceFive Ways to Ensure Secure Text Messaging in Your Medical Practice


PAProgramSearch.com: Great Pre-PA Resource

I recently received an email from Ken Johnson, the developer of PAprogramsearch.com. Ken and his significant other went to the same process that many of us did when searching for PA programs and also encountered the same frustrations. It is difficult to find out which schools have which requirements. I ended up with a spreadsheet of the schools that I was going to apply to, their prerequisites, and checkboxes for the things that I had completed. Since there's no standardization of PA programs and their prerequisites at this time is difficult for students to keep track of.... in comes PAprogramsearch.com.

This website allows you to check off particular classes that you have taken as well as shadowing hours, etc. And then produces a list of schools with the "match percentage". The site is very easy to use it appears to be up to date. I always recommend going to be official program website to double check the prerequisites (as they can change at any time) but this is a great place to start.

Financial disclosure: 
I have no monetary or other connections to this website or the developers . Just sharing a resource. 

Home page

Check off the classes that you have completed and add your GPA/Experience in hours at the top.

A list of "matches" is generated.


Subcuticular Suturing

I came across this blog post on how to do a subcuticular closure. It is well written with step by step pictures so why reinvent the wheel. I am just going to repost. Enjoy!

Source: http://abnormalfacies.wordpress.com/2012/02/20/running-subcuticular-suture-technique/


Pain Control and Anti-Emetics

When prescribing pain medications you must also consider the side effects that those medications may have on your patient such as nausea, constipation, rash, etc.

We will talk about anti-emetics today.

There are many classes of anti-emetics to consider. Most services have their favorites, but due to patient allergies and the ineffectiveness of some medications on some patients - it is good to have a few back-ups in mind to try. You can also consult the pharmacy team that you work with for additional advice. This list is not comprehensive.

Dopamine antagonist: 
Prochlorperazine (good for opiod related nausea), Metoclopramide, Haloperidol

5HT3 antagonists: 
Ondansetron* (PO and IV)




*can lead to headaches and constipation
**can be sedating

Source: MPR http://www.empr.com/antiemetic-treatments/article/125873/


Pain Control: Opiods

I will go over some general information regarding opioid use for analgesia. In subsequent entries I will go over different opioid use for 1) mild to moderate pain, 2) moderate to severe pain, and 3) severe pain. I would say for my practice most patients fall into the moderate to severe pain, but for a short period of time.


Key Points:

  • No ceiling effect (as a general statement this means the larger the dose, the larger the effect)
  • Tolerance can develop with chronic use
  • Overuse can lead to respiratory depression or seizures

Mild to moderate pain: codeine or tramadol
Moderate to severe pain: hydrocodone, oxycodone, hydromorphone
Severe pain: morphine, codeine, methadone

**Some of these can crossover between categories based on dosage.

Source: Handbook of Neurosurgery, Greenberg 6th ed