It's also important to take the patient's age into account when considering transfer for a hand injury, especially in amputations, as consideration for replantation is greater with younger patients. In general, ischemia, multiple digit injuries and amputations are the primary reasons for immediate transfer. These questions can be answered using the Isolated Hand Injury Algorithm-Hand Referral for Acute Care Management graphic, which helps providers consider patient age, injury location and severity, and thumb or multiple-digit injury or amputation, all of which may identify need for transfer. Isolated Hand Injury Algorithm-Hand Referral for Acute Care Management Isolated Hand Injury Algorithm-Hand Referral for Acute Care Management.What patients need to see a hand specialist immediately? How would you suggest trauma providers decide if a patient needs to be transferred to a Level I center? Dennison responds to some of the most common issues that arise with hand injury transfer decisions in the community. Fortunately, through the Midwest Admission and Transfer Center, surrounding facilities can call to discuss cases that are in need of urgent referral. With all the potential variations in hand injuries, it is sometimes challenging to understand what the actual issue may be, as many of those calling to refer patients are often health care providers who are not trained in the care of hand injuries. The use of guidelines helps capture all urgent conditions and review injuries that may still need to be seen soon, perhaps the next day, if initial care can be provided at the referring hospital or clinic. It is important to understand the urgent need of referral for some injuries and to know what conditions can be safely temporized overnight. Dennison, M.D., a hand surgeon at Mayo Clinic's campus in Rochester, Minnesota, reports that while the hand surgeons at Mayo Clinic receive many urgent transfers, there are patients with injuries who can be managed initially at an outside hospital or clinic and then referred to be seen the next day. Readers may email questions to (c) 2021 North America Syndicate Inc.David G. Those people can then be closely monitored, or even treated, to prevent or delay damage to the retina. A regular eye exam can identify people with elevated intraocular pressure. Treatment is aimed at preventing or at least reducing further damage. That's why it is so important to diagnose and treat glaucoma early, ideally before much damage is done to the retina.

In general, vision loss from glaucoma is irreversible. Treatment for open-angle glaucoma is to reduce the pressure, usually through medication applied to the eye via drops. Glaucoma is the second leading cause of blindness in the world (after cataracts). Without treatment, glaucoma will lead to vision loss, initially in the peripheral vision, and may eventually lead to total blindness. Glaucoma is more common in older people, Black people, those with diabetes or high blood pressure and those with a family history. The major risk factor for open-angle glaucoma is elevated pressure inside the eye, although glaucoma can happen even with normal intraocular pressures. There are several different types of glaucoma, and I am only going to consider open-angle glaucoma in adults. Second opinion, please! - D.S.ĪNSWER: Glaucoma is a disease of the retina. Is there any way I can cut down or eliminate the cloudiness? My doctor says there is not. My right eye has clouded up over time, but I still have vision in it.

ROACH: I am a senior citizen with a history of glaucoma. Similarly, Boswellia supplements have shown benefit in some people with osteoarthritis.ĭEAR DR. There are studies showing benefit for turmeric and it has little toxicity, so I think it is worth a try. One set of exercises specifically for hand arthritis from the Mayo Clinic can be found at /mayo-hand. However, remember that exercise improves pain and function.

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