A quick question about risks for cavernous sinus thrombosis

[santigold]

Sorry to bother you guys but I just want to ask a quick question.
So I'm taking this Derm elective for fun and today when I was explaining to a young teenage girl about pimple-popping and the associated risk for infection, the attending kinda ridiculed me in front of the pt saying that it almost never happens and that I should've known better not to use scar tactics on pts....

Just how common do you guys see pts presenting with CST secondary to acne popping?

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[resxn]

Sorry to bother you guys but I just want to ask a quick question.
So I'm taking this Derm elective for fun and today when I was explaining to a young teenage girl about pimple-popping and the associated risk for infection, the attending kinda ridiculed me in front of the pt saying that it almost never happens and that I should've known better not to use scar tactics on pts....

Just how common do you guys see pts presenting with CST secondary to acne popping?

not once since starting medical school in 1995

 

[santigold]

not once since starting medical school in 1995

cool, thanks.
Just wondering, do you think it's still worth while to tell the pts about CST if they have acne or it's just not necessary?

 

[Pir8DeacDoc]

Likely not worth your time. Are you concerned about infections in the "danger" triangle of the face developing? It should be treated aggressively when it happens but the chances of any intracranial problem from such an infection are still very low.

 

[santigold]

Likely not worth your time. Are you concerned about infections in the "danger" triangle of the face developing? It should be treated aggressively when it happens but the chances of any intracranial problem from such an infection are still very low.

Ya, one of those "urban myths" I learned about before going into med school.
Even in texts, it says it's rare so I wasn't sure if it's worthwhile to talk about it.


hehe

 

[OtoHNS]

You may also want to warn them of the risk of being trampled to death by a runaway herd of unicorns since that is probably more likely...

 

[ZagDoc]

You may also want to warn them of the risk of being trampled to death by a runaway herd of unicorns since that is probably more likely...

One attending in our department has begun to include "earthquake risk" after "fire risk" in the OR time out. His argument is that in the past 5 years we've have no airway fires but four intraoperative earthquakes, so obviously if we're going to discuss fires we should also discuss the more common, and dangerous, earthquakes.

 

[neutropeniaboy]

One attending in our department has begun to include "earthquake risk" after "fire risk" in the OR time out. His argument is that in the past 5 years we've have no airway fires but four intraoperative earthquakes, so obviously if we're going to discuss fires we should also discuss the more common, and dangerous, earthquakes.

Earthquake time outs...that's pretty funny.

 

[kyley3k]

I think that's a great point, but my question would be how many fires were you having before you started doing the time out? And if the answer is just as many, then why did you start doing them in the first place? I would hate to find out that the answer is secondary to a hospital bureaucrat telling you it'd be a great idea.

 

[OtoHNS]

I would hate to find out that the answer is secondary to a hospital bureaucrat telling you it'd be a great idea.

My guess is you're going to hate finding out the answer...

 

[ZagDoc]

I think that's a great point, but my question would be how many fires were you having before you started doing the time out? And if the answer is just as many, then why did you start doing them in the first place? I would hate to find out that the answer is secondary to a hospital bureaucrat telling you it'd be a great idea.

No airway fires, but there were two sentinel events of fires under/involving the drapes (one a uro laser case, one a gen surg with argon laser case) so risk management deemed it was necessary to incorporate an "assessment of fire risk" into our time out for all surgeries being performed.