Read on Twitter
1/
In an effort to conserve #PPE & increase #socialdistancing, many #dermatology services have switched to a heavily #telemedicine model. So today, I present to you:
HOW TO TAKE PHOTOS & CALL A #DERM CONSULT - a #covid19 era #tweetorial.
#MedEd #FOAMEd #dermtwitter #medtwitter
In an effort to conserve #PPE & increase #socialdistancing, many #dermatology services have switched to a heavily #telemedicine model. So today, I present to you:
HOW TO TAKE PHOTOS & CALL A #DERM CONSULT - a #covid19 era #tweetorial.
#MedEd #FOAMEd #dermtwitter #medtwitter
2/
Let's start with appropriateness of consult. We are trying hard to limit nonurgent consults for the above reasons. The following can wait for when #coronavirus isn't everywhere.
- nonmelanoma skin CA
- old rashes with a known dx
- missed a derm appt and happens to be in house
Let's start with appropriateness of consult. We are trying hard to limit nonurgent consults for the above reasons. The following can wait for when #coronavirus isn't everywhere.
- nonmelanoma skin CA
- old rashes with a known dx
- missed a derm appt and happens to be in house
3/
If it's an urgent issue, it's helpful to start with the photo. Any camera phone should be fine. If on Epic, you can use Haiku to upload directly the the EMR.
NB: texting photos isn't HIPAA compliant. We'll usually refer to the EMR, or email the photos in a secure system.
If it's an urgent issue, it's helpful to start with the photo. Any camera phone should be fine. If on Epic, you can use Haiku to upload directly the the EMR.
NB: texting photos isn't HIPAA compliant. We'll usually refer to the EMR, or email the photos in a secure system.
4/
Lighting is key. Some tips:
- Don't shine a light on the rash/lesion itself. The glare will be hard to see through (pic 1).
- Normal ambient light is fine (pic 2).
- Usually you shouldn't use flash.
Check out my hand dermatitis from the constant handwashing as an example
Lighting is key. Some tips:
- Don't shine a light on the rash/lesion itself. The glare will be hard to see through (pic 1).
- Normal ambient light is fine (pic 2).
- Usually you shouldn't use flash.
Check out my hand dermatitis from the constant handwashing as an example
5/
Take photos from far away (pic 1) & close up (pic 2). That way we can evaluate the distribution of the rash, but also see the primary lesion up close.
Look in the mouth, eyes, & groin. Take a photo (pic3) if there's something! NB: The mouth might need a flash.
pc: @dermnetnz
Take photos from far away (pic 1) & close up (pic 2). That way we can evaluate the distribution of the rash, but also see the primary lesion up close.
Look in the mouth, eyes, & groin. Take a photo (pic3) if there's something! NB: The mouth might need a flash.
pc: @dermnetnz
6/
Don't forget there are things that we can't tell from a photo. So it's helpful if you can do these physical exam maneuvers to report to us at the time of the consult call:
- blanchability of erythema
- papular (raised) or macular (flat)
- Any tenderness to palpation
Don't forget there are things that we can't tell from a photo. So it's helpful if you can do these physical exam maneuvers to report to us at the time of the consult call:
- blanchability of erythema
- papular (raised) or macular (flat)
- Any tenderness to palpation
7/
And we still like history! When the rash started, symptoms, any associations with medications or situations you might have noticed. Give us all of that information if you can!
And we still like history! When the rash started, symptoms, any associations with medications or situations you might have noticed. Give us all of that information if you can!
8/
We fully understand that we can't do everything via #telederm. We will still come in if a biopsy is necessary, or if it looks to be a serious situation. We are here for you - we just want to do our part in this #COVID19 crisis to save PPE and limit face to face contact.
We fully understand that we can't do everything via #telederm. We will still come in if a biopsy is necessary, or if it looks to be a serious situation. We are here for you - we just want to do our part in this #COVID19 crisis to save PPE and limit face to face contact.
9/
It's worth noting that the @MedDermSoc & @DermHospitalist are two groups of like minded #dermatologists who care for the sickest derm patients regularly. Best practices on consult practice are constantly being shared and revised. If you have feedback, please let them know.
It's worth noting that the @MedDermSoc & @DermHospitalist are two groups of like minded #dermatologists who care for the sickest derm patients regularly. Best practices on consult practice are constantly being shared and revised. If you have feedback, please let them know.
