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Tuesday, August 18, 2015

Nursemaid's Elbow in a Young Child. Cause, signs, and reduction.

                                       Nursemaid's Elbow


Dr. Alan Himmel

It is never a good idea to pull or tug a young child by the arm.  This action may create what is called a nursemaid's elbow. 

What essentially happens is that a person, who is trying to control an uncooperative child, grabs the child by the arm.  The child of course, still is not cooperative, and fights back, by pulling.  The resulting injury is that the head of the radius, subluxates at the elbow causing a lot of pain, guarding, and the inability of the child to want to use the arm or hand.

Often times, the radial head pops back in by itself and the pain and guarding will disappear on its own, allowing for almost instantaneous pain relief.  But, sometimes, the joint will not "go back in" without a little help.

I don't recommend doing trying to fix this at home, because without knowing for sure whether it is truly a radial head subluxation or a fracture, it is possible to cause more pain and injury.  However, if you are confident the child has a nursemaid's elbow, or if it has happened before (children who have had this injury, may tend to have it again) then this is what you can do to fix it.

Carefully supinate the hand in front of the child. Then, while palpating the radial head with your fingertip and just a little bit of pressure, use your other hand to slowly flex the arm at the elbow.  You may have to go past 90 degrees of flexion, but you will feel, with very little effort, the radial head click, and pop back into the correct position.  The child may cry a little, but the relief is instantaneous, and within a few minutes, the child should be acting normal again and giving high fives with the injured hand.

Wednesday, July 1, 2015

Five things every imaging center should know about referrals.


Five things every imaging center should know about referrals.


1.     Doctors don’t want stacks of your advertising in their office.  When you drop off your brochures, they are likely to be shoved into a drawer, or more likely, thrown away very quickly after you leave.  Fact:  There is nothing more obnoxious than dropping off 50 of your business cards and brochures and then taking only one of theirs.
2.     Office workers could not care less where a patient is sent for a scan. They are only interested in faxing the doctor’s orders and moving on to the next task.   Therefore, it’s important to make the process of sending the prescription as simple as possible.
3.     Doctors want compliant patients.  Doctors don’t write radiology prescriptions for the fun of it.  If a doctor writes a prescription for an MRI, he expects the patient to actually get the MRI.  Many doctors simply hand a prescription to a patient, and hope for the best.  Making it the patient’s responsibility to make the appointment is very unreliable and could cost a patient her life.  
4.     Doctors office workers want to do radiology referrals quickly and accurately.  A referral system that saves an office worker time, means that that office worker can get other work done.
5.     Office workers don’t have time to be fielding phone calls from imaging centers asking questions about claim numbers and patient information. Once the prescription is sent, all necessary information should be included, so the only thing that the imaging center has to do is schedule the patient.
After many requests and months of coding, the latest edition of RxPortal DeskTop is nearly available.  Soon, prescriptions will be sent from the doctor’s office using a much improved simple desktop solution:  It's as simple as the doctor’s office logging in.  Once in, the referring office sees your company imaging prescription pad, and can send the Rx quickly and securely, to your imaging center’s Fax and Email without leaving the chair.   Dr. A. Himmel, RxPortyl Solutions, LLC

Wednesday, April 1, 2015

RxPortyl ePrescriptions for Radiology

Florida PIP No Fault and Advanced Radiological Imaging.



Advanced diagnostic imaging, such as MRI, is important for patients who have been involved in motor vehicle traumas.  In fact, depending on the state you practice, ordering an MRI to visualize structures such as herniated discs and foraminal encroachment is necessary for the proper diagnosis of this type of trauma.  Moreover, it is necessary for the doctor to diagnose these injuries which can only be verified via MRI, in order to determine if the patient’s disc injury will factor into a permanent impairment.

Wouldn't it be great to be able to send MRI and other radiology prescriptions via your desktop or mobile device?  There are EMR systems in place which currently handle this, but these systems are very expensive, especially to the imaging centers.  In my research, I have seen these systems cost as much as $10,000 to imaging centers to set up.  Did you know that the largest free EMR system available now, Practice Fusion, only has 50 MRI centers across the whole country using their system?  This is out of thousands of ACR accredited imaging facilities.   There are doctors who want to use the program, but the imaging centers are not quite ready to pay that type of money.

RxPortyl is a Radiology ePrescription platform designed by doctors, for doctors and imaging centers, to make life easier and more efficient.  We invite all doctors to use RxPortyl.  There are no charges at all, including no setup charges.  There are no contracts and no commitments.  There are no strings at all.  Its a free service for you to use which will enhance your practice.    You can use it occasionally, or for every patient.   There are no limits and no minimums.

Getting started is as easy as a phone call.


954-659-8600

Tuesday, March 24, 2015

RxPortyl--First in ePrescribing radiology.

RxPortyl Solutions, LLC.

First in ePrescribing radiology.


Always free for Doctors.  Please contact us for your secure login credentials.





Wednesday, February 4, 2015

See this Fantastic Whiplash Video Infographic. This is Why you have so Much Pain!

Dr. Himmel

I have been treating patients who have sustained whiplash for practically the last 2 decades. 

 Many people are unaware that even a small impact rear end collision can cause significant pain and impairment in certain cases.  Symptoms include pain, stiffness, headache, shoulder pain, arm pain, numbness, tingling, and weakness in the upper extremities.

If you have been injured in a rear end collision, do not hesitate.  You must get examined and if treatment is necessary, you should begin as soon as possible to try and prevent future, permanent, chronic problems.  

Call our office Today:  954-659-8600

Compliments of Accident Injury Centers of Atlanta,