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Archives for 2014
Burr Holes and Skull Trephination
UC Davis Cheat Sheet Acad Emerg Med 2011;18:78 Emergency department skull trephination for epidural hematoma in patients who are awake but deteriorate rapidly. (J Emerg Med. 2010 Sep;39(3):377-83.) Authors Smith SW, et al. Show all Journal doi: 10.1016/j.jemermed.2009.04.062. Epub 2009 Jun 17. Affiliation Comment in J Emerg Med. 2012 Dec;43(6):e489-90. Abstract BACKGROUND: Blunt head […]
Atrial Fibrillation and Atrial Flutter
Chemical Cardioversion Ibutilide 1 mg over 10 minutes Avoid if EF<20% or QTc>480 must observe for 4 hours to make sure no QT prolongation augments electrical cardioversion (NEJM 1999;340(24):1849 ashman beats from variable repolarization of the bundles Holiday heart=etoh generated a-fib, can also be from withdrawal. Usually spontaneously resolves. P-ulmonary Embolism […]
Alternative Anticoagulants
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Acute Dystonia
All you need to know is in this post by Rick Body
Esophageal Pressure Monitoring
Best review (Am J Respir Crit Care Med. 2014 Mar 1;189(5):520-31. doi: 10.1164/rccm.201312-2193CI. The application of esophageal pressure measurement in patients with respiratory failure.)
Obstetric Critical Care Management
Review Article (J Intensive Care Med. 2006 Sep-Oct;21(5):278-86) Vent Stuff ↑ alveolar ventilation (20-40%), ↑ TV, ↑ RR Compensated hypocarbia (Normal 25-32 and normal bicarb 18-21) Mechanical ventilation- need to adjust for PaCO2 30-32 (compensated hypercarbia); no studies show harm with permissive hypercarbia Faster desaturation: ↑ O2 consumption + ↓ function residual capacity + ↑ […]
Podiatry
Athlete’s Foot prescribe products containing terbinafine such as lamisail AT Toenail Fungal Infections What’s the best treatment for toenail fungus? There’s no magic bullet. Lamisil (terbinafine) taken daily for 12 weeks works best. But, long-term success hovers only around 50%. It can cost upwards of $240 per month. It costs less if given in pulse […]
Hemophilia and von Willebrand’s Disease
Hemophilia A x linked recessive causing defective VIII:c, Abnormal ptt. Replace c cryoprecipitate of factor VIII 1 unit=100 units VIII 1 cc of FFP=1 unit VIII and less of IX dDAVP raises factor VIII by causing release from endothelial cells, It has ADH-like effects. Dose: 0.3 mcg/kg. Number of units=0.5 x (Desired Factor Level) x […]
Morel-Lavallee Lesions
From the Trauma Professional Blog Their experience led them to develop the following practice guideline: Bottom line: The Morel-Lavallee lesion can be challenging to treat. Although this study has limited numbers, it provides enough guidance to suggest a consistent way of managing it. I recommend adopting this algorithm to provide a standard pathway for dealing […]
Old TOC
Resuscitation and General Principles Management Airway Management A New Airway Curriculum Physiology of Preoxygenation Ventilatory Management ? Basic Vent Stuff Waveforms Pulmonary Toilet and Medications Non-Invasive Ventilation Airway Pressure Release Ventilation (APRV) High Frequency Ventilation Independent Lung Ventilation Recruitment Maneuvers Oxylator Nitric Oxide Weaning/Liberation and Extubation Lab Interpretation and ABGs Oxygen Transport & Physiology of […]
Acquired Factor Eight Inhibitors
Powerpoint Presentation by Andrew Sampson Link to aFEI Powerpoint