Guess what rhythm this is, and what would be the emergent treatment (and what about the definitive treatment?
Answer HERE
Friday, December 28, 2012
Monday, August 27, 2012
Peds DKA ... whats the difference?
Check out this great consensus article from the ADA on Peds DKA management... ARTICLE
Don't forget the risk of cerebral edema. Initial fluid resuscitation is 10-20cc/kg over 1-2hr and may be repeated as necessary.
More to come in upcoming blogs on the specifics of age and/or weight cutoffs for approaching older teenager/young adult patients using adult vs pediatric DKA management guidelines. **I have consulted the expert and I am currently awaiting a response.
Don't forget the risk of cerebral edema. Initial fluid resuscitation is 10-20cc/kg over 1-2hr and may be repeated as necessary.
More to come in upcoming blogs on the specifics of age and/or weight cutoffs for approaching older teenager/young adult patients using adult vs pediatric DKA management guidelines. **I have consulted the expert and I am currently awaiting a response.
Does Sux Increase ICP?
Fantastic literature review.
ARTICLE
Everything we give has "theoretical" risks. A commonly cited one, particularly in the realm of head trauma but also relevant to other acute neurological insults like SAH that raise ICP dramatically, is Succinylcholine elevating ICP. Many have debated the topic. The above review article is a fantastic summary of the most well respected and frequently cited source articles within the literature. Interpret on your own if you'd like, but these experts have concluded:
1) The authors could find no definitive evidence that SCH caused a rise in ICP in patients with brain injuries.
2) There is level 2 evidence that SCH caused an increase in ICP for patients undergoing neurosurgery for brain tumours with elective anesthesia.
Some of these article also identify ICP elevation from the intubating procedure itself and therefore traumatic or acute ICH patients who are intubated may experience increases from this.
ARTICLE
Everything we give has "theoretical" risks. A commonly cited one, particularly in the realm of head trauma but also relevant to other acute neurological insults like SAH that raise ICP dramatically, is Succinylcholine elevating ICP. Many have debated the topic. The above review article is a fantastic summary of the most well respected and frequently cited source articles within the literature. Interpret on your own if you'd like, but these experts have concluded:
1) The authors could find no definitive evidence that SCH caused a rise in ICP in patients with brain injuries.
2) There is level 2 evidence that SCH caused an increase in ICP for patients undergoing neurosurgery for brain tumours with elective anesthesia.
Some of these article also identify ICP elevation from the intubating procedure itself and therefore traumatic or acute ICH patients who are intubated may experience increases from this.
Thursday, August 23, 2012
Ostrich Pseudoaxioms
For lack of creative impulse, this week I have sifted through some old writing I have done in the past. Here is the link to an oldie but goodie. A blog I entered a while back, enjoy:
Link to my old blog.
Link to my old blog.
Monday, July 30, 2012
ACS in Women
This discussion was based on an article Dr. Mattu called a "must-read" for all EM docs. It includes over a million M.I. patients from 1994-2006 and gives us a very interesting picture. Below is cut from the EMRAP written summary of June 2012. Link to the article HERE.
Yummy Pesticides. Lacrimation, salivation, etc.
Ok, we don't see it often but these wackos in Bangledesh see enough to do a small randomized study on Atropinaztion of these toxidromic people. Here it is.
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