Download Emergency Medicine: A Comprehensive Study Guide, Companion by David M. Cline, John Ma, O. John Ma, Gabor Kelen, Steven PDF

By David M. Cline, John Ma, O. John Ma, Gabor Kelen, Steven Stapczynski

This article makes use of tables, charts and an summary layout to summarize the major issues of pathophysiology, prognosis, and administration stipulations encountered within the Emergency division. It beneficial properties assurance of medical protocols, fluid resuscitation and pelvic soreness.

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Extra info for Emergency Medicine: A Comprehensive Study Guide, Companion Handbook

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Increased potassium and phosphate should be suspected. ) Acidosis should be corrected with ventilation and sodium bicarbonate, 50 to 100 meq, if needed. In symptomatic patients, 5 mL (10% solution) of CaCl intravenously antagonizes the magnesium effects. Phosphate and Chloride Abnormalities Hypophosphatemia rarely occurs, except in patients receiving total parental nutrition. Hyperphosphatemia occurs mainly with renal failure and can be treated with hydration, acetazolamide, or dialysis. Chloride abnormalities usually occur in association with other metabolic disorders, such as metabolic alkalosis (hypochloremia) or dehydration (hyperchloremia).

Although frequently hypoxic, in some disorders the fall in oxygen saturation may lag behind the elevation in PCO2. Pulse oximetry may be misleading, making ABG essential for the diagnosis. The differential diagnosis includes: COPD, drug overdose, CNS disease, chest wall disease, pleural disease, and trauma. Emergency Department Care and Disposition 1. Ventilation must be increased. In many cases, this requires intubation. The hallmark indication for intubation in respiratory acidosis is depressed mental status.

The ABCs of resuscitation should be addressed. Aggressive airway management with high-flow oxygen and endotracheal intubation may be necessary. 2. Hemodynamic stabilization. Rapid infusion of crystalloid IV fluid (LR or not significant) at 500 mL (20 mL/kg in children) every 5 to 10 min. Often 4 to 6 L (60 mL/kg in children) may be necessary. In addition to blood pressure, mental status, pulse, capillary refill, central venous pressure, pulmonary capillary wedge pressure, and urine output (> 30 mL/h in adult, > 1 mL/kg per h in children) should be monitored.

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