Author jacobi Posted on July 20, 2017Format AsideCategories TidbitsTags , , ,

Pressors

Highlights from Sepsis surviving Campaign 2016:  Base on ProCESS, ProMISe and ARISE trials,  all 3 trials confirmed that there was no survival benefit of EGDT compared to usual resuscitation.  However, in all three studies patients had early antibiotics, >30ml/kg of IVF prior to randomization.  We need therefore to keep in mind that the practice has changed. Source control: empiric broad-spectrum therapy Abx to cover all likely pathogens within 1hr Initial resuscitation: 30ml/kg of IV crystalloid fluid in first 3 hours … Continue reading “Pressors”

Author jacobi Posted on July 18, 2017Format AsideCategories TidbitsTags , ,

May-Thurner Syndrome

May-Thurner syndrome (MTS) is an anatomically and pathologically variable condition leading to venous outflow obstruction as a result of extrinsic venous compression in the iliocaval venous territory. With partial venous obstruction, the condition can be asymptomatic, but progression with symptoms related to chronic venous hypertension or venous occlusion can occur, with or without venous thrombosis. It is important to keep this condition in mind whenever a patient presents acutely with lower extremity swelling or deep vein thrombosis (DVT), particularly young … Continue reading “May-Thurner Syndrome”

Author jacobi Posted on July 18, 2017August 4, 2017Format AsideCategories Education, TidbitsTags , ,

Ischemic stroke management

As soon as you identify a stroke — Call Stroke code directly by Dialing: 3-CVAT (3-2828) Goal of BP is ischemic stroke: 180/110, medications to use: Labetalol, Nicardipine TPA can be given up to 4.5 hours after the initiation of symptoms, but the benefit decreases as time passes, so if a patient is a TPA candidate try to move things as quickly as possible For patients who have contraindications to TPA, mechanical thrombectomy is another option, which is available to us … Continue reading “Ischemic stroke management”

Author jacobi Posted on July 18, 2017Format AsideCategories TidbitsTags , ,

Cause of Death for Certificatation

Notify medical examiner in cases of: Accident (including traffic) This includes accidents that happened years prior to death but that contributed to cause of death. Example: Patient who had an MVA years ago leading to quadriplegia and chronic need for mechanical ventilation who dies 2/2 ventilator associated pneumonia. Suicide Homicide Complication of medical procedure/intervention Suspected injury Unknown sequence of events leading to death When stating cause of death you can give the immediate cause of death but should also include … Continue reading “Cause of Death for Certificatation”