11/9 Flashcards
Mesenteric Ischemia Treatment
-IV fluids
-ABX
-Surgical/ Vascular/ IR Consult
-Heparin AFTER consult
In Mesenteric Ischemia if there are signs of shock, sepsis, or peritonitis, immediately consult _____________.
surgery for damage control surgery
*be sure to give abx
Anaphylaxis epi dose
0.3 mg 1:100 (IM) mid lateral thigh
Repeat every 5 minutes as needed
If patient requires >2-3 doses of IM epinephrine–> IV drip
Anaphylaxis epi dose - peds
IM Epi 0.01 mg/kg
Repeat every 5 minutes as needed.
If there is high suspicion for a pelvic fracture in a patient with signs of hemorrhagic shock, place a ____________
pelvic binder or sheet if a binder is not available.
Management of unstable pelvic fractures will be institution dependent and can involve____________ consult where available
interventional radiology
Often forgotten step in stroke and trauma cases
activation- stroke or trauma team
As a first step, give _______ to any patient with significant hyperkalemia-associated ECG changes
calcium
Calcium gluconate 1-3 g IV push through a peripheral IV
Calcium chloride 1 g IV push through a central venous line
hyperkalemia rx
-Calcium gluconate 1-3 g IV
-albuterol 20 mg
- 5-10 units regular insulin IV with dextrose 25-50 g IV (1-2 ampules 50% dextrose
- furosemide 40 mg IV push
- IVF
- Dialysis
Digoxin Toxicity on ECG
Sagging ST segments- aka Salvador Dali’s moustache
THYROID STORM MEDICATIONS
Administer medications in order
1- Propranolol / esmolol
2- Propylthiouracil / Methimazole
3- Iodine
4- Hydrocortisone
Eval this on neck exam
thyroid
Mistakenly giving ________ prior to the anti-thyroid medication will intensify the thyroid storm by increasing hormone synthesis and release worsening symptoms.
iodine
Airway in myxedema coma
Intubation of a patient with decompensated hypothyroidism can be difficult due to perioral soft tissue edema, macroglossia, and low lung reserves.
