Dr. Hogan Bedside tutorial Pearls #2

Question 1

chest drain removes 2 things:

Answer 1

fluid

air

Question 2

how to give appropriate pain relief for chest drain patient?

Answer 2

opiate plus NSAIDS so you can lower opiate dose

Question 3

how to confirm if chest drain is correctly placed? 2 ways

Answer 3

1. cough to see if air bubbles appear

2. x-ray

Question 4

how long do chest drains stay in usually?

Answer 4

72 hours

Question 5

naloxone dosage?

Answer 5

400-800ug more doses as shorter half life than opiates

Question 6

2 kinds of dialysis?

Answer 6

peritonealysis

haemodialysis

Question 7

2 phases in haemodialysis:

Answer 7

1. dialysis

2. haemofiltration

Question 8

how long per dialysis treatment? how many times per week?

Answer 8

4 hours, 3/7

Question 9

what is a fistula

Answer 9

arterial-venous anastomoses, can be created with Dacron to spare puncture of arteries/veins

Question 10

why need blood transfusion with kidney failure?

Answer 10

suppressed EPO

Question 11

what 3 things does dialysis protect against?

Answer 11

1. metabolic acidosis
2. hyperkalaemia
3. volume overload

Question 12

5 regions of hemorrhages:

Answer 12

1. extradural
2. subdural
3. subarachnoid
4. intraventricular
5. parenchymal

Question 13

Premonitory bleed?

Answer 13

early minor, assymptomatic interval, then event

Question 14

3 ways to reduced ICP:

Answer 14

surgical
dexamethosone
ventilator to decrease CO2

Question 15

steroids rule of thumb for hydrocortisone, prednisolone, dexamethasone?

Answer 15

4x25: 4 dexa = 25pred = 100hydrocort

Question 16

visual acuity affected in papilloedema?

Answer 16

nope

Question 17

papilloedema and optic discs?

Answer 17

swollen
blurred margins
enlarged blind spots