Week 3 Flashcards
Parkland Formula
Fluid requirement in 24 hours is as follows:
= 4ml x TBSA (%) x body weight (kg)
50% given in first eight hours
50% given in next 16 hours.
should generally be avoided in patients with new onset of an evolving neurological syndrome.
Succinylcholine
This is due to the risk of hyperkalemia. Depolarizing paralytics
Pulmonary function test for GBS indictaing need for intubation
Forced expiratory volume <20 mL/kg
Negative inspiratory force <30 cm H20
Guillain-Barré syndrome treatment
IVIG or plasma exchange
Neurology colleagues should be involved early once the diagnosis is suspected to help mobilize these resources or arrange for them elsewhere.
_____ is the preferred paralytic for RSI in GBS.
Rocuronium
Atropine dose
Atropine 0.5-1 mg IV q3-5min
max dose 3 mg
Bradycardia- overdose/medication toxicity
- Glucagon bolus followed by continuous infusion
- Calcium chloride 1 g or calcium gluconate 3 g
- High-dose insulin
- IV lipid emulsion
Asthma- adjunct treatments to decrease the likelihood of intubation for refractory symptoms
-magnesium sulfate 2 g
-β2-agonist therapy
–subq Terbutaline
–IM epinephrine 0.3 mg
SJS treatment with ____________ appears to be the most widely accepted therapy.
IVIG
___________ is the first line therapy for cocaine chest pain
benzos
Cocaine: Consider ___________ for pts with ischemic changes on EKG with persistent HTN after 1st line therapy as beta blockers are contraindicated
IV phentolamine
Status Epilepticus algorithm
1st- Benzo
2nd- Kepra
3rd- Ketamine/ Phenobarb
4th- Propofol
Post perirectal ID management
Sitz baths
Stool softeners
Wound dressings/ packing change
Special labs for ETOH case
Poc BGL
OSM gap
Anion gap
Co-ingestions
Eclampsia, for systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg, give antihypertensives:
Labetalol 20 mg IV or
Hydralazine 5-10 mg IV
Aim to stabilize BP ≤160/90 mm Hg.
Seizure ppx in Eclampsia
magnesium sulfate:
4-6 g IV over 20 minutes –> infusion of 2 g/h.
*If the patient seizes, give an additional 2 g IV bolus.
*monitor reflexes
Preeclampsia is defined as
new-onset HTN after 20 weeks gestation
-plus-
proteinuria or signs of end-organ dysfunction.
Eclampsia is defined as
development of seizures in a patient with preeclampsia.
________ is the clinical presentation of hemolysis, elevated liver enzymes, and low platelet count in pregnancy
HELLP syndrome
HELLP is considered a variant of preeclampsia with severe features.
Standard Naloxone dose
0.4 mg IV,l IM, IN, or IO every 5 minutes
or
2 mg if the initial response is inadequate and repeat 2 mg as needed.
