...To Do or Not to Do? Presentation Outline Case Presentation Initial Trauma Management Continued Trauma Management ED Thoracotomy - Indications ED Thoracotomy - Therapies ED Thoracotomy – Technique When is it Time to Quit? Summary and Conclusion Case Presentation - KA History of Present Illness: EMS arrived at 8:07am to find 30 yo male supine on street. Pt found pulseless and apneic. No witnesses identified. Neighbors state they heard multiple shots fired and saw pt lying on ground without movement immediately prior to their arrival. Past Medical History: Unknown What do you want to do??? Initial Management Don’t Forget ABC’s First! A = Airway Pt was orally intubated in the field with size 8 ETT B = Breathing Pt was bagged via BVM and bilateral BS confirmed C = Circulation Pt was pulseless with NO BP! ECG monitor revealed a narrow complex rhythm at 100. A 14 gauge IV was placed in left AC. Arrival to Hospital - TAA Pt arrived in TAA at 8:22am, intubated and bagged, without pulses, with CPR in progress. What do you want to do??? Reassess ABC’s first and LOOK at the patient!!! Physical Examination reveals a 1-2 cm circular entrance wound midline just below nipple line with profuse bleeding. What do you want to do??? Management Continued Exclude Correctible Causes of PEA Severe Hypovolemia Cardiac Tamponade Tension Pneumothorax Rupture of the Ventricular Wall What do you want...
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...Case Study Patient age range: Mid 70’s Allergies: enalapril (hives); iodine containing compounds (hives) Diet: Regular Diet Activity: Skilled Therapy Mobility Group: Ambulate to bedside commode with assist of 2. Diagnosis: Arterial Occlusion; Thrombosed Popliteal Aneurysm (acute obstruction) Presenting Symptom(s): The patient’s chief complaint was left leg pain from the left knee down to the left foot. When asked the patient he was unable to appropriately respond to the question due to confusion. History of present illness: The patient is a male in his mid 70s. The patient presented with new onset left lower extremity ischemia. He was started on an IV heparin drip and transported to ED. He was found to have am occluded left popliteal aneurysm with occlusion of all tibial vessels. The patient was taken to the OR with vascular service for initiation of thrombolysis therapy. He is currently hospitalized for left lower extremity ischemia, angiogram, thrombolysis, bypass femoral popliteal thrombectomy, irrigation and debridement of wound, and a fasciotomy. Then, he was taken back to the OR for debridement of left anterolateral muscular compartment necrosis. This morning, he was noted to be “confused”. The patient was stable and oriented until at least yesterday evening. Per the primary team, he did not appear confused when seen at 6am. He was also noted to have a temperature of 37.4. He did not have any labs checked for 2 days, but this morning his labs...
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...immense dedication and support in improving patient safety in recent years. Without their invaluable and incessant efforts in planning and executing various improvement initiatives to enhance patient safety through risk identification and mitigation, the publication of this annual report would not have been as meaningful. Patient Safety and Risk Management Department Quality and Safety Division 2 ANNUAL REPORT ON SENTINEL AND SERIOUS UNTOWARD EVENTS (1 October 2012 – 30 September 2013) TABLE OF CONTENTS Executive Summary 4 CHAPTER 1 – Introduction 9 CHAPTER 2 – Sentinel and Serious Untoward Event Policy 11 CHAPTER 3 – Sentinel Events Reported from 1 October 2012 to 30 September 2013 13 CHAPTER 4 – Serious Untoward Events Reported from 1 October 2012 to 30 September 2013 21 CHAPTER 5 – Actions Taken and Discussion 26 CHAPTER 6 – Conclusion 42 CHAPTER 7 – The Way Forward 44 Annex I: Annex II: HA Sentinel and Serious Untoward Event Policy Summary of Individual Sentinel Events and Recommendations for Improvement 3 ANNUAL REPORT ON SENTINEL AND SERIOUS UNTOWARD EVENTS (1 October...
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...Courtesy of L E K A R SPECIAL EDITION Authors: Marino, Paul L. Title: ICU Book, The, 3rd Edition Copyright ©2007 Lippincott Williams & Wilkins ISBN: 0-7817-4802-X Authors Dedication Quote Preface to Third Edition Preface to First Edition Acknowledgments Table of Contents Section I - Basic Science Review Basic Science Review Chapter 1 - Circulatory Blood Flow Chapter 2 - Oxygen and Carbon Dioxide Transport Section II - Preventive Practices in the Critically Ill Preventive Practices in the Critically Ill Chapter 3 - Infection Control in the ICU Chapter 4 - Alimentary Prophylaxis Chapter 5 - Venous Thromboembolism Section III - Vascular Access Vascular Access Chapter 6 - Establishing Venous Access Chapter 7 - The Indwelling Vascular Catheter Section IV - Hemodynamic Monitoring Hemodynamic Monitoring Chapter 8 - Arterial Blood Pressure Chapter 9 - The Pulmonary Artery Catheter Chapter 10 - Central Venous Pressure and Wedge Pressure Chapter 11 - Tissue Oxygenation Section V - Disorders of Circulatory Flow Disorders of Circulatory Flow Chapter 12 - Hemorrhage and Hypovolemia Chapter 13 - Colloid and Crystalloid Resuscitation Chapter 14 - Acute Heart Failure Syndromes Chapter 15 - Cardiac Arrest Chapter 16 - Hemodynamic Drug Infusions Section VI - Critical Care Cardiology Critical Care Cardiology Chapter 17 - Early Management of Acute Coronary Syndromes Chapter 18 - Tachyarrhythmias Section VII - Acute Respiratory Failure Acute Respiratory Failure Chapter 19 - Hypoxemia...
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...Clinical guidelines Diagnosis and treatment manual for curative programmes in hospitals and dispensaries guidance for prescribing 2010 EDITION © Médecins Sans Frontières – January 2010 All rights reserved for all countries. No reproduction, translation and adaptation may be done without the prior permission of the Copyright owner. ISBN 2-906498-81-5 Clinical guidelines Diagnosis and treatment manual Editorial Committee: I. Broek (MD), N. Harris (MD), M. Henkens (MD), H. Mekaoui (MD), P.P. Palma (MD), E. Szumilin (MD) and V. Grouzard (N, general editor) Contributors: P. Albajar (MD), S. Balkan (MD), P. Barel (MD), E. Baron (MD), M. Biot (MD), F. Boillot (S), L. Bonte (L), M.C. Bottineau (MD), M.E. Burny (N), M. Cereceda (MD), F. Charles (MD), M.J de Chazelles (MD), D. Chédorge (N), A.S. Coutin (MD), C. Danet (MD), B. Dehaye (S), K. Dilworth (MD), F. Fermon (N), B. Graz (MD), B. Guyard-Boileau (MD), G. Hanquet (MD), G. Harczi (N), M. van Herp (MD), C. Hook (MD), K. de Jong (P), S. Lagrange (MD), X. Lassalle (AA), D. Laureillard (MD), M. Lekkerkerker (MD), J. Maritoux (Ph), J. Menschik (MD), D. Mesia (MD), A. Minetti (MD), R. Murphy (MD), J. Pinel (Ph), J. Rigal (MD), M. de Smet (MD), S. Seyfert (MD), F. Varaine (MD), B. Vasset (MD) (S) Surgeon, (L) Laboratory technician, (MD) Medical Doctor, (N) Nurse, (AA) Anaesthetist-assistant, (Ph) Pharmacist, (P) Psychologist We would like to thank the following doctors for their invaluable help:...
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...A kid with Hepatitis A can return to school 1 week within the onset of jaundice. 2. After a patient has dialysis they may have a slight fever...this is normal due to the fact that the dialysis solution is warmed by the machine. 3. Hyperkalemia presents on an EKG as tall peaked T-waves 4. The antidote for Mag Sulfate toxicity is ---Calcium Gluconate 5. Impetigo is a CONTAGEOUS skin disorder and the person needs to wash ALL linens and dishes seperate from the family. They also need to wash their hands frequently and avoid contact. positive sweat test. indicative of cystic fibrosis 1. Herbs: Black Cohosh is used to treat menopausal symptoms. When taken with an antihypertensive, it may cause hypotension. Licorice can increase potassium loss and may cause dig toxicity. 2. With acute appendicitis, expect to see pain first then nausea and vomiting. With gastroenitis, you will see nausea and vomiting first then pain. 3. If a patient is allergic to latex, they should avoid apricots, cherries, grapes, kiwi, passion fruit, bananas, avocados, chestnuts, tomatoes and peaches. 4. Do not elevate the stump after an AKA after the first 24 hours, as this may cause flexion contracture. 5. Beta Blockers and ACEI are less effective in African Americans than Caucasians. 1. for the myelogram postop positions. water based dye (lighter) bed elevated. oil based dye heavier bed flat. 2.autonomic dysreflexia- elevated bed first....then check foley...
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...the student relies less on memory and more on logical pathophysiology. The text has been updated to include current information on rapidly developing topics, such as HIV and AIDS (vaccine efforts and all the new anti-HIV medications), Ebola virus, Hantavirus, E. coli outbreaks, Mad Cow Disease, and brand-new antimicrobial antibiotics. The mnemonics and cartoons in this book do not intend disrespect for any particular patient population or racial or ethnic group but are solely presented as memory devices to assist in the learning of a complex and important medical subject. We welcome suggestions for future editions. 1) Write in a conversational style for rapid assimilation. 2) Include numerous figures serving as "visual memory tools" and summary charts at the end of each chapter. These can be used for "cram sessions" after the concepts have been studied in the text. 3) Concentrate more on clinical and infectious disease issues that are both interesting and vital to the actual practice of medicine. MARK GLADWIN, MD BILL TRATTLER, MD D CONTENTS Preface v PART 1 1 2 3 BACTERIAL TAXONOMY CELL STRUCTURES, VIRULENCE FACTORS, and TOXINS...
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...How to go to your page This eBook set contains two volumes. The main content pages are contiguously numbered: use the Table of Contents to find those page numbers. The front matter pages and indices are labeled with the Volume number and page separated by a colon. For example, to go to page vi of Volume 1, type Vol1:vi in the “page #” box at the top of the screen and click “Go”. To go to page vi of Volume 2, type Vol2:vi in the "page #" box… and so forth. Encyclopedia of Human Body Systems This page intentionally left blank Encyclopedia of Human Body Systems VOLUME 1 Julie McDowell, Editor Copyright 2010 by ABC-CLIO, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher. Library of Congress Cataloging-in-Publication Data McDowell, Julie. Encyclopedia of human body systems / Julie McDowell. p. cm. Includes bibliographical references and index. ISBN 978–0–313–39175–0 (hard copy : alk. paper) 1. Human physiology—Encyclopedias. I. Title. QP11.M33 2011 612.003—dc22 2010021682 ISBN: 978–0–313–39175–0 EISBN: 978–0–313–39176–7 14 13 12 11 10 1 2 3 4 5 This book is also available on the World Wide Web as an eBook. Visit www.abc-clio.com for details. Greenwood An Imprint of ABC-CLIO, LLC ABC-CLIO, LLC...
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