When you are triaging a patient - look to see if prior Hx of HTN - that can give you a clue as to whether they are relatively hypotensive at presentation.
In order to see if a patient is " protecting the airway" - look for coughing or gag reflex. If you notice patient drooling or "death rattle" noises, likely not protecting airway. When looking for pneumoperitoneum on U/S- air does not conduct (so will look like poor windows).
Posted 11/14/16 09:49:31 AM by Adam Faye
Asterixis: Lapse of posture - typically we look for b/l flapping tremor at the wrist (can also be seen in tongue, foot or any skeletal muscle) Kussmaul Breathing:
Deep and rapid breathing pattern often a/w metabolic acidosis. Distinct because other causes of tachypnea usually cause rapid and shallow respirations.
Posted 11/14/16 09:54:13 AM by Adam Faye
Typically given if pH <7.1 to reduce LV contractility, Arrhythmias, Arterial vasodilation/constriction and impaired responsiveness to vasopressors. (However, has not been shown to improve mortality and remember giving HCO3 --> H20 + CO2 which can increase CO2 levels) Resp. Acidosis:
Elevated pCO2- maximize Rate/TV If large tense ascites, consider increasing PEEP once intubated to increase intrathoracic pressure and improve lung recruitment.
Posted 11/14/16 10:13:50 AM by Adam Faye
Did NOT improve survival or reversal of shock (independent of response to corticotropin). Decreased time to reversal of shock.
Use of steroids in adults with severe sepsis (not in septic shock) did not reduce the risk of progression to septic shock within 14 days.
Posted 11/14/16 10:25:00 AM by Adam Faye
Created by Christopher Kelly
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