Severe pelvic trauma

Feb 17, 2017 by in CRITICAL CARE Comments Off on Severe pelvic trauma

Figure 12.1. (a) Young–Burgess lateral compression (LC) pelvic fracture classifications; (b) computed tomography (CT) of LCI fracture pattern; (c) radiograph of LCI fracture pattern. (Reprinted with permission from Hammel J….

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Infective endocarditis

Feb 17, 2017 by in CRITICAL CARE Comments Off on Infective endocarditis

History Common causative organism Native valve Streptococcus viridans, Staphylococcus aureus Prosthetic valve Staphylococcus epidermidis IVDA Staphylococcus aureus Presentation Classic presentation Presentation is nonspecific and variable, but the most common symptoms…

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Sickle cell emergencies

Feb 17, 2017 by in CRITICAL CARE Comments Off on Sickle cell emergencies

Common causes Possible causes Pulmonary infectionFat embolismRib infarction ThromboembolismIn situ thrombosisLung sequestrationIatrogenic (excessive hydration, excessive narcotic use) Splenic sequestration Splenic sequestration, or intrasplenic trapping of RBCs, is a major cause…

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Tumor lysis syndrome

Feb 17, 2017 by in CRITICAL CARE Comments Off on Tumor lysis syndrome

High risk Non-Hodgkin lymphoma Burkitt lymphoma Lymphoblastic lymphoma B-cell acute lymphoblastic leukemia (ALL) ALL with white blood cell count (WBC) >100 000/microliter Acute myelogenous leukemia (AML) with white blood cell…

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Shock

Feb 17, 2017 by in CRITICAL CARE Comments Off on Shock

Distributive Severe inflammatory response syndrome (SIRS) and sepsis, neurogenic, anaphylaxis, adrenal insufficiency/Addisonian crisis, drug or toxin reaction, hepatic failure Hypovolemic Hemorrhage (trauma, GI bleed, ruptured AAA), GI losses (diarrhea, vomiting,…

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Acute respiratory distress syndrome

Feb 17, 2017 by in CRITICAL CARE Comments Off on Acute respiratory distress syndrome

Direct injuries to lungs Indirect injuries Pneumonia Sepsis Aspiration• Gastric contents• Near-drowning• Hydrocarbons/solvents Severe trauma• Multiple fractures• Head injury• Burns Smoke or toxic gas inhalation Pancreatitis Pulmonary contusion Multiple blood…

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Small bowel obstruction

Feb 17, 2017 by in CRITICAL CARE Comments Off on Small bowel obstruction

Type Etiology Mechanical A physical barrier exists that blocks normal intestinal flow Closed-loop Two sequential sites of obstruction block a portion of bowel, usually through a hernia or adhesive band…

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Care of the dying patient

Feb 17, 2017 by in CRITICAL CARE Comments Off on Care of the dying patient

Ten-step guide Tips/examples Establish a proper setting Quiet, appropriate parties invited, pagers turned off. Introductions “Can you tell me something about your mom?” Assess patient/family understanding “What have the doctors…

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Hypothermia

Feb 17, 2017 by in CRITICAL CARE Comments Off on Hypothermia

Figure 65.1. ECG of a patient with hypothermia and Osborn waves. Diagnosis and evaluation Confirm hypothermia with rectal thermometer, indwelling Foley with temperature sensor, or other means of core temperature…

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Tachyarrhythmias

Feb 17, 2017 by in CRITICAL CARE Comments Off on Tachyarrhythmias

0.12 seconds. A wide complex rhythm suggests an aberrancy in the normal conduction system and is usually the result of one of the following: A preexisting or rate-related abnormality within…

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