CRITICAL CARE

Malignant hyperthermia

Jun 26, 2021 by in CRITICAL CARE Comments Off on Malignant hyperthermia

• Risk factors for malignant hyperthermia (MH) include a family history of severe hyperthermia or sudden hypermetabolic state during anesthesia with exposure to succinylcholine and/or potent inhalation anesthetics, and ryanodine…

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Toxidromes and their treatment

Jun 26, 2021 by in CRITICAL CARE Comments Off on Toxidromes and their treatment

• Flumazenil, when used for benzodiazepine overdose, may unmask seizures caused by a coingested substance or precipitate acute withdrawal in the patient who habitually uses benzodiazepines. • β-Adrenergic antagonists, when…

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Tolerance, dependency, and withdrawal

Jun 26, 2021 by in CRITICAL CARE Comments Off on Tolerance, dependency, and withdrawal

• Physical dependency and withdrawal have been documented in all agents used for sedation and analgesia in the pediatric intensive care unit, including benzodiazepines, barbiturates, opioids, dexmedetomidine, propofol, and the…

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Neuromuscular blocking agents

Jun 26, 2021 by in CRITICAL CARE Comments Off on Neuromuscular blocking agents

• Through the blockade of skeletal muscle function, neuromuscular blocking agents (NMBAs) cause cessation of respiratory function, mandating airway control and the institution of mechanical ventilation. NMBAs should not be…

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Burn and inhalation injury

Jun 26, 2021 by in CRITICAL CARE Comments Off on Burn and inhalation injury

Pearls • The accurate estimation of burn severity is crucial both for appropriate resuscitation and for maintenance of adequate urine output and hemodynamics, including blood pressure and cardiac output. The…

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Bites and stings

Jun 26, 2021 by in CRITICAL CARE Comments Off on Bites and stings

• Snakebite-related morbidity and mortality are reduced most effectively by rapid transport, intensive care support, and the administration of antivenin. • Pit viper envenomation may produce both painful local tissue…

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Pediatric thoracic trauma

Jun 26, 2021 by in CRITICAL CARE Comments Off on Pediatric thoracic trauma

• Because of increased bone elasticity, rib fractures are uncommon in children and indicate significant traumatic energy delivery, raising concern for injuries of underlying viscera or nonaccidental trauma. • Children…

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