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emDOCs Revamp – Acute Chest Syndrome

EMDocs

Abdomen : ND, NT, no guarding or rebound MSK : Tenderness to palpation over L ribs 7-9 Derm : No rashes Imaging: Image 1: Case courtesy of Miriam Leiderer, Radiopaedia.org, rID: 81468 Chest radiograph (CXR) shows new left lower lobe opacity What’s most likely diagnosis? C or 100.4 mg/kg, max 0.4 C or 100.4 mg/kg, max 0.4

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ToxCard: Local Anesthetic Systemic Toxicity

EMDocs

1-5] Since then, many more medications have been developed and deployed. 1-5] This post focuses on the identification and management of Local Anesthetic Systemic Toxicity (LAST). 3-5,7] Symptom onset is usually within 1 minute of intravascular injection but can be delayed if multiple injections or continuous infusion. [5]

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TEG-Guided Resuscitation of Patients with Cirrhosis and Non-Variceal Bleeding

REBEL EM

A meta-analysis of fifteen RCTs comparing blood product transfusion rates of cardiothoracic and surgery patients found significantly lower transfusion rates of FFP in TEG/ROTEM guided group compared to traditional tests, with no difference in survival rates (Fahrendorff 2017). 2020;71(1):235-246. Article: Kumar M et al. Hepatology.

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What Lies Beneath

EMS 12-Lead

A 65 y/o Female was admitted to the ICU for septic shock. Question 1: What is the rhythm? Beat 1 : Sinus, narrow QRS complex. The assumption is that a premature complex discharged prior to Beat 1, which prolonged its respective refractory period in the same manner as Beat 5.

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Penetrating chest trauma

Don't Forget the Bubbles

He has already climbed Ben Nevis in Scotland, visited the Gobi desert (possibly from the comfort of his parents 4 x 4, but who’s judging) and has his bronze D of E nailed. She calls out her findings: A – OK B – 1 puncture mark to the anterior left chest wall, covered with a three-sided dressing. Actively oozing.

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Inotropes and Vasopressors: Doses, indications, contraindications and effects

ECG & Echo Learning

Most agents exhibit both vasopressor and inotropic effects (Figure 1). Below follows a drug manual for use in the CCU (coronary care unit), ICU (intensive care unit) or ER (emergency room). μg/kg/min Bolus : 1 mg IV every 3 to 5 min (max 0.2 mg/kg) IM: (1:1000): 0.1 De Backer D, Creteur J, Silva E, Vincent JL.

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Sickle Cell Disease Module

Don't Forget the Bubbles

Figure 1: Clinical manifestations and long-term consequences of sickle cell disease Training and education on sickle cell disease: Training and education are crucial to improve morbidity and mortality. Investigations : Bloods show Hb of 8 g/L, White cell count 13x 10 9 /L, Platelets 570 x10 9 /L, CRP 35mg/L.

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