A Week in Review: Feb 20th - Feb 24th
Monday: Back to Basics - Baby, It's Cold Outside: Death by Hypothermia
Rewarm strategy based on CV status, NOT current temperature
First = Passive (ie removal from cold environement, including clothes)
Second = Active External - warm water emersion, heating blankets, warm forced air
Third = Active Core - Warm IV Fluids, GI, Bladder, Peritoneal, Pleural Lavage
Finally = ECMO - check the post for all the details
Tuesday: Advanced Practice - How did the STD get there, Doc??
Don't forget about disseminated gonococcal infection (migratory polyarthalgia, rash)
Diagnosis made via fluid culture (although only positive 40%), use clinical correlation
Treatment = IV Ceftriaxone followed by oral therapy after improvement in rash / joint effusion
Wednesday: Whats the Diagnosis? by Joesph Cesarine
Thursday: #EMconf - Dialysis Catheter Infections and Other Nephrology Pearls
Most Common Causes of CRBI are gram positives (Staph), start wtih Vanc (20mg/kg) and Cefepime (1gm)
Make sure to check if your dialysis patient still makes urine!
No data to support immediate dialysis after IV contrast, HOWEVER, definately dialysis after Gadolinium for MRIs
How to make the Diag: look for High Volume Resuscitation + Decreased Compliance + Increased Abdominal Content
Treatment based on Grade (intra abdominal pressure)
If Greater than 20 mmHg time to consider decompressive laparotomy