I've always thought that with a plasma transfusion, blood type is critical, just as with PRBC's, and that therefore a Type A patient, for example, must get only Type A or AB plasma.
However, someone told me that in an emergency, a Type A plasma ...
I know that the recommendation for treating hypertension in a subarachnoid bleed is to keep the BP below 140, but is there any accepted recommendation for traumatic subarachnoid bleeds?
Would you treat a BP of 230/120 in a patient with a traumat...
I'm wondering what protocols/decisions strategies the neurologists in your ICU/ER use for deciding to use Keppra prophylacticaly for seizures, and mannitol/hypertonic saline? I ask the question because I don't seem to see uniformity in how certain pa...
Thanks for your responses! What do you guys think is the best way to monitor tube placement during transport of a neonate? In adults waveform capnography is great because you get an immediate alert if the tube is dislodged (i.e., into the hypopharanx...
For a neonate, can waveform capnography be used for ET tube confirmation (post intubation and during transport)? I guess I don't see why it shouldn't be, but I don't see any reference to waveform capnography in my NRP book.
I get that, but my understand is that an arterial occlusion of the leg is going to happen in the femoral artery, or in the popliteal artery proximal to the knee. In either case, you'd have no circulation to the lower leg, and thus neither a pedal pul...
Thanks for the reply. My understanding is that we are mainly checking pedal or posterior tibial pulses to make sure the patient hasn't developed an arterial clot higher up in the leg, in which case we would find neither pulse. So, as long as we are f...
If you can feel or Doppler a pedal pulse, is there really any need to find a posterior tibial pulse? Likewise, if you can get a posterior tibial pulse, any need to feel for a pedal pulse?
Thanks for your replies. I didn't realize I had gotten any messages, hence this late reply. I've worked in the ER for many years, but I've never seen a seizure due to hyponatremia. We're always ready to treat for this whenever the L.A. marathon comes...
Has anyone ever seen a hyponatremic seizure in the ER? I'm just curious on how the patient presented, how long the seizure lasted, if you saw immediate relief from treatments, etc. details.
Taking a two-week paramedic course may certify you on paper, but it will not make you a competent paramedic. You need a bunch of experience working as a medic, not just a little bit of classroom time. I understand that flight programs look more favor...
Thanks for your responses. We didn't want to do amio because she wasn't anticoagulated yet. The obvious thing to me was to do rate control, but I wasn't sure if Cardizem was the right thing to use since it would antagonize the Levophed. The doc didn'...
How would you treat this patient in regards to rate control: Pt has been going in AF for a few days, and now they are in AF RVR with a rate of 130. The patient is also on Levophed at 5 mcg/min. BP is 100/60.
I recently heard of a case (if I remember it was the EmCrit podcast, but it may have been another) where a patient with asymptomatic HTN was given hydralazine IVP for a BP of 175/90 in the ED. The patient was admitted for an unrelated complaint (cell...
