https://wikem.org/w/api.php?action=feedcontributions&feedformat=atom&user=Njoshi8WikEM - User contributions [en]2026-04-19T18:13:45ZUser contributionsMediaWiki 1.38.2https://wikem.org/w/index.php?title=GEMC:Using_Simulations_in_Emergency_Education&diff=14944GEMC:Using Simulations in Emergency Education2013-12-05T19:47:31Z<p>Njoshi8: I added links to blog postings I have written for academic life in EM</p>
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<div>=General=<br />
This the main page for the [[GEMC: Global Emergency Medicine Curriculum (Main)|Global Emergency Medicine Curriculum Project's]] '''Using Simulations in Emergency Education''' section. For point of care treatment information see the respective category page and non-GEMC notes.<br />
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=Using Simulations in Emergency Education=<br />
==Book Chapters - May Not Be Open Access==<br />
*<br />
==Journal Articles==<br />
*<br />
==Blogs & Web Sites==<br />
*<br />
http://academiclifeinem.com/simulation-trick-of-the-trade-paper-mache/<br />
http://academiclifeinem.com/simulation-trick-of-the-trade-blindfold-the-leader/<br />
http://academiclifeinem.com/crisis-resource-management/<br />
http://academiclifeinem.com/aliem-sim-case-series-mass-casualty-building-bombing/<br />
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==Protocols & Guidelines==<br />
*<br />
==Slide Sets==<br />
*<br />
==Podcasts==<br />
*<br />
==Videos==<br />
*<br />
==Other Resources==<br />
*<br />
<br />
*[[GEMC: Global Emergency Medicine Curriculum (Main)]]<br />
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[[Category:GEMC]]</div>Njoshi8https://wikem.org/w/index.php?title=Preeclampsia&diff=14943Preeclampsia2013-12-05T19:44:32Z<p>Njoshi8: /* Diagnosis */</p>
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<div>== Background ==<br />
#Preeclampsia and eclampsia are diagnosed after 20wks gestation and <4wk post-partum<br />
##May occur sooner w/ gestational trophoblastic disease<br />
#Defined as SBP>140 or DBP>90 in previously normotensive pt AND proteinuria >0.3gm in 24h or persistent proteinuria > 1+ on dipstick<br />
#Only 10% of cases occur prior to 34wk<br />
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==Work-Up==<br />
#CBC<br />
##Thrombocytopenia suggests severe disease<br />
#Chemistry<br />
##Elevated Cr suggests severe disease<br />
#LFT<br />
##AST/ALT elevation suggests severe disease<br />
#LDH<br />
##Elevation suggests microangiopathic hemolysis<br />
#Uric acid level<br />
##Often elevated in preeclampsia<br />
#UA<br />
##Proteinuria<br />
<br />
==Diagnosis==<br />
*Mild preeclampsia:<br />
**SBP > 140 or DBP > 90<br />
**Proteinuria > 0.3 g/24 hrs or > 1+ on urine dipstick<br />
*Severe preeclampsia suggested by any of the following:<br />
**SBP >160 or DBP>110<br />
**Neurologic sequelae<br />
***Visual disturbances<br />
***Mental status changes<br />
***Focal neurologic symptoms<br />
***Severe headache refractory to analgesia<br />
**Pulmonary edema<br />
**GI involvement<br />
***Epigastric or RUQ pain<br />
***LFT abnormalities (> 2x normal)<br />
**Thrombocytopenia < 100,000 plt/mm^3<br />
**Impaired fetal growth<br />
**Oliguria (<500 mL in 24hr)<br />
**Proteinuria of 5 gm in 24hr OR 3+ on two random urine samples collected 4hr apart<br />
***Lack of proteinuria is not rule-out!<br />
<br />
In 2013, ACOG has decided to remove proteinuria from the definition of preeclampsia<br />
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==Treatment==<br />
#Only definitive tx is delivery<br />
##Mild preeclampsia - induction or C-section if > 37 wks; consider close monitoring if 34-37 wks<br />
##Severe Preeclampsia - induction or C-section independent of GA<br />
#Some cases of mild preeclampsia may be candidates for outpatient therapy<br />
##close follow up and return precautions is key<br />
##Repeat lab tests 1-2x per week (platelet count, creatinine, AST)<br />
#BP Control<br />
##Lower to Sys 130-150, dia 80-100<br />
###[[Labetalol]]<br />
####Option 1: Initial 20mg; then doses of 20-80mg q10min to total of 300mg<br />
####Option 2: Initial 20mg; then IV infusion of 1-2mg/min<br />
###Hydralazine<br />
####5mg IV over 1-2min; repeat bolus of 5-10mg q20min PRN to total of 30mg<br />
#Prevent eclampsia<br />
##[[Magnesium]]: Load 4-6g IV over 15min followed by 2-3g per hr<br />
###Observe for loss of reflexes, respiratory depression<br />
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==Disposition==<br />
*Consult w/ OB/GYN regarding d/c versus admission<br />
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==See Also==<br />
*[[Post-Partum Emergencies]]<br />
*[[Eclampsia]]<br />
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==Source==<br />
*Tintinalli<br />
*EBM, Volume 12, Number 8, Aug 2010. Postpartum Emergencies<br />
*Uptodate<br />
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[[Category:OB/GYN]]</div>Njoshi8