Sandbox: Difference between revisions

Revision as of 20:33, 31 May 2023

Acidosis	Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock	Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement
		Hyperventilate
		Consider intravenous bicarbonate if pH <7.20 after above actions have been taken
Cardiac tamponade	Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI	Give fluids; obtain bedside echocardiogram
		Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.
Hypothermia	Alcohol abuse, burns, CNS disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma	If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.
		If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas
Hypovolemia, hemorrhage, anemia	Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma	Give fluids
		Transfuse pRBCs if hemorrhage or profound anemia is present
		Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min

Authors:

@@ Line 1: / Line 1: @@
+{| class="wikitable"
-{|class="wikitable"
+! Acidosis !! Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock !! Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement  !!  !!  !!  !!  !!  !!  !!
-|+Typical imaging findings in normal pressure hydrocephalus versus brain atrophy.<ref> Ishii M, Kawamata T, Akiguchi I, Yagi H, Watanabe Y, Watanabe T, Mashimo H (March 2010). "Parkinsonian Symptomatology May Correlate with CT Findings before and after Shunting in Idiopathic Normal Pressure Hydrocephalus". Parkinson's Disease. 2010: 1–7. doi:10.4061/2010/201089. PMC 2951141. PMID 20948890.</ref>
-|  |
-|align="center"|[[File:Normal pressure hydrocephalus versus atrophy, NPH.jpg|335px]]
-|align="center"|[[File:Normal pressure hydrocephalus versus atrophy, CA.jpg|333px]]
 |-
-|
+|  ||  || Hyperventilate  ||  ||  ||  ||  ||  ||  ||
-! Normal pressure hydrocephalus !! Brain atrophy
 |-
-| Preferable projection ||colspan=2| Coronal plane at the level of the posterior commissure of the brain.
+|  ||  || Consider intravenous bicarbonate if pH <7.20 after above actions have been taken  ||  ||  ||  ||  ||  ||  ||
 |-
-| Modality in this example || CT || MRI
+| Cardiac tamponade || Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI || Give fluids; obtain bedside echocardiogram  ||  ||  ||  ||  ||  ||  ||
 |-
-| CSF spaces over the convexity near the vertex (red ellipse) || Narrowed convexity ("tight convexity") as well as medial cisterns || Widened vertex (red arrow) and medial cisterns (green arrow)
+|  ||  || Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.  ||  ||  ||  ||  ||  ||  ||
 |-
-| Callosal angle (blue V) || Acute angle || Obtuse angle
+| Hypothermia || Alcohol abuse, burns, CNS  disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma || If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.  ||  ||  ||  ||  ||  ||  ||
 |-
-| Most likely cause of leucoaraiosis (periventricular signal alterations, blue arrows)
+|  ||  || If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas  ||  ||  ||  ||  ||  ||  ||
-| Transependymal [[cerebrospinal fluid]] diapedesis
+|-
-| Vascular encephalopathy, in this case suggested by unilateral occurrence
+| Hypovolemia, hemorrhage, anemia || Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma || Give fluids  ||  ||  ||  ||  ||  ||  ||
+|-
+|  ||  || Transfuse pRBCs if hemorrhage or profound anemia is present  ||  ||  ||  ||  ||  ||  ||
+|-
+|  ||  || Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min  ||  ||  ||  ||  ||  ||  ||
 |}