Acid–base interpretation
7.35, alkalemia refers to a pH 7.45. Acidosis refers to a process that increases hydrogen ion concentration, while alkalosis refers to a process that decreases hydrogen ion concentration. Patients are…
Severe sepsis and septic shock
SIRS Criteria (2 of the following are required) Fever or hypothermia <36°C (96.8°F) or >38°C (100.4°F) Tachycardia HR >90 bpm Tachypnea RR >20 or PaCO2 <32 mmHg Leukocytosis/leukopenia <4000/microliter, >12…
Necrotizing soft tissue and skin infections
Type Microbial etiology Type I Polymicrobial (most common) Type II Monomicrobial (streptococci, staphylococci, clostridia) Type III Vibrio vulnificus (associated with seawater exposure) Presentation Classic presentation NSTIs are notoriously difficult to…
Thyroid storm
Infection/sepsis Surgery Acute coronary syndrome/myocardial infarction Cerebral vascular accident Trauma (especially neck trauma) Medication noncompliance Thyroid hormone ingestion Iodine contrast Presentation The broad clinical picture is one suggestive of a…
Pericarditis and myocarditis
Viral Bacterial Fungal Parasitic Radiation induced Drug induced Neoplastic Systemic inflammatory disease Myocardial infarction/Dressler syndrome (pericarditis) Traumatic (pericarditis) Metabolic (pericarditis) Peripartum (myocarditis) Myocarditis Myocarditis is an inflammatory disorder of the…
Ischemic strokes
These statements must be true in order to consider tPA administration:1. Ischemic stroke onset within 3 hours, or in certain causes within 4.5 hours.2. Measurable deficit on NIH Stroke Scale…
The boarding ICU patient in the emergency department
Figure 5.1. Components of oxygen delivery. CaO2, arterial oxygen content; PaO2, partial pressure of oxygen; SaO2, oxygen saturation; Hgb, hemoglobin. Endpoints of resuscitation Endpoints of resuscitation (EOR) are vital to…
Acute kidney injury and emergent dialysis
0.3 mg/dL within 48 hours, or Increase in serum creatinine to 1.5 times baseline within the prior 7 days, or Urine volume <0.5 mL/kg/hour for 6 hours. There are three…
Complications of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)
Pneumocystis jirovecii pneumonia (PCP) Esophageal candidiasis Wasting syndrome Kaposi sarcoma Disseminated Mycobacterium avium infection Tuberculosis Cytomegalovirus (CMV) disease HIV-associated dementia Recurrent bacterial pneumonia Toxoplasmosis Immunoblastic lymphoma Chronic cryptosporidiosis Burkitt lymphoma…
Severe traumatic brain injury
8) following head trauma with either Significant mechanism of injury (fall from height, high speed MVC), or Significant physical examination findings (depressed skull fracture, facial trauma, scalp lacerations). Severe TBI…
