RESPIRATORY

Pulmonary and critical care pearls

Sep 14, 2018 by in RESPIRATORY Comments Off on Pulmonary and critical care pearls

Respiratory mechanics and sounds: ( Fig. 28.1 ) • Inspiration: • Active process in which diaphragmatic contraction generates negative intrathoracic pressure, sucking air into the conducting airways • Exhalation: •…

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Diabetic emergencies

Sep 14, 2018 by in RESPIRATORY Comments Off on Diabetic emergencies

Common misconceptions and mistakes • Extreme hyperglycemia always implies profound dehydration and is pathognomonic for a hyperosmolar-type presentation • Diabetic ketoacidosis (DKA) always requires aggressive fluid resuscitation • Attributing ketoacidosis…

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Advanced care planning and the family meeting

Sep 14, 2018 by in RESPIRATORY Comments Off on Advanced care planning and the family meeting

Common misconceptions and mistakes • Parsing out critical care into its individual interventions, asking surrogates what they think their loved one would want (eg, triple-lumen catheter [TLC] placement, nasogastric [NG]…

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Code status

Sep 14, 2018 by in RESPIRATORY Comments Off on Code status

Common misconceptions and mistakes • Advising your patients to avoid resuscitation based on your assessment of the severity of their baseline cardiopulmonary disease and your “certainty” that resuscitation attempts would…

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Bedside presentations in the ICU

Sep 14, 2018 by in RESPIRATORY Comments Off on Bedside presentations in the ICU

Common misconceptions and mistakes • Giving three complete, separate physical examinations when presenting a single new admission (emegency department [ED] examination, intensive care unit (ICU) admit examination, and the current…

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The obtunded inpatient with normal vital signs

Sep 14, 2018 by in RESPIRATORY Comments Off on The obtunded inpatient with normal vital signs

Common misconceptions and mistakes • All unarousable patients should be immediately intubated because “they are not protecting their airway” • Failing to realize that only a finite number of processes…

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Hemoptysis

Sep 14, 2018 by in RESPIRATORY Comments Off on Hemoptysis

Common misconceptions and mistakes • Believing that a double-lumen tube is the preferred airway in a patient with massive hemoptysis • Failing to treat patients with bronchiectasis and hemoptysis with…

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Liberation from mechanical ventilation

Sep 14, 2018 by in RESPIRATORY Comments Off on Liberation from mechanical ventilation

Common misconceptions and mistakes • Labeling a patient as “failure to wean” because of a rapid shallow breathing pattern (ie, increased rapid shallow breathing index [RSBI]) during spontaneous breathing trial…

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