Dog and Cat Bites (Clinical)
Overview Epidemiology[1,3,4] International data are lacking, but statistics in the United States include: Table: Demographics based on animal Dog bites Cat bites Approximately 90% of all animal bites Approximately 10% of all animal bites Men > women Women > men Children > adults Adults > children Less often result from provocation More often result from […]
Carbon Monoxide Poisoning (Clinical)
Etiology Pathophysiology Clinical Presentation The symptoms of CO poisoning are varied and nonspecific. The severity of the clinical presentation of CO poisoning depends on the amount of CO in the inhaled air, the duration of the exposure, and the general state of health of the affected individual. Mildly to moderately CO-intoxicated individuals[1–3,5] Severely CO-intoxicated individuals[1–3,5] […]
Malignant Hyperthermia (Clinical)
Overview Definition[1,2] Malignant hyperthermia (MH) is a hypermetabolic response in a patient exposed to a volatile anesthetic or succinylcholine resulting in fever, muscle rigidity, rhabdomyolysis, and pulmonary and cerebral edema. Epidemiology[2,5] Etiology[2,4] Triggering substances: “Safe” anesthetics for patients with previously diagnosed malignant hyperthermia: Pathophysiology[1,2] Clinical Presentation and Diagnosis Symptoms may appear at any point during […]
Serotonin Syndrome (Clinical)
Overview Definition[4] Serotonin syndrome is a potentially life-threatening condition caused by large increases in serotonergic activity due to exposure to serotonin agonists. Defining symptoms include altered mental status, autonomic instability, and neuromuscular abnormalities (tremors, myoclonus). Epidemiology[4,6] Etiology[6] Serotonin syndrome occurs secondary to use of therapeutic medication, drug interactions, or overdose. Pathophysiology Serotonin syndrome occurs from […]
Invasive Mechanical Ventilation
Definition and Indications Definition Invasive mechanical ventilation (IMV) is a form of advanced airway management used to deliver oxygen and/or to regulate ventilation at the level of the trachea through 3 main routes: Common indications for IMV Considerations There are several modes of IMV that are managed jointly based on: Invasive mechanical ventilation is not […]
Noninvasive Ventilation
Indications Definition Noninvasive ventilation (NIV) is respiratory support that does not require an artificial, invasive airway (such as an endotracheal tube). Types Indications The most common indication for use is acute respiratory failure: Common conditions that may be suitable for NIV: Contraindications While NIV may reduce the need for invasive mechanical ventilation and its associated […]
Airway Management
Airway Assessment Assessing airway, breathing, and circulation is essential in the approach to treating critically ill patients. Airway patency Visualization of the airway and observation of the individual can help determine the following: Patent airway: Partially obstructed airway: Complete obstruction: Respiratory effort Determining whether an individual is breathing will also guide management options. Airway Opening […]
Multitrauma
Overview Definition Multitrauma or polytrauma is defined as 2 or more severe injuries in at least 2 areas of the body (with at least 1 life-threatening injury). Epidemiology Trauma is a leading cause of mortality and morbidity globally. Hemorrhage is the most common preventable cause of mortality in trauma. Factors associated with poor outcomes in […]
Penetrating Abdominal Injury
Overview Definition A penetrating abdominal injury is the result of trauma from an object puncturing the skin, entering the body, and creating a wound. Epidemiology Etiology Pathophysiology and Clinical Presentation Mechanism of injury Clinical manifestations Diagnosis Because of the wide variety and severity of injuries associated with penetrating abdominal trauma, a prompt but careful history […]
ACES and RUSH: Resuscitation Ultrasound Protocols
Overview Background Basics of ultrasonography Abdominal and Cardiac Evaluation with Sonography in Shock (ACES) Definition Abdominal and cardiac evaluation with sonography in shock is a POCUS examination exam used in cases of nontraumatic undifferentiated hypotension performed in the ER. Principles Protocol Table: ACES protocol: Possible findings in shock Type of shock Cardiac IVC Aorta Peritoneal […]