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I was on call in a hot summer weekend night. I received a call for possible urgent left thoracotomy for traumatic diaphragmatic rupture. He was 35 yrs. old...
Very well hndled, although I'd have inserted an a-line from the start. There was too much opportunity for wide BP swings. Especially, as you said, during a...
Canceled a case last Friday. 75 Y/O for Wertheim hysterectomy with distended abdomen (ascites), +3 leg edema and a sodium of 122 meq/L. At what sodium do you...
Thanks, like I said I did so many bowel obstruction cases over the yrs and I never needed invasive monitoring plus nowadays there is the warning about...
Also me, I would postpone her untill correction of her suspected dilutional hyponatremia (ascities, lower limb edema). I usually could not accept elective...
Invasive monitoring, DL ETT but due to a full stomach considerations the El Ganzouri or equivalent index should be determined, if it is easier intubate with a...
There was no problem as regarding the intubation score. His inter-incisor distance was 5 cm, thyromental distance of 6 cm, unlimited neck extension, and...
128 I have accepted if it is chronic and resistant to treatment - there's a good number of such cases. no difference for sex or age, although females are known...
Well a DL ETT is often more difficult to insert than a single lumen and if he aspirates on induction everyone will tell you you should have used a single lumen...
Elderly patients still carry the higher risk to develop hyponatremia and this poses higher incidence of postoperative delayed recovery, cognitive dysfunction...
We had a similar case several years back. We did an RSI with a regular ET, then converted immediately to a double lumen ET to isolate the left lung. We then...
Ivan, While a PICC is good for longterm infusion, and does have lower infection problems, you can't hydrate rapidly as you know. That's why I suggested the a...
Very fascinating Joe. For the current patient, NG tube was inserted preoperatively in the radiology suit by thoracic registrar, stomach was suctioned,...
... *The attached file and the following links are my reference for my statement:* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938515/?tool=pubmed ...
I have been working for about two years sporadicly with an ophtalmologist. Before start the procedure the surgeon has spoken to the patient, later I speak the...
Recently a recent (second) NEJM paper by dr Avidan was posted here with no response. In line with his first paper it showed there was little difference in...
The Pentax AWS has one size channel so I'd think it may be difficult. The Airtraq on the other hand has a dedicated DL optical scope (looks exactly like the...
1. I didn't mention a CV line, although one could make a case for one, but I think an a-line would have been a really good idea. PICC lines are useless for any...
Nice story - barring anyone reporting any more encounters with autonomic hyperreflexia I guess we could view it as something that surely requires GA or...
Thanks for your time Mohamed - very useful overview ! In light of these findings - does anyone use D5 anymore ? Sandy H. suggested its use for rehydration of...
... For pure dehydration, (intracellular fluid deficit), 5% glucose (which is also a crystalloid by the way) is the best fluid. Balanced salt solutions do...
Thanks Ivan, I no longer use D5W except for diabetic, hepatic, and pediatric patients. I usually use dextrose in NaCl 0.45% in the later two. I am scarred...
I never use D5 in replacing fluid deficit or Maintainace or dehydration in adults except if there is indication like DM Mohamed kashlan Sent from my iPhone...
When we talk about fluid resuscitation we mainly need intravascular volume repletion as that will show as low BP. Ideally cells who are also dehydrated after...
Dear All, I'd like to share my thought about an important issue regard the amount of resident physicians' work per week in your country. As the Libby Zion law...
Dear Dr Ahmadi If possible please indicate the exact timing of residency work. I mean at what time in the morning the work start and to wath time it continue....
... ….except for the sugar crystals, which are dissolved in the water…. ... Thanks for posting this link from Kerry Brandis, who has been an instrumental...
Dr.Mohamed R.El-Tahan, M.D. Assistant professor of Anaesthesia & Surgical ICU King Faisal University, Ad-Dammam, Saudi Arabia Association of Cardiothoracic...
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