Post-cardiac arrest care
- Four key areas: - Blood pressure support - Immediate catheterization - Targeted temperature management - Full-body imaging Blood pressure support - If SBP below 90 or MAP below 65 mmHg - Initial treatment: 1-2 liters of IV saline or Lactated Ringer's - Vasopressors if BP remains low - Norepinephrine for non-arrest patients - Dopamine, vasopressin, and phenylephrine as second-line agents - Epinephrine for severe hypotension or last resort Immediate catheterization - ST-elevation myocardial infarction (STEMI) patients: immediate PCI - Non-STEMI patients: - Observational studies suggest potential benefits - Randomized controlled trials show mixed results Targeted temperature management (TTM) - Therapeutic hypothermia at 33°C initially recommended - TTM2 trial: no significant difference between 33°C and 36°C - Maintain core body temperature between 32°C and 36°C for at least 24 hours - Trained professionals for induction and monitoring Full-body imaging - Reveals important findings in some cases - Routine use of extensive imaging controversial - Further research needed to determine true benefit Conclusion - Complex decision-making in post-cardiac arrest care - Stay informed on evolving evidence and guidelines - Provide optimal care to patients following a cardiac arrest event
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MRI Sequences in Clinical Medicine
T1-Weighted Sequence:
T2-Weighted Sequence:
Diffusion-Weighted Imaging (DWI):
Gradient-Recalled Echo (GRE) Sequence:
In summary, There are four primary MRI sequences:
Platelet Transfusion Threshold
Immediate Platelet Transfusion:
When to Transfuse Platelets?
Transfuse if platelet count is below 10,000 per microliter:
Transfuse if platelet count is below 20,000 per microliter:
Transfuse if platelet count is below 30,000 per microliter:
Transfuse if platelet count is below 50,000 per microliter:
Transfuse if platelet count is below 70,000 per microliter:
Transfuse if platelet count is below 100,000 per microliter:
Here are the top 6 reasons why I love Emergency Medicine
Post-Intubation Sedation
Introduction:
Guidelines:
Conclusion:
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