ICU Notes Discussion..By Dr.Amany Fathy🩺❤️
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Recent studies have shown that the use of β-blockers are safe and may even be beneficial in pts of Aortic stenosis
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A 45-year-old male is found unconscious in a cold environment (core temp 28°C). He has bradycardia and hypotension. What is the most appropriate initial management step?
Anonymous Quiz
18%
Passive external warming blankets only
6%
Aggressive Mechanical ventilation with high PEEP
4%
Immediate Surgical exploration for frostbite
71%
Rapid active rewarming with warm IV Fluids
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🌟Remember

Women with pulmonary hypertension should avoid becoming pregnant due to very high maternal mortality
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🌟Pheochromocytoma + nausea/vomiting → NEVER give metoclopramide

Metoclopramide trigger Catecholamines release causes Hypertensive Crisis
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🌟Metformin

High dose (> 2 g daily) interferes with enterohepatic circulation of the bile salts (Bile salt malabsorption) .... diarrhoea
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🌟SVT → Adenosine

🌟AF + RVR → Rate control

🌟VT + pulse → Amiodarone/Cardioversion

🌟VF/Pulseless VT → Defibrillate
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A 68-year-old male, post-op day 2 after open abdominal aortic aneurysm repair, requires urgent CT angiography for suspected graft thrombosis.
Anonymous Quiz
18%
Increase norepinephrine to 1.0 mcg/Kg/min
6%
Secure airway with endotracheal intubtion
59%
Ensure all IV lines are secured and Labeled
18%
Administer prophylactic antibiotics for transport
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The American Diabetes Association Standards of Care recommends most SGLT2 inhibitors be stopped three days before a scheduled surgery
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The DPP-4 inhibitors
(e.g. sitagliptin, vildagliptin, saxagliptin, alogliptin, linagliptin) should be withheld on the day of surgery
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Metformin should be stopped 48 hours before and 48 hours after surgery[in high risk pts] to decrease the risk of a lactic acidosis.
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