2 days neonate presented with faiture of passage of stool
OE :- absence of anal opening
Dx :- imperforate anus
Tx :- temporary colostomy for evacuation then scadualed operation
We should examine the neonates completely after the delivery to look for any abnormalities and anus shouldn’t be missed..
OE :- absence of anal opening
Dx :- imperforate anus
Tx :- temporary colostomy for evacuation then scadualed operation
We should examine the neonates completely after the delivery to look for any abnormalities and anus shouldn’t be missed..
Forwarded from My ED cases (Murtadha Ali)
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Jitterness
Sign of hypocalcemia
ناخذها قاعدة اي فت او ابنورمال موفمنت بالنيونيت نشوف الراندم والكالسيوم( والالكترولايت بس مو دائما)
النيونيت يكونوا كلش سنستف للجيجن بالفلود او المنرل
يعني ممكن دوز وحدة تنساها تسوي هايبوكلايسيميا او غيرها مو مثل الكبار
ممكن ثالث يوم من الحياة تنسى الاورال فيدينك انه تضيفه
تلكيه الكالسيوم والبوتاسيوم متخربطات اذا ما ضايفهن على المنتننس مال الفلود
This pt sr ca was 6.5
Sign of hypocalcemia
ناخذها قاعدة اي فت او ابنورمال موفمنت بالنيونيت نشوف الراندم والكالسيوم( والالكترولايت بس مو دائما)
النيونيت يكونوا كلش سنستف للجيجن بالفلود او المنرل
يعني ممكن دوز وحدة تنساها تسوي هايبوكلايسيميا او غيرها مو مثل الكبار
ممكن ثالث يوم من الحياة تنسى الاورال فيدينك انه تضيفه
تلكيه الكالسيوم والبوتاسيوم متخربطات اذا ما ضايفهن على المنتننس مال الفلود
This pt sr ca was 6.5
Acute respiratory distress syndrome
⭕️Definition:
🌀acute respiratory insult or worsening in respiratory status within 1 week.
🌀 bilateral infiltration without alternative explanation such as effusion, nodules or atelectasis.
🌀Edema not fully explained by fluid overload or CHF.
🌀Hypoxemia.
⭕️Etiology:
🌀direct ➡️ pneumonia, aspiration, inhalational injury, lung contusion and near drowning
🌀 indirect ➡️ sepsis, shock , DIC, pancreatitis, TRALI , trauma.
⭕️ Treatment: the 6 Ps
⁃ PEEP.
⁃ Prone position .
⁃ Paralysis( not routinely recommended unless dyssynchronised ventilation) .
⁃ Peeing ( fluid balance) target Cvp 2-4 cm H2o
⁃ Pulmonary vasodilator such as NO.
⁃ Perfusion( v-v ECMO) maybe useful if refractory.
⭕️Definition:
🌀acute respiratory insult or worsening in respiratory status within 1 week.
🌀 bilateral infiltration without alternative explanation such as effusion, nodules or atelectasis.
🌀Edema not fully explained by fluid overload or CHF.
🌀Hypoxemia.
⭕️Etiology:
🌀direct ➡️ pneumonia, aspiration, inhalational injury, lung contusion and near drowning
🌀 indirect ➡️ sepsis, shock , DIC, pancreatitis, TRALI , trauma.
⭕️ Treatment: the 6 Ps
⁃ PEEP.
⁃ Prone position .
⁃ Paralysis( not routinely recommended unless dyssynchronised ventilation) .
⁃ Peeing ( fluid balance) target Cvp 2-4 cm H2o
⁃ Pulmonary vasodilator such as NO.
⁃ Perfusion( v-v ECMO) maybe useful if refractory.
Forwarded from AAS Medical Notes (Mohammed S)
ECG.pdf
18.4 MB
ECG كتاب
مبسط ويبدا مباشرة من ارذميات ويفيد بالطوارئ مجمع من مواقع
ecgwaves, healio, litfl, medscape
للفائدة _يفيد المقيمين_
مبسط ويبدا مباشرة من ارذميات ويفيد بالطوارئ مجمع من مواقع
ecgwaves, healio, litfl, medscape
للفائدة _يفيد المقيمين_
#طب_عدلي نقلاً عن دكتور يزن امير
A 4 year old boy found dead in the garage at his family house. The father said the child was active and otherwise healthy, the child was playing alone.
Autopsy showed a nylon balloon lodged in the larynx.
Suffocation by foreign body can occur at any age, however, children (unattended) are more prone to this tragic event.
A 4 year old boy found dead in the garage at his family house. The father said the child was active and otherwise healthy, the child was playing alone.
Autopsy showed a nylon balloon lodged in the larynx.
Suffocation by foreign body can occur at any age, however, children (unattended) are more prone to this tragic event.
⚜️ Case
A 17-year-old man is brought to the ER by his mother after he was stung by an insect. He had been playing football at the local park when his mother thought she saw a bee near his leg. He is feeling nauseous and reports a rash on his leg that is spreading to the rest of his body. He complains that his throat feels itchy and feels like he is having palpitations. He has a history of asthma.
⭕️ On Examination
Vital signs: temperature of 36.8°C, blood pressure of 85/60, heart rate of 110 and regular, respiratory rate of 24, 95% O 2 saturation on air.
General examination reveals a blotchy, erythematous rash on his right leg that is spreading upwards towards his trunk, as well as swelling of his lips and tongue. Cardiac examination is unremarkable, and auscultation of the chest is notable for mild expiratory wheeze.
What’s your dx and how to manage
A 17-year-old man is brought to the ER by his mother after he was stung by an insect. He had been playing football at the local park when his mother thought she saw a bee near his leg. He is feeling nauseous and reports a rash on his leg that is spreading to the rest of his body. He complains that his throat feels itchy and feels like he is having palpitations. He has a history of asthma.
⭕️ On Examination
Vital signs: temperature of 36.8°C, blood pressure of 85/60, heart rate of 110 and regular, respiratory rate of 24, 95% O 2 saturation on air.
General examination reveals a blotchy, erythematous rash on his right leg that is spreading upwards towards his trunk, as well as swelling of his lips and tongue. Cardiac examination is unremarkable, and auscultation of the chest is notable for mild expiratory wheeze.
What’s your dx and how to manage
👍1
⭕️Anaphylactic shock⭕️اليوم خل نحجي شوية عن الanaphylactic shock والي نكدر نختصرها ببساطة
It’s a sudden general immunological reaction to foreign substances
يعني بمجرد ما يتعرض بعض الاشخاص لأحد المحفزات راح يتحفز عنده رد فعل مناعي اتجاهها ويسويلي اعراض … فشنو هاي المحفزات و شنو هاي الاعراض؟
المحفزات هي عديدة و لكن اهمها ممكن تكون ادوية 💊 معينة او لقاحات 💉 ، انواع من الاكل 🍱، لسعة النحل 🐝 او الحشرات الاخرى ، مادة اللاتكس غيرها.
زين شلون راح يجيني المريض ؟؟؟
اولا وقبل كلشي راح ينطونا الاهل بالهستري انه المريض متعرض لوحدة من الاشياء الي عددناهن فوك ☝🏻☝🏻و اذا مكلولنا لازم احنا نسال عنهن من نشوف الاعراض و نشك بالمريض.
اما كأعراض فالمريض راح يجيني عنده واحد او اكثر من الاتي :
⚜️Skin : pruritus , erythema , rash and urticaria.
⚜️Respiratory: lip , tongue and epiglottis swelling > URT obstruction
Or dyspnea, wheeze , chest tightness and hypoxia .
⚜️CVS : Peripheral vasodilation > hypotension and shock, Arrhythmia and ischemic chest pain.
⚜️GIT : N/V , diarrhea and abdominal cramps.
شلون راح نشخصه ؟ عادة اكو كرايتيرا من ضمنها انه لازم تكون الاعراض فجأة طلعت خلال دقايق الى ساعات و هي تتمثل ب
Acute onset illness that involves the skin and/or mucosa, with either respiratory compromise or hypotension
هسه بعد ما عرفنا شبي المريض نجي شلون نتعامل وياه بالطوارئ 😎
1- remove or discontinue the causing substance.
2- put patient in supine position and raise the legs.
3-ABCD including secure the airway and give O2, IV lines.
4- give adrenaline as soon as possible 0.5ml IM and can repeat every 3-5 min
5- give fluids 1-2L in adults and 20mg/kg in children if BP didn’t respond to adrenaline
6-Allermin 10 mg and hydrocortisone 100-200mg
و منطلع المريض لازم نبقيه تحت المراقبة
Any patient with an anaphylactic reaction must at least be observed for several hours in case of biphasic reaction, and any patient with a severe reaction should be admitted.
اقترحولنا مواضيع عدكم مشكلة بيها حته اذا الله سهل بالايام الجاية نوضحها او نبسطها الكم 😬