A 56 yr-old male is admitted to the ICU
with a blood pressure of 225/135 and
complains of a headache and nausea. He reports he ran out of blood
... [Show More] pressure
meds three days ago, but also appears
to be confused to the date and situation. What is the most appropriate treatment
approach?
A patient has sepsis, receives Lactated
ringers 500ml IV bolus.Which finding in- dicate that this intervention is having it's
intended effect?
72 male patient in ICU for 6 days on the
ventilator for treatment of a COPD ex- acerbation. He has been receiving VTE
prophylaxis and subcutaneous Heparin
since admission.Today his platelet count
decreased significantly to 43,000 and
was found to have new DVT on his right
upper extremity. What do you suspect is
the most likely cause of these findings?
TRALI:
2 Hallmark signs of HIT:
Rapidly lower the diastolic pressure to
100 with IV antihypertensive meds, then
continue to gradually reduce the diastolic
pressure to 85 with oral antihypertensive
meds. The maximum initial decrease should be
no more than 25% reduction from initial presenting value. Reducing the blood
pressure too quickly can lead to cerebral
edema or renal failure. ScvO2 of 72%
Early goal directed therapy for sepsis
includes early fluid resuscitation at 30
ml/kg to maintain a CVP of 8-12 or 12-15
if mechanically ventilated, MAP greater
than 65, ScvO2 greater than 70%, and
urine output greater than 0.5 kg/hr
HIT
The hallmark sign of HIT is a signifi- cant decrease in platelet count over a
24 hours period (>50%) within 5-10 days
of administering Heparin. The other hall- mark sign is a new development of DVT
despite being on VTE prophylaxis.
is a complication from a blood transfu- sion reaction, which causes acute lung
injury typically within 6 hours of a blood
transfusion. Decrease in platelet count over a 24 hr
period. New development of DVT despite being
on VTE prophylaxis. [Show Less]