Perceptions of emergency care in Kenyan communities lacking access to formalised emergency medical systems: a qualitative study.
Broccoli MC, Calvello EJ, Skog AP, Wachira B, Wallis LA.
BMJ Open. 2015 Nov 19;5(11):e009208
Month: November 2015
The Turban Technique – A Scalp Bandage that Stays!
Here’s a quick and easy technique for bandaging a scalp – where the bandage stays where you want it to.
Antibiotics for Acute Exacerbations of COPD
…if your patient needs BiPAP or ICU, they should also get antibiotics!
ACLS REVISION: De Winter’s T-waves in precordial leads and ST elevation in inferior leads.
Persistent precordial ‘‘hyperacute’’ T-waves signify proximal left anterior descending artery occlusion
Blood gas measurements in DKA
- Guidelines recommend checking an ABG or VBG in all patients with DKA. This practice is not evidence-based and should be abandoned.
- ABG or VBG provides little information about whether or not the patient has DKA (beyond what is already known from the serum chemistries).
- Rather than pH, serum bicarbonate may be used to gauge the severity of acidosis.
- There is no evidence that detecting or reacting to a very low pH is helpful.
- Decisions about the level of ventilatory support that a patient needs can almost always be made on a clinical basis. When in doubt, close attention to the patient with serial examination is often a sound approach. Focus on the patient, not the blood gas.
- VBG might be helpful in cases where it is unclear whether the patient requires intubation, or if there is a significant underlying respiratory disease (e.g. COPD or obesity hypoventilation syndrome).
