BUMC Basics.pdf - Anesthesia Home

More documents

Recommendations

Info

12 INTERN CROSS-COVER CHEAT SHEET The following are general suggestions. Indicated medications are recommended but this sheet does not replace the need to refer to your own prescribing reference (Epocrates, etc). Not all medications or suggestions are useful for all patients. Please use your own clinical judgment. Patients that you should definitely go see are indicated with a *. Again, please use your clinical judgment when evaluating whether or not to see a patient. When in doubt, just go lay eyes on them. Altered Mental Status MOVE STUPID • Metabolic (hypothyroid, hepatic encephalopathy) • Oxygen (Hypoxia from PNA, pulm edema, etc) • Vascular (TIA, CVA, Subdural hematoma) • Electrolytes (Specifically Na, Ca) • Seizure • Trauma • Uremia • Porphyria • Infection (sepsis/meningitis) • Drugs Things to do • Chart to see hospital course • History to narrow differential • Physical, esp. neuro exam and vital signs • If fever, do BCx, UCx, CXR • Pulse ox with ABG for hypoxia. If CXR shows edema, give IV Lasix. • IVF if hypotensive • CT head to r/o bleed or CVA • Electrolytes & CBC • LP if you suspect meningitis • Lactulose therapy if hepatic encephalopathy: Lactulose 30 g packet PO Q8 hours; titrate to 3-4 BM’s per day • Start ABX if patient appears ill • Stabilize seizure with drug therapy (Valium, dilantin, etc.)
Chest pain 13 DDx to consider • MI • Angina • PE • Pericarditis • Musculoskeletal • Pneumonia • PTX • Anxiety (very common) • Aortic Dissection • Pleurisy • Boerhave’s syndrome (ruptured esophagus) Things to do • Obtain history to try to elucidate etiology of CP • Focused Physical • Evaluate chart to see past history (CAD, etc.) • EKG after you take history. This will help limit the DDx above. • Cardiac enzymes if cardiac cause is considered. • CXR to look for pneumonia and aortic aneurysm • ABG for PE and pneumonia • Pain meds if musculoskeletal • Mild anxiolytic if anxiety • 100% O2 by facemask if small PTX, Chest tube if large PTX (>15%) If it’s angina, do following: • EKG first! Make sure it’s not a STEMI. Trend out CKMB/Troponins. • Check BP and then give NTG q 5 min until CP relieved. Make sure nurse checks BP in between each Nitro to avoid hypotension • If pt requires more than 3 nitro, give IV morphine 2 mg-4 mg for pain relief. If you are unsuccessful after 20-30 min, pt will need IV NTG in ICU. Think MONA BASH for UA/NSTEMI/STEMI: Morphine/Oxygen/Nitro/Aspirin/B- Blocker/ACE Inhibitor/Statin/Heparin
Page 1 and 2: BUMC BASICS
Page 3 and 4: • Status Epilepticus • Stroke m
Page 5 and 6: 5 Welcome to Baylor University Medi
Page 7 and 8: 7 Rounding on your patients: • Se
Page 9 and 10: 9 2. gloves only. During codes, if
Page 11: 11 • There is one resident and 3
Page 15 and 16: SOB DDx • Pneumonia • PE • An
Page 17 and 18: 17 • Heparin • Lidocaine • Ni
Page 19 and 20: 19 TPC (cont’d) Pager Cell Phone
Page 21 and 22: 21 Gen Surgery Neurologists Urgent
Page 23 and 24: 23 OBTAINING A CONSULT AT BAYLOR Ob
Page 25 and 26: 25 • Enter 2 initial zeros and th
Page 27 and 28: 27 • Albuterol/Atrovent nebulizer
Page 29 and 30: 29 CARDIOLOGY CCU IN GENERAL You ar
Page 31 and 32: 31 Unstable Angina/NSTEMI • Can u
Page 33 and 34: 33 Post PCI Complications — In yo
Page 35 and 36: 35 function, elevated troponin T is
Page 37 and 38: 37 **0-1 point non-cardiogenic, 2 p
Page 39 and 40: 39 • Erythromycin • Phenothiazi
Page 41 and 42: 41 Therapy — Therapy is guided by
Page 43 and 44: 43 Nitroglycerine (Onset in 2-5 min
Page 45 and 46: 45 Treatment: • Vasovagal: Recogn
Page 47 and 48: 47 GI/HEPATOLOGY GI CONSULTS AND GR
Page 49 and 50: 49 hepatitis, obesity), then they p
Page 51 and 52: 51 timing and necessity of ERCP for
Page 53 and 54: 53 the liver transplant ICU) where
Page 55 and 56: 55 GI bleeding (**See above under G
Page 57 and 58: 57 • Barium Enema (clear liquids
Page 59 and 60: 59 Pseudomonas: • Piperacillin/Ta
Page 61 and 62: 61 • Neoplasm: Lymphoma, leukemia
Page 63 and 64:
63 mortality. It lowers mortality i
Page 65 and 66:
Pneumonia (immunocompromised) (cont
Page 67 and 68:
67 BRAIN DEATH EXAM • Can order b
Page 69 and 70:
69 SEIZURES Can use BZD ativan IV o
Page 71 and 72:
71 3. Stop anticoagulants and rever
Page 73 and 74:
73 ONCOLOGY THE ACUTE LEUKEMIC “T
Page 75 and 76:
Timeline*: 75 Day 0 (admit) — Bon
Page 77 and 78:
77 PALLIATIVE CARE AND CLINICAL ETH
Page 79 and 80:
79 release oxycodone, and hydromorp
Page 81 and 82:
81 • Institutional Ethics and Pal
Page 83 and 84:
83 PULMONARY ARDS Definition: Need
Page 85 and 86:
85 MECHANICAL VENITALTION Oxygen su
Page 87 and 88:
87 • Ineffective respiratory effo
Page 89 and 90:
89 - Daily sedation vacations at 07
Page 91 and 92:
91 • After 1 wk of intubation det
Page 93 and 94:
93 - Sustained changes in the heart
Page 95 and 96:
95 PULMONARY EMBOLUS (PE) Evaluatin
Page 97 and 98:
97 RADIOLOGY RADIOLOGY HINTS IF YOU
Page 99 and 100:
Superficial Abscess/Mass Abscess/Ma
Page 101 and 102:
101 RENAL ACID/BASE DISTURBANCES Qu
Page 103 and 104:
103 ACUTE KIDNEY INJURY Acute Kidne
Page 105 and 106:
105 Mg
Page 107 and 108:
107 CHRONIC KIDNEY DISEASE Stage GF
Page 109 and 110:
Hypovolemic Hyponatremia EABV low R
Page 111 and 112:
111 fluid pulled off and into the p
Page 113 and 114:
113 Colorectal Surgery, and Plastic
Page 115 and 116:
115 • Social work: Circle Social
Page 117 and 118:
Ear Health Antipyrine/Benzocaine ot
Page 119 and 120:
Magnesium Oxide 400mg tab Prenatal
Page 121 and 122:
121 DUEWALL’S FAVORITE MNEMONICS
Page 123:
123
show all

BUMC Basics.pdf - Anesthesia Home

Create successful ePaper yourself

Delete template?

Save as template?