BUMC Basics.pdf - Anesthesia Home

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58 INFECTIOUS DISEASES BUGS AND DRUGS (This is not a comprehensive list, but think of these drugs when you are dealing with the listed bugs; refer to Sanford Guide and your prescribing references for treatment doses and specific clinical scenarios) Atypical PNA (Chlamydia, Mycoplasma, Legionella) • Azithromycin (Zithromax) • Levofloxacin (Levaquin) Candidemia • Micafungin (Mycamine) • Fluconazole (Diflucan) • Voriconazole (Vfend) • Amphotericin B • Liposomal Amphotericin B (AmBisome) Candiduria • C. albicans (No chronic foley, has symptoms, +pyuria): Fluconazole • C. glabrata (With symptoms): Fluconazole, Amphotericin B Chronic foley: Change out foley and monitor (unless neutropenic) Good anaerobic coverage: • Zosyn (and anti-pseudomonal penicillins) • Merrem (and other carbepenems) • Clindamycin (anaerobes above the diaphragm) (Cleocin) • Metronidazole (anaerobes below the diaphragm) (Flagyl) MRSA • Vancomycin • Linezolid (Zyvox) • Trimethoprim/Sulfamethoxazole (Bactrim) • Daptomycin (Cubicin)-not indicated for tx of PNA • Tigecycline (Tygacil) • Minocycline (for CA-MRSA) • Doxycycline (for CA-MRSA)
59 Pseudomonas: • Piperacillin/Tazobactam (Zosyn) • Meropenem (Merrem) • Imipenem/Cilastatin (Primaxin) • Doripenem(Doribax) • Ceftazidime (Fortaz) • Cefepime (Maxipime) • Gentamicin (Garamycin) • Tobramycin (Nebcin) • Amikacin (Amikin) • Ciprofloxacin (Cipro) • Levafloxacin (Levaquin) • Colistin (for multiresistant strains) VRE • Linezolid (Zyvox) • Daptomycin (Cubicin) • Tigecycline (Tygacil) • Quinupristin and dalfopristin (Synercid) Etiologies FEVER IN THE ICU • VAP (PNA developing after 48 hours intubation) - Risk highest in the first week - Higher risk in patients with comorbidities, ARDS, paralyzed, H2B, NGT; mortality 20 to 60 percent. - Infection control/prevention: NIV; if possible, carafate over other anti-ulcer, tight cuff seal (>20cm); semi-recumbent position. • Central line infection - Infection rate: Fem>PICC>IJ>SCL - No evidence to support prophylactic scheduled changes, but should be changed if new infection arises. Consider changing anyway if in >3 weeks. • Other catheter related infections (foley catheter, arterial line, peripheral IV) • CMV infection after blood transfusion • Surgical site infections
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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 and 12: 11 • There is one resident and 3
Page 13 and 14: Chest pain 13 DDx to consider • M
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: 57 • Barium Enema (clear liquids
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
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Hypovolemic Hyponatremia EABV low R
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111 fluid pulled off and into the p
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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
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