PEER VII Pearls

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  1. Why is the routine use of bicarbonate NOT recommended in the management of DKA?
    • -Worsening hypokalemia
    • -Leftward shift of the oxyhemoglobin dissociation curve, worsening tissue hypoxia and intracellular acidosis
    • -Hypertonicity
    • -Sodium overload
    • -CSF acidosis
    • -Cerebral edema in children
    • -Only benefit is that it will decrease the work of breathing
  2. 7 P's of RSI
    • Prepare
    • Personnel
    • Preoxygenate
    • Premedicate
    • Potent induction agent
    • Paralytic
    • Pass tube
  3. When should you think about using Rocuronium instead of Succinylcholine?
    • 1. Concern for hyperkalemia (Burns > 10% of body surface, > 72hours old, < 6 months; Paralysis > 3d, < 6mo; Denervation syndrome; Crush injury > 3d, < 6mo; Abdominal sepsis > 3d)
    • 2. Concern for increased intraocular pressure
    • 3. Hx of malignant hyperthermia
    • 4. Hx of musculodystrophy/MS/ALS
    • 5. Recent cocaine use (at risk for prolonged neuromuscular blockade from low cholinesterase levels)

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Author:
Reed.Simons
ID:
7541
Filename:
PEER VII Pearls
Updated:
2010-07-11 14:00:37
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PEER VII Pearls
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PEER VII Pearls
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