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Hyponatriemia!

4 Jun

Today 3 incredible talks about hyponatriemia. Everything you need to know in the ED!

These talks are the top 3 talks about hyponatriemia from the MNSHA Masterclass: Acute Medical Emergencies. They are in the PechaKucha style, which means 20x20sec talks….so about 6 1/2 minutes.

 

Nr. 1 is from Klaartje Caminada. She shows the real art of PechaKucha!

 

Nr 2. is from Jasper Rebel, who makes hyponatriemia really, really  easy….in 10 steps.

 

Nr 3. is from Heleen van der Peijl. She explains hyponatriemia step by step.

 

Hope you will enjoy the talks….and hyponatriemia!

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Anaesthetics – dose adjustments

19 Dec
Dose adjustment of anaesthetics in the morbidly obese. (J. Ingrande, H. Lemmens)
Propofol-induction: LBW
Etomidate-induction: LBW
Fentanyl: LBW (dame for sufentanil and remifentanil)
Morfine: IBW
Succinylcholine: TBW (in obesity more pseudochlinesterase so more rapid brake down)
Rocuronium: IBW (/LBW)
Midazolam-induction: TBW
Here: propofol: TBW, opposed to I/LBW in other references.

Fascia Iliaca Compartment Block

10 Oct

Here are 4 Critical Approved Topics about Fascia Iliaca Compartment Block (FICB), sent to us by Leonieke Groot, an Emergency Medicine resident working in OLVG in Amsterdam.

1. FICB by (junior) Emergency Physicians effective for femoral fractures?  –> Yes
2. FICB vs opiates, which is better? –> FICB give more pain relieve and has less side-effects.
3. FICB with landmarks vs ultrasound? –> Ultrasound guidance improves the success rate of FICB.
4. FICB also successful in children? –> Yes, it gives better analgesia before and after the procedure then systemic anagesia.
CAT FICB-kinderen (in Dutch)
CAT FICB kinderen (in Dutch)
FICB seems a very good method for pain reduction in femur fractures! Leonieke, thanks for sharing this information with all your colleagues. This is why we started EMDutch and we hope more people will follow and share their information.  (That’s what FOAMed is all about!)

Ductal dependent lesion in neonates

25 Sep

While searching for answers in ductal dependent blood flow (while listening to the EMRAP of this month), I thought it would be nice to share my very short summary with you.

Gr Laura

Neonatal cardiology – Ductal Dependant blood flow

Atlas of Pediatric EM:

Hypoplastic left heart syndrome (HLHS) refers to a spectrum of CHDs that have very small LV and other associated anatomic abnormalities. There is inadequate anterograde flow to support the systemic circulation because of the hypoplasia of the left heart. Because systemic circulation is supported by the right side of the heart through the ductus arteriosus, these lesions are referred to as ductal-dependent lesions. Examples of ductal-dependent systemic blood flow lesions include HLHS, critical coarctation of the aorta and aortic arch interruption. Examples of right-sided ductal-dependent lesions (pulmonary circulation dependent on patency of the ductus arteriosus) include pulmonary atresia with intact ventricular septum, tricuspid atresia and critical pulmonary stenosis.

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Interesting bits

30 Jun

http://lifeinthefastlane.com/2013/05/a-good-death/

http://intensivecarenetwork.com/index.php/icn-activities/icn-podcasts/615-75-flower-on-iconoclastic-view-of-neurocritical-care

Laura