Alcohol Withdrawal

Alcohol Withdrawal / Delirium tremens   Delirium tremens: The criteria for withdrawal delirium are delirium (a rapid-onset fluctuating disturbance of attention and cognition, sometimes with hallucinations) plus alcohol withdrawal.   Clinical features: Most common signs and symptoms of alcohol withdrawal are tremors, autonomic hyperreactivity ( fever, tachycardia, sweating, tachypnea, elevated blood pressure) , GI upset, nausea, … Read moreAlcohol Withdrawal

Acute Heart Failure

Heart Failure is heart’s inability to eject blood (systolic dysfunction) or fill with blood (diastolic dysfunction), causing circulatory congestion, dyspnea, fatigue and weakness. Acute HF is a sudden reduction in cardiac performance, resulting in acute pulmonary edema and hypotension with or without peripheral edema.    Classification: ACC/AHA)  task force divided CHF into the following stages: Stage … Read moreAcute Heart Failure

Influenza

INFLUENZA    Although most persons who become infected with influenza viruses will recover without sequelae, influenza can cause serious illness and death, particularly among persons aged ≥65 years and <2 years and those with medical conditions that confer high risk for complications from influenza.     Vaccination:  Routine annual influenza vaccination for all persons aged ≥6 … Read moreInfluenza

Sepsis and Septic shock

Surviving Sepsis Guidelines:  In their own words of wisdon – " The recommendations in this document are intended to provide guidance for the clinician caring for adult patients with sepsis or septic shock. Recommendations from these guidelines cannot replace the clinician’s decision-making capability when presented with a patient’s unique set of clinical variables. These guidelines are intended to be best … Read moreSepsis and Septic shock

Vasopressors and Shock

Shock is a physiologic state characterized by a significant reduction of systemic tissue perfusion, resulting in decreased oxygen delivery to the tissues. This creates an imbalance between oxygen delivery and oxygen consumption.    Mechanism: Systemic tissue perfusion is determined by the cardiac output (CO) and systemic vascular resistance (SVR):  CO is the product of heart rate and … Read moreVasopressors and Shock

Ventilator Weaning

  Ventilator Weaning:    In most patients, mechanical ventilation can be discontinued as soon as the underlying reason for acute respiratory failure has been resolved. Hence, the first step in ventilator weaning is to reverse the process that caused the respiratory failure to begin with. However, 20-30% of patients are considered difficult to wean from ventilator. … Read moreVentilator Weaning

Basics of Mechanical Ventilation

Mechanical Ventilation:  Respiratory failure is caused by failure to oxygenate (Type I respiratory failure), with resultant decreae in PO2 or failure to ventilate (Type II respiratory failure), with a resultant increase in PCO2.     Breathing Pattern consists of a Control variable, Breath sequence and a targeting scheme.    Ventilator can control only one variable at a time.     Equation of Motion: … Read moreBasics of Mechanical Ventilation

Acute Coronary syndrome

Acute Coronary Syndrome Unstable angina (UA),  non–ST-segment elevation myocardial infarction (NSTEMI) and STEMI are among the acute coronary syndromes (ACS).  Stable angina pectoris is characterized by chest or arm discomfort that is reproducibly associated with physical exertion or stress and relieved within 5–10 minutes by rest and/or sublingual nitroglycerin.  Unstable angina describes the occurrence of angina pectoris or equivalent ischemic discomfort … Read moreAcute Coronary syndrome