Had a call recently that came in as possible flu like symptoms. Pre arrival was nausea and vomiting, increasing lethargy, leg pain, and onset of shaking ? rigors
The patient in question was post OP x 6 weeks liver surgery removal of tumors. Other co comorbidities included chf, hep c and lung...
A further question
At what point do you resort to cpap in an exacerbation
Do you jump straight in with it or do you use it if patient not responding to standard salbutamol and combivent nebulizer treatments ?
The consensus of opinion is that this is the reason the treatment is contraindicated in exacerbations
Is it a case of the benefits out weighing the risk for those systems that use cpap for these patients ?
We have CPAP in our system solely for APE
We cannot use it for exacerbations of copd although we can use it in APE regardless of a history of copd
Have been reading some articles and saw a recent podcast advocating its use for exacerbations of copd
Is it a safe and effective treatment in...
I will give the fentanyl a go in my next acs patient
One more question we also give intranasal fentanyl and I've been very disappointed as have nearly all my colleagues with its lack of effect with adults although it's very good with paediatric pain
What are your experiences with...
We've just got fentanyl with the very same dosing limits plus the restriction that we cannot give both iv morphine and iv fentanyl to the same patient it has to be one or the other. We've been told that the fentanyl is stronger but at those doses it may wear off quicker than morphine so we...
Out of interest what are the dosing administering protocols with fentanyl compared to morphine
We use morphine initial loading dose 4mg iv and 2mg increments titrated to effect (BP permitting)
Thoughts and experience with managing pain in a drunk patient with severe pain from a traumatic injury.
Morphine contraindicated in acute alcohol intoxication. Is IN fentanyl ok
This patient in question has a dislocated shoulder and a head laceration from a fall from standing, GCS 15 and vital...
This was pre hospital in a rural setting
I suppose the question is how aggressive in the field should we be with sirs markers in a situation like this
I needed initially to use the copd exacerbation protocol/cpg. My sepsis protocol is paracetamol if temp warrants it. Benzylpenicillin and fluid...
Had a patient with copd exacerbation that had expected sirs markers ie resp and pulse rate added to an elevated blood glucose not a diabetic. I treated the copd with nebs and hydrocortisone but was wondering on reflection should I have treated her also as as sepsis. pt was Apyrexic.