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Disease Management

3.1 Manages the care of the critically ill patient with specific acute medical conditions 

3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill patient

 

Organ System Failure: Recognises and manages the patient with

  • Circulatory failure

  • Acute renal failure

  • Acute liver failure

  • Neurological impairment

  • Acute gastrointestinal failure

  • Severe acute respiratory failure/ARDS 

  • Sepsis

  • Intoxication with drugs or environmental toxins

  • Life-threatening maternal peripartum complications and manages care 

Disease Management

Salicylate Overdose from the Emergency Medicine Cases podcast series

A useful 20 min podcast case covering Salicylate poisoning from this Canadian Emergency Medicine Podcast.

 

Key points from the podcast

  • May be an insidious onset of non-specific symptoms

  • The triad of Hyperventillation, Tinnitus, GI upset with classical ABG of respiratory Alkalosis and raised anion gap metabolic acidosis is not always present

Key Management​

  • Poisons centre (Toxbase in the UK)

  • Fluid resuscitate

  • Correct electrolytes 

  • Alkalinise the urine and serum

  • Standard RSI could lead to rapid deterioration so give Bicarbonate bolus plus infusion peri-intubation

  • May need high ventilatory rate to prevent acidosis

  • CVVH will be needed f severely ill requiring intubation (for more info see Here)

Reminder

Anion Gap = Na - (CL + HCO3)

MUDPILERS as a cause of Anion Gap Metabolic Acidosis 

Methanol, Ureamia, DKA, Paraldehyde, Isoniazid, Lactic Acidosis, Ethanol/ETOH/Ethylene Glycol,Rhabod/Renal Failure, Salicylates 

 

Click below to go to the show notes

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