Symptom Management WS November, Parichart Piasupun
|
|
|
- Gordon Briggs
- 5 years ago
- Views:
Transcription
1 Symptom Management WS November, 2016 Parichart Piasupun RN., MNS., Cert. Palliative Care Karunruk Palliative Care Center Faculty of Medicine, Khonkaen university
2 68-year-old man. Address: Muang area, Khon Kaen province. Diagnosis TVD c Post cardiac arrest c HIE c ESRD c DM c HT Admitted: Aug 31,16. Referred to PC team: Oct 12,16. Reason: evaluation and proper management and ACP.
3 Chief Complaint. Chest pain 20 min PTA. Present Illness: 1 day PTA: He came for follow up at Srinagarind hospital. 20 minute PTA: developed epigastric pain, dyspnea, sweating and chest pain. 5 minute PTA: while being transfer to hospital by his wife, he became unconscious. EKG showed asystole when arrived in ER, CPR for 8 min.
4 History of : 19Y - DM treated with insulin. 13Y - HT. 8Y - Dyslipidemia & diabetic retinopathy. 4Y - CKD Cr 1.6, Cr rising (GFR 18-22) 2Y - TVD, with PAD (CAG 90% stenosis of mid & distal LAD, 90% stenosis of mid LCX, total occlusion of RCA. Refused CABG. Heavy smoking and drinking.
5 Respiratory failure: on ET- tube and ventilator (PCV mode, IP 14, RR 14, PEEP 5, FiO 2 0.3) TVD: Emergency CAG same findings. Failed PCI. Cardiologist offer CABG but family refused. Moved to CCU for brain recovery with therapeutic hypothermia, later developed convulsions (GTC) EEG no epileptic form discharge. Seizures were controlled with Keppra. Conscious not regained.
6 AKI on top of CKD Cr rising fro 3.4 to 6.4 Nephrologist suggested long term CAPD but family refused due to carer burden. Pneumonia and bed sore developed (A.baum. MDR) Tracheostomy done on D35. Became un2-3 days before he was referred to PC team he had an alteration of consciousness his GCS dropped (E1VTM2) CT brain emergency.
7 CBC: HCT 29.3%, WBC 11,600/cmm, Plt 325,000/cmm Blood chem: BUN 86.8, Cr 6.4 (GFR = 9) Na 144, K 4.1, HCO , Cl 103 meq/l, Alb 3, Ca 7.6 mg/dl Lacunar infarction at Rt. thalamus, Rt. basal ganglion and posterior limb of Rt. Internal capsule. Old cerebral infarction at Rt. Frontal lobe. Aging brain atrophy. Acute sinusitis of Rt. ethmoid sinus and bilateral sphenoid sinuses.
8 1 st PC team visit: an elderly man, unconscious, looked thin, on tracheostomy tube with ventilator and retained NG-tube for feeding. V/S: BT 38.7 C, PR 102/min, RR 16/min, BP113/52 mmhg HEENT: pale conjunctiva, no jaundice. Lung: mild secretion sound. Abdomen: soft, not tender.
9 Unconsciousness. Fever. Bed sores at both buttocks. Constipation.
10 Colistin 75 mg IV drip in 1 h. OD Sodamint 2x3 Ticagrelor (90) 1x2 Keppra (500) 1 tab q12h. Omeprazole (20) 1x2 ac Mixedtard (70:30) unit. Senokort (7.5) 2x1 BD (1.2:1) 300 ml x 4 feeding
11 68 Retired government officer Care giver 67 Teacher, retired 7 years ago Care giver of both grandchildren Y 4 Y
12 Wife and daughter were proxy and main care givers. Patient refused CABG, said that he not afraid of dying, but worried about their grandchildren, and did not want to suffer in the terminal stage.
13 Oct 12,16 - Family meeting conduced to define goal of care (wife and daughter). Family knew nature of his disease, but did not know prognosis. We informed that the patient will soon die of uremia and recommended withdrawal of all life supports. Family decided to continue ventilator, feeding and ATB, refused vasopressors, and CPR. Place of dead hospital.
14 Oct 17,16. He had GI bleeding, Hct decreased to 22% but gain some consciousness (awake, but not aware). Family meeting for re-setting goal of care. Family asked for blood transfusion and continue ATB. Transfused with 2 unit PRC, Hct increased to 30%. Oct 20,16 - ATB discontinued after D10, no fever, Cr increased to 8.8 mg/dl, his conscious ran down again.
15 Oct 26,16 - Recurrent massive GI bleeding, Hct and BP drop, severe breathlessness and agitation. Conducted family meeting to review goal of treatment. Family decided to continue ventilator, but withhold/withdraw other life supports.
16 Dyspnea controlled with MO 20 + Midazolam 10 mg IV drip in 24 h, Hyoscine butyl Br 1 amp q6h. Patient looked comfort. Offered family to make merit and let them care for him beside his bed until he died. Oct 28,16, died peacefully in the hospital (total of 16 days after referred to our team)
Recurrent CA cervix stage IIIB. Varissaya Kannakham, RN. Karunruk Palliative Care Center Faculty of Medicine, Khon Kaen University
Recurrent CA cervix stage IIIB Varissaya Kannakham, RN. Karunruk Palliative Care Center Faculty of Medicine, Khon Kaen University Functional status PPS 60% Address Kalasin province Last admission : 20/6-29/7/16
End of Life Care Communication and Advance Illness Care Planning. Gideon Sughrue MD May 18, 2013
End of Life Care Communication and Advance Illness Care Planning Gideon Sughrue MD May 18, 2013 Objectives End of life Care Communication Describe Palliative Care Place in therapy What is hospice? What
New Concepts in Acute Coronary Syndromes Beyond 2000 (XX) Interactive Case Presentations
New Concepts in Acute Coronary Syndromes Beyond 2000 (XX) Interactive Case Presentations Dr. Richard Bon Surrey Memorial Hospital, Surrey, BC Canadian Cardiovascular Congress 2014 October 26, 2014 Conflicts
Difficult Data Definitions and Scenario s
Difficult Data Definitions and Scenario s Presenter Disclosure Information Cornelia Anderson BSN, RN To following relationships exist related to this presentation: No Disclosures Objectives Discuss key
Percutaneous Endoscopic Gastrostomy in Stroke and Advanced Dementia. Dr DF da Costa Sheffield Teaching Hospitals
Percutaneous Endoscopic Gastrostomy in Stroke and Advanced Dementia Dr DF da Costa Sheffield Teaching Hospitals Objectives Role of Gastrostomy in nutritonal support Consideration of Risks v Benefits Review
Clinical Radiological Pathological Conference
Clinical Radiological Pathological Conference CASE 1: A 59-year-old female Housekeeper Live in Phuket, Thailand Progressive dyspnea for 1 year Present illness 1 year PTA : She developed dyspnea on exertion
CASE-BASED SMALL GROUP DISCUSSION
MHD I, Session 11, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD I SESSION 11 Renal Block Acid- Base Disorders November 7, 2016 MHD I, Session 11, Student Copy Page 2 Case #1 Cc: I have had
Scenario #4A: Geriatric Trauma Resuscitation Version-5
Scenario #4A: Geriatric Trauma Resuscitation Version-5 Goals & Objectives: 1. Discuss the principles of initial assessment of a geriatric trauma patient. 2. Recognize physiologic and anatomic changes that
Mechanical versus bioprosthetic valve. Intern: Supervisor: VS
Mechanical versus bioprosthetic valve Intern: Supervisor: VS Patient basic data ID: N102110716 Name: Age: 64 years old Sex: male Occupation: Admission date: 0960528 Chief complaint Exertional dyspnea for
Both MI and UA can not be Yes. Please correct. Yes
2. MIUA (1) Page MI UA Both MI and UA can not be Yes. Please correct. Did MI occur? No Did UA Requiring admission to hospital or emergency room occur? (after randomization) Date of UA onset Yes Time of
CASE-BASED SMALL GROUP DISCUSSION
MHD II, Session XII, STUDENT Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION Session XII MHD II April 21, 2014 STUDENT COPY Helpful Resource: ACP Medicine online available through LUHS Library Infectious
Palliative Sedation An ICU Perspective. William Anderson; B.Sc. MD FRCP(C) Department of Critical Care Thunder Bay Regional HSC
Palliative Sedation An ICU Perspective William Anderson; B.Sc. MD FRCP(C) Department of Critical Care Thunder Bay Regional HSC Conflict Disclosure Information: Presenter: Dr. Will Anderson I have no financial
Canadian Trauma Trials Collaborative. Occult Pneumothorax in Critical Care (OPTICC): Standardized Data Collection Sheet
Canadian Trauma Trials Collaborative STUDY CENTRE: Institution: City / Province: / Occult Pneumothorax in Critical Care (OPTICC): Standardized Sheet PATIENT DEMOGRAPHICS: First Name: Health record number
Palliative care in Neurology from the real experience
Palliative care in Neurology from the real experience Haruthai Chotisukarat, MD Pain specialist and Anesthesiologist Prasat Neurological Institute 1 History Present illness 58 years old, Thai male A year
Complicated PTCA of Left Main Total Occlusion in NSTEMI
Complicated PTCA of Left Main Total Occlusion in NSTEMI Dr AM Thirugnanam MD, FSCAI, PhD Sr. Interventional Cardiologist Ipcard Cardiac Care Center, Hyderabad, India Disclosure Statement of Financial Interest
Sepsis: Management ANUPOL PANITCHOTE, MD. Division of Critical Care Medicine Department of Medicine, Khon Kaen University, Thailand
Sepsis: Management ANUPOL PANITCHOTE, MD. Division of Critical Care Medicine Department of Medicine, Khon Kaen University, Thailand Vital signs Symptoms LAB BT > 38.3 or < 36 ๐ C HR > 90 bpm RR > 20 /min
Exam 1 Review. Cardiopulmonary Symptoms Physical Examination Clinical Laboratory Studies
Exam 1 Review Cardiopulmonary Symptoms Physical Examination Clinical Laboratory Studies WBC Count Differential A patient had been admitted to the hospital for acute shortness of breath. A CXR examination
Prehospital Resuscitation for the 21 st Century Simulation Case. VF/Asystole
Prehospital Resuscitation for the 21 st Century Simulation Case VF/Asystole Case History 1 (hypovolemic cardiac arrest secondary to massive upper GI bleed) 56 year-old male patient who fainted in the presence
Optimize vent weaning and SBT outcomes. Identify underlying causes for SBT failures. Role SBT and weaning protocol have in respiratory care
Optimize vent weaning and SBT outcomes Identify underlying causes for SBT failures Role SBT and weaning protocol have in respiratory care Lower risk of developing complications Lower risk of VAP, other
Images have been removed from the PowerPoint slides in this handout due to copyright restrictions.
Arterial Blood Gas Interpretation Routine Assessment Inspection Palpation Auscultation Labs Na 135-145 K 3.5-5.3 Chloride 95-105 CO2 22-31 BUN 10-26 Creat.5-1.2 Glu 80-120 Arterial Blood Gases WBC 5-10K
Epilepsy CASE 1 Localization Differential Diagnosis
2 Epilepsy CASE 1 A 32-year-old man was observed to suddenly become unresponsive followed by four episodes of generalized tonic-clonic convulsions of the upper and lower extremities while at work. Each
Post-Cardiac Arrest Syndrome. MICU Lecture Series
Post-Cardiac Arrest Syndrome MICU Lecture Series Case 58 y/o female collapses at home, family attempts CPR, EMS arrives and notes VF, defibrillation x 3 with return of spontaneous circulation, brought
A walk through a STEMI
A walk through a STEMI M.M. s Story Kim Robison Ashley Corcoran Situation M.M. is an 82 year old male brought in by private vehicle on 10/22/17 to the Emergency Department Pt. c/o left arm numbness, pain
CARES Targeted Temperature Management (TTM) Module
CARES Targeted Temperature Management (TTM) Module OHCA Data Dictionary June 2014 1 CASE NUMBER This is the number assigned to the patient by the hospital. The case number is the number the hospital assigns
No social problems noted No past med hx Mother had spontaneous rupture of fetal membranes SB born on Needed to be resuscitated at birth
No social problems noted No past med hx Mother had spontaneous rupture of fetal membranes SB born on 9-16-2011 Needed to be resuscitated at birth (included assisted vent) Had generalized edema and possible
Case Scenarios. Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC. Consultant, Critical Care Medicine Medanta, The Medicity
Case Scenarios Dr Shrikanth Srinivasan MD,DNB,FNB,EDIC Consultant, Critical Care Medicine Medanta, The Medicity Case 1 A 36 year male with cirrhosis and active GI bleeding is intubated to protect his airway,
CASE from South Korea
CASE from South Korea Bon-Kwon Koo, MD, PhD, Seoul, Korea Outpatient clinic of a non-interventional cardiologist F/56 Chief complaint: Angina with recent aggravation, CCS II~III Brief history: # Stroke
End of Life Care in Dementia. Dr Rosie Lockwood Consultant Geriatrician Sheffield Teaching Hospitals
End of Life Care in Dementia Dr Rosie Lockwood Consultant Geriatrician Sheffield Teaching Hospitals Rosie.Lockwood@sth.nhs.uk Agenda Some facts and figures What are the challenges? What is good care? How
Tracheostomy Sim Course
Patients Name: Robert Smith Patients Age / DOB: 45 year old gentleman on medical ward Major Medical Problem Displaced tracheostomy tube Learning Goal Medical Early recognition of displaced tracheostomy
Scenario Development Template
Scenario Development Template Scenario Title: Inf STEMI, ICH, PEA Arrest Author: E. Merrick Last edit: April 12, 2018 Set up: Confederates: Duration: Scenario 20 min Debriefing 30 min Learning Objectives:
Critical Care Case Presentation 27 th Nov,2013. Done By: Sara AlArfaj
Critical Care Case Presentation 27 th Nov,2013 Done By: Sara AlArfaj Outlines: Topic Review. 1) Background 2) Etiology 3) Epidemiology 4) Diagnosis 5) Treatment Case Components. Diabetic Foot Infections
Patient: Becky Smith DOB: 01/26/XXXX Age: 5 y/o Attending: Dr. D. Miles Allergies: NKA MR#: 203. Patient Chart #203 Becky Smith
Patient Chart #203 Becky Smith 1 Property of CSCLV CSCLV Rev: 06/04/2018 Chief Complaint: Abdominal pain. Informant: Parents. HISTORY & PHYSICAL HPI: Ill looking patient, healthy until 2 days ago when
Syncope: Ockham s Razor
Syncope: Ockham s Razor Time/Place Wednesday, 25 th January 2006 10am-12pm Room 210, Wallace Wurth Building Facilitators Michael Grimm & Tony Grabs Aims Illustrate multiple possible causes for a common
End of Life Care in IJN Our journey. Dato Dr. David Chew Soon Ping Consultant Cardiologist National Heart Institute Malaysia
End of Life Care in IJN Our journey Dato Dr. David Chew Soon Ping Consultant Cardiologist National Heart Institute Malaysia End of Life Dying is final part of everyone journey in life Deaths used to occur
MHD I SESSION X. Renal Disease
MHD I, Session X, Student Copy Page 1 CASE-BASED SMALL GROUP DISCUSSION MHD I SESSION X Renal Disease Monday, November 11, 2013 MHD I, Session X, Student Copy Page 2 Case #1 Cc: I have had weeks of diarrhea
Safer Tracheostomy Care Course
Patients Name: Samira Patel Patients Age / DOB: 65 year old female on a general ward Major Medical Problem Blocked tracheostomy tube Learning Goal Medical Early recognition of respiratory distress Understanding
APPOINTMENT OF ENDURING GUARDIAN (pursuant to section 6 of the Guardianship Act 1987 NSW) Instrument appointing an enduring guardian
APPOINTMENT OF ENDURING GUARDIAN (pursuant to section 6 of the Guardianship Act 1987 NSW) Instrument appointing an enduring guardian (encompassing Advance Healthcare Directive) 1. Appointment of enduring
Cardiac arrest simulation teaching (CASTeach) session
Cardiac arrest simulation teaching (CASTeach) session Instructor guidance Key learning outcomes Overall aim: Scenarios should be facilitated by the Instructor in such a way that they are performed correctly.
Department of Cardiovascular Medicine Saga University Mitsuhiro Shimomura
Complex Intervention For Hemodialysis Patient Department of Cardiovascular Medicine Saga University Mitsuhiro Shimomura TCTAP 2012 Case A 77 year old female had been treated with hemodialysis(hd) for chronic
Multiple Choice Questions
Multiple Choice Questions 25yo M presents without psychiatric or medical history, with complaint of tremor to the ER. He denies drinking alcohol but his friend at bedside takes you to the side and reports
Case study Group 2 presentation
Case study Group 2 presentation Patient profile HN 3095-57 Female 60 years old Hometown : Sa Kaeo province Occupation : farmer No drug and food allergy Chief complain Left neck mass 10 years PTA that gradually
Therapeutic hypothermia
INDUCED HYPOTHERMIA Dr. Attilla Kiss M.D. Acting Medical Director Emergency Services EMS Medical Director St. John Medical Center OBJECTIVES Define and explain Induced Hypothermia Discuss both pre-hospital
Evaluating an Apparent Unprovoked First Seizure in Adults
Evaluating an Apparent Unprovoked First Seizure in Adults Case Presentation A 52 year old woman is brought to the emergency room after a witnessed seizure. She was shopping at the local mall when she was
SUDDEN ILLNESS. Fainting Diabetes Seizures Stroke
SUDDEN ILLNESS Fainting Diabetes Seizures Stroke FAINTING When someone suddenly loses consciousness and then reawakens. Fainting is not usually harmful and the person will recover quickly. FAINTING - TREATMENT
Advance Care Planning: not just for Geriatrics
Advance Care Planning: not just for Geriatrics RAIsing Awareness, A Geriatric Refresher Day March 4, 2015 St. Elias Centre 750 Ridgewood Avenue, Ottawa ON K1B 6N1 Disclosure No conflicts of interest No
CRRT Interactive Hyperkalemia Cases AKI & CRRT conference 2018
CRRT Interactive Hyperkalemia Cases AKI & CRRT conference 2018 Case 1 Potassium Clearance A 70 kg male is placed on CVVH with a total ultrafiltration rate (effluent rate) of 20 ml/kg/hr. The Blood Flow
CRRT Interactive Hyperkalemia Cases AKI & CRRT conference 2018
CRRT Interactive Hyperkalemia Cases AKI & CRRT conference 2018 Case 1 Potassium Clearance A 70 kg male is placed on CVVH with a total ultrafiltration rate (effluent rate) of 20 ml/kg/hr. The Blood Flow
Course Handouts & Post Test
STROKE/COMA: DISEASE TRAJECTORY AND HOSPICE ELIGIBILITY Terri L. Maxwell PhD, APRN VP, Strategic Initiatives Weatherbee Resources Hospice Education Network Course Handouts & Post Test To download presentation
Angela Johnson, PharmD, CGP
Angela Johnson, PharmD, CGP Review general clinical principles related to aging Recognize geriatric considerations for disease processes Identify changes in condition that should prompt eltc/provider notification
Case Presentation. Dr. K. MonaLisa PG in Psy
Case Presentation Dr. K. MonaLisa PG in Psy Name : XYZ Age : 35 years Sex : Female Religion : Hindu Marital status : Married Residence : Nalgonda Education : Intermediate Occupation : House-wife Socio-economic
What You Need to Know about a Kidney Transplant
Page 1 of 5 What You Need to Know about a Kidney Transplant This information will help you understand the risks, benefits and possible complications involved in a kidney transplant. Please read it carefully.
CRRT Fundamentals Pre-Test. AKI & CRRT 2017 Practice Based Learning in CRRT
CRRT Fundamentals Pre-Test AKI & CRRT 2017 Practice Based Learning in CRRT Question 1 A 72-year-old man with HTN presents to the ED with slurred speech, headache and weakness after falling at home. He
Med 536 Communicating About Prognosis Workshop. Case 1
Med 536 Communicating About Prognosis Workshop Case 1 ID / CC: 39 year-old woman status-post motor-vehicle collision History of the Presenting Illness Previously healthy 39 year-old woman was found in
Post-Resuscitation Care. Prof. Wilhelm Behringer Center of Emergency Medicine University of Jena
Post-Resuscitation Care Prof. Wilhelm Behringer Center of Emergency Medicine University of Jena Conflict of interest Emcools Shareholder and founder, honoraria Zoll: honoraria Bard: honoraria, nephew works
ECLS Registry Form Extracorporeal Life Support Organization (ELSO)
ECLS Registry Form Extracorporeal Life Support Organization (ELSO) Center ID: Center name: Run No (for this patient) Unique ID: Birth Date/Time Sex: (M, F) Race: (Asian, Black, Hispanic, White, Other)
Med 536 Communicating About Prognosis Workshop. Case 2
Med 536 Communicating About Prognosis Workshop Case 2 ID / CC: 33 year-old man with intracranial hemorrhage History of the Presenting Illness 33 year-old man with a prior history of melanoma of the neck
Comfort with Geriatric Emergency Medicine Competencies: A Survey of Canadian Emergency Medicine Residents
Comfort with Geriatric Emergency Medicine Competencies: A Survey of Canadian Emergency Medicine Residents Tristan Snider HBSc MD FRCP Emergency Medicine Resident, University of Toronto Don Melady BA MD
STORMY DENGUE with bloody problems. Anand M.Patil PICU MED/SURG TEAM Apollo Childrens Hospitals Chennai
STORMY DENGUE with bloody problems Anand M.Patil PICU MED/SURG TEAM Apollo Childrens Hospitals Chennai 1 HISTORY 4 ½ years girl Day 1: Fever, Lethargy, Low urine output Hypotension, high PCV,low platelets
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) Rv
ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) Rv.8.18.18 ACUTE RESPIRATORY DISTRESS SYNDROME (ARDS) SUDDEN PROGRESSIVE FORM OF ACUTE RESPIRATORY FAILURE ALVEOLAR CAPILLARY MEMBRANE BECOMES DAMAGED AND MORE
Chapter 39. Objectives. Objectives 01/09/2013. Geriatrics
Chapter 39 Geriatrics Prehospital Emergency Care, Ninth Edition Joseph J. Mistovich Keith J. Karren Copyright 2010 by Pearson Education, Inc. All rights reserved. Objectives 1. Define key terms introduced
A case of hypokalemia MIHO TAGAWA FIRST DEPARTMENT OF MEDICINE NARA MEDICAL UNIVERSITY
A case of hypokalemia MIHO TAGAWA FIRST DEPARTMENT OF MEDICINE NARA MEDICAL UNIVERSITY Case 57 y.o. male CC: Weakness HPI: About 20 years ago, he developed bilateral lower extremity weakness. Laboratory
Emergency Surgery Board Department of General Surgery Rambam Health Care Campus
Emergency Surgery Board Department of General Surgery Rambam Health Care Campus Surgical Complications of Peptic Ulcer Disease Case Presentation and Review of the Literature Case Presentation 40y male
Palliative Care: Communication. Edward W Martin MD MPH Home and Hospice Care of RI May 13, 2010
Palliative Care: Communication Edward W Martin MD MPH Home and Hospice Care of RI May 13, 2010 End-of-Life Discussions You shouldn t have counseling at the end of life Senator Charles Grassley Aug 12 2009
A END-OF-LIFE PROGRAMME LONG TERM CARE MODEL
A EVALUATION OF A END-OF-LIFE PROGRAMME EMBEDDED WITHIN A COMMUNITY LONG TERM CARE MODEL IN SINGAPORE PILOT STUDY of COMMUNITY END-OF-LIFE CARE for older non-cancer patients 1 October 2010 30 Sept 2012
Care of the dying in End Stage Kidney Disease (ESKD) - Conservative. Elizabeth Josland Renal Supportive Care CNC St George Hospital
Care of the dying in End Stage Kidney Disease (ESKD) - Conservative Elizabeth Josland Renal Supportive Care CNC St George Hospital Introduction What does conservative management look like? How does the
Care in the Last Days of Life
Care in the Last Days of Life Introduction This guideline is an aid to clinical decision making and good practice in person-centred care for patients who are deteriorating and at risk of dying. The patient
Definitions. Definitions. Weaning. Weaning. Disconnection (Discontinuation) Weaning
Definitions 2 Disconnection (Discontinuation) Implies patient no longer needs that form of therapy 80% of patients requiring temporary MVS do not require weaning Definitions 3 Implies some need for MVS
ECMO Extracorporeal Membrane Oxygenation
ECMO Extracorporeal Membrane Oxygenation patienteducation.osumc.edu ECMO Table of Contents ECMO: Extracorporeal Membrane Oxygenation... 3 ECMO Treatment... 5 Care Team... 7 Discontinuing ECMO... 8 Notes,
October 17, 2013 Dr Valerie Desjardins Centre Hospitalier Pierre-Le Gardeur
October 17, 2013 Dr Valerie Desjardins Centre Hospitalier Pierre-Le Gardeur None 69 yrs old Active, 4 km brisk walk daily Slim (60 kg, 1m73, BMI=20) Past History: Medical HypoT4 DLP (+), Smoker (+), Db
Objectives 2/11/2016 HOSPICE 101
HOSPICE 101 Overview Hospice History and Statistics What is Hospice? Who qualifies for services? Levels of Service The Admission Process Why Not to Wait Objectives Understand how to determine hospice eligibility
Pediatric Advanced Life Support
Pediatric Advanced Life Support Pediatric Chain of Survival Berg M D et al. Circulation 2010;122:S862-S875 Prevention Early cardiopulmonary resuscitation (CPR) Prompt access to the emergency response system
Objectives. Emergency Department: Rapid Fire Diagnosis 10/4/16. Why emergency medicine is unique. Approach to the emergent patient
Emergency Department: Rapid Fire Diagnosis Julie Beard DO St. Luke s Hospital Emergency Department October 4 th, 2016 Objectives Why emergency medicine is unique Approach to the emergent patient Discuss
Potassium A NNA VINNIKOVA, M. D.
Potassium A NNA VINNIOVA, M. D. DIVISION OF NEPHROLOGY Graphics by permission from The Fluid, Electrolyte and Acid-Base Companion, S. Faubel and J. Topf, http://www.pbfluids.com Do you want to hear a Sodium
ENTERAL FEEDING ISSUES IN THE COMMUNITY. Gary Simpson Home Enteral Feed Specialist Dietitian
ENTERAL FEEDING ISSUES IN THE COMMUNITY Gary Simpson Home Enteral Feed Specialist Dietitian HEF DIETETIC SERVICE Service started in 2002 (HAZ funded now substantive) 2 wte. Band 7 Dietitian 1 wte. Band
ND STROKE Coordinators Case Studies. STEMI and Stroke Conference, Fargo, ND, August 5, 2014
ND STROKE Coordinators Case Studies STEMI and Stroke Conference, Fargo, ND, August 5, 2014 STROKE Coordinator Case Study Essentia Health, Fargo Essentia Health Stroke Alert Process Within 24 hours of Last
(EEG) Faculty: M. Kabiraj, M. Fiol, D. MacDonald, M. Mikati
(EEG) Moderator: N. Biary Faculty: M. Kabiraj, M. Fiol, D. MacDonald, M. Mikati Neurosciences 2003; Vol. 8 Supplement 2 S145 S146 Neurosciences 2003; Vol. 8 Supplement 2 Mohammad Kabiraj, Nabil Biary Department
TOO SWEET TOO STORMY. CONSULTANTS: Dr. Saji James Dr. J. Dhivyalakshmi Dr. P. N. Vinoth. PRESENTOR: Dr. Abhinaya PG I (M.D Paeds)
TOO SWEET TOO STORMY PRESENTOR: Dr. Abhinaya PG I (M.D Paeds) CONSULTANTS: Dr. Saji James Dr. J. Dhivyalakshmi Dr. P. N. Vinoth Unit IV, Dept. Of Paediatrics, SRMC & RI 14year old female complaints of
Subhairline EEG Part II - Encephalopathy
Subhairline EEG Part II - Encephalopathy Teneille Gofton September 2013 Objectives To review the subhairline EEG changes seen with encephalopathy To discuss specific EEG findings in encephalopathy To outline
Case conference. Welcome Dr. Lawrence Tierney
Case conference Welcome Dr. Lawrence Tierney Case: 18 year-old male CC) hamatomesis, Fever and cough HPI) 1 st admission One month ago, he admitted to our hospital because of hematemesis. He had weight
Wen Hsien Hsu MD, FACS Vascular Surgery Department of Surgery Taipei Medical University- Wan Fang Hospital Taipei Taiwan
Combined open surgery and endovascular stenting for a long -standing Iatrogenic femoral arterial-venous fistula complicated with pulmonary hypertension Wen Hsien Hsu MD, FACS Vascular Surgery Department
A patient with acute heart failure and renal impairment ACCA Masterclass 2017
A patient with acute heart failure and renal impairment Dr Sofie Gevaert Mister P. J.M., 67-years-old Cardiac risk factors: Ex-smoker, AHT, Type 2 diabetes, BMI 43, Hyperlipidaemia Medical history: 2009:
Preoperative Cardiac Risk Assessment: Approach & Guidelines
Preoperative Cardiac Risk Assessment: Approach & Guidelines By, Liam Morris, MD., FACC (02/03/18) CPG : Clinical Practice Guidelines GDMT : Guidelines Directed Medical Therapy GWC : Guideline Writing Committee
1/29/2014. Kimberly Johnson Hatchett, MD PGY-4 11/15/13
Kimberly Johnson Hatchett, MD PGY-4 11/15/13 History of Present Illness 14 month old previously healthy infant boy presented via EMS after being found by his mother to be breathing loudly and non-responsive.
POST-OP CARDIAC SURGERY PHYSICIAN S ORDER SHEET USE BALLPOINT PEN ONLY. CARDIAC INTENSIVE CARE UNIT
PHYSICIAN S SHEET Automatically Activate, if not in agreement, cross out and initial Activated by Checking Box ALLERGIES: None known YES Patient s Height: Patient s Weight: ALL MEDICATION and INTRAVENOUS
7/4/2015. diffuse lung injury resulting in noncardiogenic pulmonary edema due to increase in capillary permeability
Leanna R. Miller, RN, MN, CCRN-CMC, PCCN-CSC, CEN, CNRN, CMSRN, NP Education Specialist LRM Consulting Nashville, TN Objectives Identify the 5 criteria for the diagnosis of ARDS. Discuss the common etiologies
Renal and Urology Fellowship Questions
Renal and Urology Fellowship Questions HOT TOPICS UTI/Pyelonephritis - paed Acute Renal Failure Rhabdomyolysis Hyperkaleamia dialysis patient Subacute Bacterial Peritonitis in PD Patient Renal Transplant
Mid-term results from real-world REPARA registry. Felipe Hernandez, on behalf of the REPARA investigators
Mid-term results from real-world REPARA registry Felipe Hernandez, on behalf of the REPARA investigators Potential conflicts of interest Speaker's name: Felipe Hernandez I have the following potential
Aortic valve replacement. Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England.
Aortic replacement Brought to you in association with EIDO Healthcare and endorsed by the Royal College of Surgeons England. Discovery has made every effort to ensure that we obtained the information in
Presenter Disclosure
Presenter Disclosure Presenter s name: Wanida Nuwisait, Department of Physiology, Faculty of Medicine, University of Toronto I do not have an affiliation (financial or otherwise) with a commercial organization
Capnography: The Most Vital of Vital Signs. Tom Ahrens, PhD, RN, FAAN Research Scientist, Barnes-Jewish Hospital, St. Louis, MO May, 2017
Capnography: The Most Vital of Vital Signs Tom Ahrens, PhD, RN, FAAN Research Scientist, Barnes-Jewish Hospital, St. Louis, MO May, 2017 Assessing Ventilation and Blood Flow with Capnography Capnography
Respiratory Care and Organ Donation
Respiratory Care and Organ Donation Whitni Noyes, RN, OPTC Midwest Transplant Network Midwest Transplant Network CMS requires every accredited hospital to have an agreement with an OPO. MTN is the first
ACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS. Myriam Farah, MD, FRCPC
ACUTE KIDNEY INJURY A PRIMER FOR PRIMARY CARE PHYSICIANS Myriam Farah, MD, FRCPC Clinical Assistant Professor Division of Nephrology, University of British Columbia November 2016 1. How to recognize acute
INSTITUTE OF NEUROSURGERY & DEPARTMENT OF PICU
CEREBRAL BYPASS An Innovative Treatment for Arteritis INSTITUTE OF NEUROSURGERY & DEPARTMENT OF PICU CASE 1 q 1 year old girl -recurrent seizure, right side limb weakness, excessive cry and irritability.
EMT. Chapter 14 Review
EMT Chapter 14 Review Review 1. All of the following are common signs and symptoms of cardiac ischemia, EXCEPT: A. headache. B. chest pressure. C. shortness of breath. D. anxiety or restlessness. Review
Myth or Real? The Potential Serious Side Effects of Ticagrelor
447 International Journal of Collaborative Research on Internal Medicine & Public Health Myth or Real? The Potential Serious Side Effects of Ticagrelor Wassam EL Din Hadad EL Shafey* Cardiology Department,
Case Number 5 Anton s Syndrome
Case Number 5 Anton s Syndrome Luke Portelli Reviewed by: Dr. Pierre Ellul Case Summary: Demographic details: Mr. AS, male, Nadur Referred from: Gozo General Hospital 57-year-old male admitted to ITU with
Perforation of a Duodenal Diverticulum. Elective Student S. C.
Perforation of a Duodenal Diverticulum 2008 4 Elective Student S. C. Case History An elderly male presented to the Emergency Department with abdominal pain. Chief Complaint: Worsening, diffuse abdominal
Chapter 1. Perioperative Evaluation and Management of Surgical Patients. Oral Exam Questions
Chapter 1 Perioperative Evaluation and Management of Surgical Patients Oral Exam Questions Case 1 A 62-year-old man with a PMH significant for hypertension, and a 40-pack-year history of smoking is found
Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe )
PROTOCOL Sedation Hold/Interruption and Weaning Protocol ( Wake-up and Breathe ) Page 1 of 6 Scope: Population: Outcome: Critical care clinicians and providers. All ICU patients intubated or mechanically
A Diagnostic Dilemma saved by sound
A Diagnostic Dilemma saved by sound Dr Syam Ravindranath MBBS DNB, Dr Ash Mukherjee FCEM FACEM We p r e s e n t a d i a g n o s t i c a l l y c h a l l e n g i n g s c e n a r i o in a 59 y e a r old f