Gunshot Wounds (Arms and Legs)

Evaluate 5 important structures when evaluating gunshot wounds in an extremity. Blood Vessel Injuries 3 Categories Hard-Signers Mnemonic: HARD Bruit Hypotension Arterial/pulsatile bleeding Rapidly expanding hematoma Deficits (pulse) Audible BRUIT/thrill These patients likely need OR Soft-Signers Significant vascular oozing/bleeding Large hematoma These patients need to be screened with ABI (ankle brachial index) ABI <0.9 or […]

Asthma and COPD

5 core treatments and 5 MORE treatments 5 Core Treatments Albuterol Beta agonist Bronchodilator Core treatment for asthma Ipratropium Anti-muscarinic Relax muscles around the airways Works synergistically with albuterol Steroids Decrease inflammation in the airways Prednisone (PO) Methylprednisone (IV) BiPAP (COPD) Decreases work of breathing Decreases rates of intubation Decreases mortality Antibiotics (COPD) Infection common […]

GI Bleed

Basic Categories Upper GI Bleed Symptoms Coffee ground emesis Melena Black tarry stool Digested blood Common causes Peptic ulcer disease Varices Lower GI Bleed Symptoms Bright red blood per rectum (BRBPR) Maroon/bloody stools Common causes Diverticulosis Colon cancer Angiodysplasia AV Malformations History Ask about risk factors for upper GI bleed Peptic ulcer risk factors NSAIDS […]

Pulmonary Embolism

Introduction Pulmonary embolism (PE) is caused when a deep venous thrombosis from somewhere else in the body “embolizes” and becomes lodged in the pulmonary arteries Can cause pulmonary infarction (which mimics pneumonia on chest x-ray) Basic Approach to the Diagnosis of PE Step 1: Consider PE in any patient with signs or symptoms consistent with […]