View Full Version : Peds chat: Poisoning and accidents, Emergency management in

02-28-2005, 08:22 PM
[[dua_frank] hey sanz
[dua_frank] how are you?
[dua_frank] did you get my file?
[dua_frank] my stupid emails not working anymore
[dua_frank] if you need to send me any mails please write to me at [email protected]
[dua_frank] i had to create a new one
[lanny] hi guys
[[fero] hi lanny
[dua_frank] hey megs
[lanny] hi megs
[fero] hi megs
[dua_frank] didn't see you guys
[dua_frank] hi lanny and fero
[dua_frank] missed yesterday
[lanny] hey there dua
[sanz] oh ok
[fero] hi dua
[megs] sanz so how is it going>
[lanny] we missed you too
[dua_frank] how did it go yesterday?
[lanny] well we exhausted immuno
[megs] well dua but missed u
[sanz] hey lanny
[sanz] hi megs
[megs] :) sanz ready for the big day???
[lanny] sure the transc is posted for you to see dua
[dua_frank] really lanny? :D
[dua_frank] :)
[lanny] hi sanz
[dua_frank] wow thanks a lot
[sanz] megs yeah! Bring it on!!!
[sanz] hehe just kidding
[sanz] i'm a total nervous wreck now
[lanny] yea bring it on !!!!!!!!!!!!!!
[sanz] 7 days more and counting...
[dua_frank] lanny where did you post the transcript?
[lanny] thats the attitude
[dua_frank] i don't see it on the forum
[megs] u will be just fine sanz dont woeey
[lanny] oh its not there?
[dua_frank] nope
[sanz] i'm doing my NMBE form 2 tmrw
[samantha] hi guys
[dua_frank] hi sammy
[megs] no lanny i didnt see it
[lanny] it usu takes like 2 days before it appears
[fero] hi samantha
[megs] goodluck sanz
[lanny] chk again tomorrow dua
[sanz] how are you megs?
[dua_frank] oh but doc said he wouldn't be doing that for us anymore
[dua_frank] so i had started posting the transcrips from day before
[dua_frank] i missed yesterday and expected one of you guys here do to that :(
[lanny] but he didnt say when he is going to stop
[sanz] lanny, how have you been?
[dua_frank] hes been telling us forever now lanny lol
[lanny] oh relly
[dua_frank] he messaged me twice until i promised him i'll do it
[sanz] i was gonna be here yesterday but the Oscars got me fixed to the couch....
[dua_frank] and started doing that from day before yesterday
[lanny] i thought you two were working something out
[dua_frank] nah
[dua_frank] but yeah there is a way
[lanny] sanz im fine still hanging
[dua_frank] i could write to him the days i miss posting the chat here and ask him to pull it out of his logs and post for us
[lanny] that will be nice dua
[dua_frank] lets hope he does that for us
[megs] ok
[megs] lets start guys
[lanny] sanz my thoughts are with you, no doubt you will be ok
[dua_frank] ok megs
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[uniteus] hi guys
[dua_frank] hi uni :)
[lanny] shoot megs
[sanz] lanny thnx... i sure wish i could take ALLLLL of you to the exams with me!!!!
[fero] hi uni
[uniteus] miss u dua yest
[dua_frank] lol sanz
[lanny] shoot megs
[megs] what is the commonest cause of death in adolescent???
[sanz] you can all do it while i say i agree
[uniteus] good luck sanz
[sanz] or disagree
[dua_frank] lol
[dua_frank] missed you all yesterday too uni
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[dua_frank] was sitting in the emergency room for 8 hours
[megs] hey uni welcome
[dua_frank] wasted my sunday :(
[lanny] oh yes youre so knowledgable to help us out
[sanz] megs road traffic accidrent
[megs] yup sanz
[megs] may ask the 2nd most and 3rd common cause???
[lanny] whats today guys
[sanz] congenital and neoplasm i think...
[megs] accidental deaths due to???
[lanny] accident
[dua_frank] its accidents and ED today lanny
[uniteus] motor vehichle
[megs] i mean to say accidental death causes sanz
[shreya] alcohol
[dua_frank] and poisoning
[sanz] road traffic and poison
[sanz] then drowning
[megs] yup sanz
[megs] v good
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[sanz] what are the 3 grades of contussion?
[sanz] sorry concussion
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[fero] grade one just confusion, 2> confusion + amnesia , grade 3> all 3
[sanz] great fero :)
[sanz] ace
[fero] los of concuious in grade 3
[megs] fero *)
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[fero] y megs?
[sanz] grade 1 - confusion, no amnesia, no LOC
[sanz] grade 1 - confusion adn amnesia, no LOC
[sanz] grade 3 - confusion, amnesia and LOC
[lanny] having probs with the site
[sanz] wb lanny
[lanny] just got back on
[dua_frank] wb
[megs] wb lanny
[lanny] sanz whats the q to you r answer
[lanny] please
[sanz] grades of concussion
[lanny] thanks
[sanz] which grade needs a CT scan?
[uniteus] 3
[sanz] yup
[fero] age a child gos for regular seat belts?
[sanz] 5-7
[fero] rt, sanz
[sanz] depends on his weight too
[samantha] subcutaneous bleed battle sign what does that mean?
[megs] agree wight more than 20 pounds
[sanz] basal skull #
[fero] mastiod bleed
[samantha] rt sanz
[samantha] and fero
[shreya] grade 1- confusion, grade2 - confusion+ amnesia, grade 3-confusion+ amnesia+ loss of consiousness. ----lanny
[sanz] remember no antibiotics needed for basal skull #
[samantha] 40 pounda
[fero] 20 lbs is not much for regular seat belts megs
[fero] 40 lbs child goes into bosster seat
[sanz] 20 kg maybe? i dont remember the weight but i know it is an impt factor...
[samantha] 5 yrs old or 40 lbs go to regular seat belt
[megs] yeah fero
[megs] sorry got confused
[samantha] they keep changing
[fero] rt samantha
[megs] acetaaminophen poisoning..cinical presebtation??/
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[uniteus] tinnitus and GI symptoms - vomiting
[megs] not tinittus uni
[fero] tinnitis.....???
[megs] thas for aspirin poisoning
[uniteus] oh..sorry i was thinking of aspirin
[fero] rt megs
[shreya] increased liver enzymes.
[dua_frank] jaundice
[dua_frank] cholestasis
[megs] yup dua
[megs] why cholestasis dua
[dua_frank] jaundice due to?
[dua_frank] i thought it was cholestasis
[megs] jaundice is due to hepatocellular necrossi
[dua_frank] oh right
[dua_frank] thanks
[dua_frank] what drug causes cholestasis?
[dua_frank] OCPs?
[megs] what is treatment??
[uniteus] N acetylcystine for acetami tox
[megs] yeah uni
[sanz] NAC
[fero] lev > 150ug and < 8 to 16 hrs give NAC
[sanz] yup
[megs] agree fero
[sanz] if hx suggests that the kid has taken .7.5 mg give NAC as well
[fero] rt sanz
[sanz] >7.5mg or >150mg/kg
[megs] thanx sanx
[megs] sanz
[dua_frank] so youre saying give NAC between 7.5 to 150 mg?
[sanz] 5 yr odl swallowed battery... next step?
[fero] oil of wintergreen,,wat pois?
[sanz] dua no...
[dua_frank] EDTA
[sanz] one single dose of 7.5 mg
[dua_frank] oh ok
[dua_frank] got it
[sanz] or >150mg/kg
[dua_frank] thanks
[megs] oral succimer sanz
[sanz] fero, dont know...
[megs] vit a fero
[megs] not sure
[fero] oil of wintergreen has asprin
[fero] ASA
[sanz] in swallowed battery case, do CXR, if the battery is seen lodged in esophagus, immediate endosope to remove it
[megs] oh...didnt know that fero.
[uniteus] battery --> CXR to determine where the battery is sanz? then need to remove it
[sanz] uni great :)
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[uniteus] :)
[sanz] what acid bas disorer in ASA poison?
[megs] ok sanz..i thought u r talking about lead poisoning
[fero] batteries is an ex of acidic r baisc medium?
[sanz] basic i think...
[sanz] or is it acid?
[fero] rt sanz.....also in general basic is more harmful r acidic stuff?
[sanz] yes, alk
[lanny] basic is more harmful
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[fero] rt lanny...cause liguafactive necrosis so chance of perforation
[dua_frank] whats r?
[lanny] isnt caustic the same as basic
[megs] yes lanny
[fero] o sorry sanz batteries is ex of acidic,,,detergent ( dish washer is basic
[megs] they r same
[dua_frank] whats ex?
[fero] batteries r acidic
[dua_frank] whats r fero :(
[dua_frank] oh are...
[fero] drano and dishwasher detergent r ex of basic
[megs] hey guys pl ans my silly q...what is the battery u guys r taking about??
[dua_frank] battery as in the one you put in the remote control
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[megs] ok...thanx dua
[lanny] regular batteries
[dua_frank] sanz is making it point that you need to take x ray to remove that as a foreign object than to treat it like a case of poisoning megs
[megs] got it dua thanx
[sanz] the battery that kids swallow are button batteries
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[sanz] they cant swaloow the ones you put in the remote control
[fero] endoscopy is even otherwise indicated i think to look for perforation
[dua_frank] welcome
[sanz] they'll choke i think!
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[dua_frank] sanz you'd be surprised at what all they can swollow :P
[lanny] agree sanz thats the batteries you look for
[sanz] button batteries i think are mercury or alk... i cant remember now...
[lanny] like watch battreies
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[sanz] but they're at risk of esoph perf
[sanz] if the battery is in stomach, there is no urgency to do endo right away
[lanny] radio batteries have mercury
[lanny] i think theyre alkaline
[sanz] dua, hehe
[sanz] imagine poo-ing it out *ouch*
[dua_frank] blood lead level of 45, what do you do?
[dua_frank] sanz lol
[sanz] dialysis?
[fero] EDTA?
[dua_frank] yes fero
[dua_frank] chelation
[dua_frank] i take that back
[samantha] EDTA
[dua_frank] at 70 immediate chelation by edta
[dua_frank] at 45 just immediate medical and environmental intervention
[dua_frank] less than that counselling
[sanz] thnx dua
[dua_frank] so that answers megs query
[dua_frank] one time lead consumption doesn't need chelation
[dua_frank] it takes time to build in the body
[dua_frank] abnormal is anything above 10
[dua_frank] 10microgm/dl
[dua_frank] at 15 you need to screen every 3 months with counselling
[dua_frank] 70 you chelate
[samantha] yes dua
[dua_frank] please correct me if i am wrong
[dua_frank] like if there is anything like acute lead poisoning where you need EDTA
[dua_frank] i'm not sure about this
[megs] dua like to add to u r point
[samantha] for moderate intoxication consider chelation and oral succimer
[dua_frank] yes sammy
[dua_frank] yes please megs, go ahead
[fero] side effect of iron pois....1 to 2 months after ingestion?( long term)
[megs] if kids r symptomatic then immediately treat
[megs] dont bother about the levels
[dua_frank] thats a good point mes
[dua_frank] megs
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[dua_frank] and i accept that :)
[uniteus] agree megs
[sanz] fero, GI bleed and anemia?
[sanz] good pt megs thnx
[megs] long term fero???
[fero] GI scarring, obs, pyloriv stenosis..sanz
[fero] long term i meant 1 to 2 months , not acute
[uniteus] pyloric stenosis occur in these pt fero? didnt know dat
[sanz] oh yeah. thnx fero
[megs] isit due iron deposition in body
[megs] fero???
[dua_frank] what metabolic conditions do you see in acute and achronic aspirin poisoning and why?
[fero] has to do something with scariing it causes i guess
[megs] ok fero good point u told us
[sanz] in kids, it's primary met acidosis with compensatory repr alk
[fero] dua, there r 2 views... in that regard some books say kids just have metabolic acidisis
[fero] other view is as in adults > met acidosis+ rep alkalosis
[megs] agree fero
[fero] so which one megs
[uniteus] aspirin is acute- met acidosis wid anion gap (due to incr salicycli acid) with comp resp alkalosis( breathing )
[megs] kids have metabolic acidosis
[fero] agree uni,,but i thought there is a diff in kids and adults
[lanny] yes fero
[fero] thas wat i learnt megs ,,pead kaplan confused me today
[uniteus] i think they r more prone to met aci
[uniteus] thx fero
[lanny] adults have resp acidosis as primary
[dua_frank] i would go with fero's answer too
[dua_frank] metabolic acidosis lanny, in chronic
[fero] lanny resp?
[dua_frank] and acute resp Alkalosis
[dua_frank] thats in adults though
[lanny] dont aspirin inhib the resp ctr?
[dua_frank] they do
[fero] stimulate lanny
[dua_frank] which is actute
[dua_frank] stimulate yes
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[fero] asprin stim resp cent guys
[dua_frank] so that causes hypercapnea
[lanny] oh got it the other way thanks fero
[dua_frank] more co2 pushed out of lungs
[lanny] so its a primary resp alkalosis
[lanny] and metab acidosis
[dua_frank] yes
[lanny] both as primary right
[fero] i lernt this for adults till now,,, but now even for kids kaplan say this
[dua_frank] no metabolic acidosis is due to inh of oxydative phosphorylation
[fero] :(
[dua_frank] yes fero i read that too
[dua_frank] controvery when it comes to kids
[lanny] agree dua but its still primary its not compens ru\ight
[dua_frank] yes both are primary
[lanny] right?
[lanny] thanks dua
[dua_frank] just depends on acute or chronic
[dua_frank] welcome
[lanny] yes
[fero] \
[uniteus] dua..tell us ans please
[dua_frank] uni lets go with the adults type
[megs] yeah dua
[megs] can u summerise and tell
[dua_frank] resp alkalosis in acute due to sti of resp centre in medulla
[dua_frank] met acidosis in chronic due to inh of oxy phos
[samantha] metabolic acidosis is due to inhibition of krebs cycle
[megs] ok so no diff in kid or adults
[samantha] also
[sanz] megs there is...
[dua_frank] yes megs i would go with that
[sanz] resp alk in kids happens very fast
[sanz] so by the time you see the pt, they're usus in met acidosis
[dua_frank] true sanz
[sanz] so in kids, it's pri met acidosis with respr alk as compensation
[dua_frank] but that still means that resp alk followed by MA
[lanny] compensated sanz
[dua_frank] right?
[fero] perforated nasal septum> wat drug abuse suspected?
[sanz] in adults, it's pri met acidosis and pri respr alk
[megs] thanx sanz
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[dua_frank] good point though
[lanny] cocaine
[sanz] cocaine fero
[fero] rt sanz lanny
[dua_frank] kids abuse cocaine too :O
[dua_frank] dayum :O
[samantha] cocaine fero
[lanny] sanz i agree they both occur simultan
[fero] wat about pupil? in cocian pois?
[sanz] dilate
[lanny] dilate
[sanz] cuz it's stimulant
[megs] dilate
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[lanny] anisocoria in what dz?
[fero] wat other suns cause dilated pupil with similar sypm?
[sanz] ineq of pupils... in PCP?
[sanz] amphetamine
[megs] atropine amphetamine
[uniteus] mydriasis cocaine
[fero] thas nystigmas in pcp
[fero] rt megs
[megs] vertical nystagmus fero in pcp
[fero] am FAT AMINE ,,,,FAT PUPILS
[lanny] sanz is it PCP?
[dua_frank] lol fero
[sanz] fero hehe good one!
[sanz] lanny, you asked the q... i'm asnwering!
[sanz] so i dont know... wuz the ans?
[lanny] asked cause not sure which poison
[sanz] hehehe
[sanz] anyway, gtg...
[fero] lanny wats an.......??? :)
[sanz] see you all around :)
[lanny] will let you know tom sanz
[uniteus] bye sanz n thx
[fero] bye sanz
[sanz] ok lanny dont worry abt it
[sanz] hey dua, i'll check my email tmrw then :)
[samantha] bye sanz
[sanz] thnx again
[dua_frank] sure :)
[dua_frank] most welcome sweety
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[dua_frank] bye
[shreya] anti histamines- fixed dilated pupils
[fero] rt sherya
[dua_frank] whats the first step you do in aspirin and acetaminophen poisoning?
[fero] u can get anti histamine pois with wat OTC medication?
[samantha] ipecac
[megs] anticcold fero
[fero] rt megs
[megs] apecac agree
[megs] induse vomiting
[lanny] diphenhydramine fero
[megs] induce
[dua_frank] empty stomach
[dua_frank] second step?
[fero] rt lanny cold medica in gen
[samantha] and acivated charcoal
[megs] carcoal
[shreya] activated charcoal
[dua_frank] correct for iron
[dua_frank] not for acetaminophen
[dua_frank] thats a blunder in acetaminophen
[dua_frank] never charcoal in acetaminophen
[dua_frank] coz charcoal would inactivate NAC
[fero] dua no
[dua_frank] its contraindicated
[megs] why dua??
[megs] dont agree with u dua
[dua_frank] its works with aspirin
[fero] me too
[samantha] sorry what is NAC/
[dua_frank] n acetyl cysteine
[samantha] ok dua
[dua_frank] ok then controversy
[fero] no real contra indications for charcoal
[dua_frank] yuore right with that fero
[dua_frank] except in this case
[dua_frank] it does not harm your body
[dua_frank] but it will inactivate NAC if you wanted to give that
[fero] how ever its ineffective in cynide, na, K CL ACIDS,bases
[megs] for what poisonings charcoal is no effective??there r 4
[dua_frank] fero already gave the answer
[fero] dua kaplan peads clearly say that its given in acetam pos...
[dua_frank] fero kaplan is known to be wrong a lot of times
[fero] megs,,,,,acids, bases, acynide
[megs] alcohol hydrocarbon lithium and iron
[dua_frank] lets check standard texts and clear this
[uniteus] acid, alkali megs
[fero] dua if kaplan say the other way then,,, man i am in deep troubleeeeee
[dua_frank] lol
[dua_frank] fero kaplan is full of mistakes
[fero] my....my....
[megs] no dua agree with fero
[fero] ok we will check this point
[dua_frank] it might be right with this point megs
[dua_frank] i'm talking in general about kaplan
[dua_frank] thats what a lot of messages on usmle.net talked about
[shreya] may b dua is rt..check the first sentence in treatemnt of acetaminophen in kaplan.
[fero] well,,,wat i can say
[dua_frank] i'll accept it if you get me reference from any standard text book
[dua_frank] i can't accept kaplan as authority, sorry
[fero] ok BOSS I WILL..LOL
[megs] ok dua
[dua_frank] thanks fero
[fero] LEV it for tom discuss
[dua_frank] ok
[fero] we will give it few min
[samantha] i see lol what is it fero
[samantha] lol
[dua_frank] sammy just discovered the lol button
[dua_frank] :P
[fero] treatment of kerosene posing?
[samantha] no when i typed something else this came on
[dua_frank] oh
[megs] prevent aspiration
[dua_frank] lavage?
[fero] lavage is contra indic,,,,but in sever we do..with adjustments,,anyone know?
[megs] with cought endotracheal tube in place we can do lavage
[fero] good megs
[megs] just prevent aspiration in lung
[fero] rt
[dua_frank] nice
[uniteus] nil by mouth
[samantha] resp complication avoided endotracheal intub
[megs] ok which vital parameter is important in peds???for evaluation of bld loss
[fero] RR
[fero] NOT sure
[uniteus] PR
[megs] its evaluation of heart rate..
[megs] uni correct
[megs] which is sesitive measure of perfusion???
[lanny] isnt this in adults too
[dua_frank] no lanny
[dua_frank] BP in adults right?
[megs] blood pressure is most sensitive in lanny
[dua_frank] capillary refil megs?
[megs] yup dua
[megs] in adult i mean
[samantha] pulse oximetry is used is what megs?
[megs] bp falls very late in kids
[dua_frank] absent PR and not breathing
[dua_frank] dx?
[megs] for oxygen saturation sammy
[samantha] is it for hypoxia?
[megs] yah sammu
[samantha] ok megs
[megs] cardiac arrest
[megs] dua
[dua_frank] good megs
[dua_frank] whats the mcc for cardiac arrest in kids?
[fero] conge
[dua_frank] fero congenital cardiac arrest? :P
[dua_frank] thats like a dead baby isn't it? :P
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[dua_frank] asystole is the ans
[megs] in chidren below 8 yrs in we r using ETT ENDOTRACHEAL TUBE WHICH ONE IS PREFERRED CUFFED ON UNCUFFED???
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[uniteus] uncuffed
[megs] yeah uni
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[uniteus] subglottis does the sealing megs?
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[megs] rt uni
[uniteus] ok..thx..wasnt sure
[uniteus] what screening test to do in youn children suspected with lead poisoning?
Please rephrase your last message.
[dua_frank] something
[fero] finger stick test
[dua_frank] finger
[uniteus] rt dua n fero
[dua_frank] won't let me type pr ick
[dua_frank] lol
[megs] what is that uni
[uniteus] :D
[dua_frank] measure lead level in that blood megs
[uniteus] to screen for lead poisoning u take fingerstick blood test (screening -cheap n easy) like diascan stick megs
[megs] ok uni
[megs] thanx
[fero] urine turn vin rose after giving deferox? wat does that mean
[dua_frank] in what two conditions don't you resusitate with fluids in case of pulselessness
[megs] in cogestive cardiac failure dua
[megs] dunno ans to ur q fero
[dua_frank] myocarditis and hypoplastic left heart syndrome
[dua_frank] tell us please fero
[fero] well that was a giveaway...deferox,,,,,,,????/ofcourse ironpoisn....free iron binds to defer...so urine turn vinrose colour
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[dua_frank] lol fero
[fero] too easy..ya
[dua_frank] tricky :P
[dua_frank] too easy to be true lol
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[dua_frank] what drug do you give for asystole, bradycardia, V fib?
[fero] pt has repeated concussion grade 1( 3 times) your adviceto the pat?
[megs] asystole rx atropine
[megs] for brady too
[dua_frank] epinehrine megs
[dua_frank] bradycardia and av block give atropine
[lanny] epineph in v fib
[megs] yeah low dose epinephrine i guess
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[dua_frank] you give IV epi right?
[dua_frank] what if this doesn't work
[dua_frank] whats the other way you can give epi?
[megs] cardiac areest give high dose epinephrine 1 in 1000 dil
[lanny] IV lidocaine dua
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[megs] intratrachel
[dua_frank] good megs
[dua_frank] yep down the ET tube
[shreya] as an inhalant??
[dua_frank] no shreya
[dua_frank] well yes
[dua_frank] in a way
[dua_frank] except you're pouring it down the tube
[dua_frank] meaning it will get absorbed by the alveoli and enter circulation
[shreya] oh ok
[dua_frank] theory is earliest absorption
[shreya] thanks
[dua_frank] welcome
[shreya] whts ur ans fero??
[lanny] dua will it be abs faster in ET tube?
[dua_frank] what other drugs can be given intratracheally?
[fero] donno sherya
[shreya] concussion- grade 3..
[dua_frank] yes lanny
[dua_frank] not in tube
[dua_frank] but consider it as a line reaching the lungs directly
[fero] o...if grade 1 occurs 3 times....advice not to return to sports,,,for that season
[dua_frank] and you would be delivery epi through oxy humidifier
[dua_frank] i think
[shreya] ok
[dua_frank] not sure exactly how but i think its that way
[lanny] dua youre talking about the lungs or the heart
[dua_frank] endotracheal tube goes to the lungs lanny
[dua_frank] anything that gets absorped by lungs goes first to heart
[lanny] i know that ok what was the q....
[lanny] ok i got it
[dua_frank] q was if you IV epi does not work, whats the other mode of delivering it
[lanny] thanks
[dua_frank] welcome
[dua_frank] what are the other drugs that can be given this way?
[dua_frank] thanks fero
[dua_frank] basically all other drugs we just mentioned that can help the heart
[shreya] oh.
[dua_frank] like lidocaine and atropine
[lanny] bretylium
[dua_frank] do they give that iv lanny?
[lanny] yes
[dua_frank] oh yeah
[dua_frank] i forgot
[dua_frank] with lidocainefor v fib
[lanny] its poorly abs in gi tract so given parenterally
[dua_frank] thanks lanny
[lanny] its used ig lidoc i.v. doent work
[lanny] if lidocaine
[dua_frank] thanks
[lanny] pleasure
[dua_frank] i have a stupid q
[dua_frank] whats the difference between cardioversion and defibrillation?
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[lanny] when you defibrill you dardiovert i think
[fero] same...more r less....i remember there is minor diff
[lanny] basically the same ?
[dua_frank] all i know is that you run electricity through the body :(
[fero] just one of this is used in the ER settings
[samantha] cardiovert can be chemical
[samantha] defibrillate is electrical
[dua_frank] sammy CV can also be with electrical
[samantha] dua
[uniteus] application of an electric shock in order to restore normal heart beat for cardioversion
[lanny] i thknk cardioversion is an umbrella term
[fero] agree with lanny
[lanny] its like cardio conversion
[uniteus] defri is restoration of the rhythm of a fibrillation heart...
[dua_frank] ok uni so synchronised is CV. do you mean that? and non synchronised is defib?
[uniteus] dictionary
[dua_frank] makes some sense
[lanny] converting abnormal rhytms to normal
[dua_frank] ok so in fib you defibrillate...
[dua_frank] and tachs you CV
[dua_frank] ok then :)
[uniteus] yeah..
[uniteus] think so..
[lanny] dua they wont get this technical they are basically the same thing
[uniteus] just more words to confuse us i think but same basis
[dua_frank] i know lanny, it was just my own curiosity, sorry if i disturbed the flow
[lanny] rememebr we are wtill looked at as 4 th yr med students basic knowledge.
[dua_frank] yes right
[lanny] no dua i am just pointing out i have asked myself this same q
[fero] ok salt water drown is bad fresh water? which effects the lunggs more?
[lanny] fresh
[dua_frank] fresh
[uniteus] fresh
[fero] rt lanny
[dua_frank] why?
[fero] y
[megs] lung oedema
[lanny] cause hypotonic fluid washes asay lung surfactant leading to ARDS
[lanny] away
[fero] becauz surfactant is washed
[dua_frank] nice
[fero] pul edema in salt water drowning
[lanny] yea cause salt is abs leading to holding of water edema
[fero] ECG changed in imiprimine overdose?
[lanny] remember salt is an osmole
[lanny] prolong QT?
[uniteus] prolonged QT interval????
[fero] rt and QRS wide......how do we treat this?
[dua_frank] just checked
[lanny] flu....
[dua_frank] activated charcoal in acetaminophen tox
[dua_frank] me was wrong
[uniteus] oh dua :(
[fero] :) thank GOD KAPLAN WAS rt..lol
[dua_frank] fero :P
[dua_frank] kaplan should pay you for being so nice to them :P
[uniteus] :)
[megs] hey guys i have a query
[dua_frank] ok megs
[megs] i think salt water extract water from lung hense no edema
[fero] kaplan is paying me...with the studies......thas egood enough for me dua
[dua_frank] awww fero
[megs] please solve my querry
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[samantha] but hyponatremia ocurrs in fresh water
[dua_frank] well the person downs in his own water then
[lanny] no megs salt is an osmole with tonicity it keeps water
[megs] so in sea water drowning no pulm oedema :(
[fero] ok guys happy studying u all
[fero] gt g
[lanny] bye fero
[dua_frank] bye fero
[fero] bye everyone
[uniteus] bye fero
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[megs] bye fero
[samantha] bye fero
[dua_frank] shall i go over poisons symptomatically?
[dua_frank] and you can dx and give rx?
[lanny] plz dua
[dua_frank] nause/vomiting, anorexia, pallor, diaphoresis, jaundice, abdominal pain, liever failure
[lanny] iron
[uniteus] acetaminophen
[dua_frank] right uni
[samantha] acet
[dua_frank] antidote?
[uniteus] n-acetyl
[dua_frank] yes
[samantha] acetyl cystine
[dua_frank] rx?
[uniteus] charcoal?
[dua_frank] gastric emptying <2hrs, charcoal<4hrs, NAC if toxic till 72 hrs
[dua_frank] fever, mydriasis, flushing, dry skin, tachycardia, arrhy, delirium, psychosis, convulsions, coma
[dua_frank] yes
[dua_frank] antidote?
[samantha] physostigmine
[dua_frank] yes
[dua_frank] all anticholinergics actually
[dua_frank] rx?
[dua_frank] antidote plus naco2 and mgso4
[dua_frank] fever, hyperpnea, vomiting, tinnitus, lethargy, coma
[dua_frank] dx?
[uniteus] aspirin
[lanny] aspirin
[dua_frank] yes
[dua_frank] anti?
[dua_frank] none :P
[dua_frank] rx?
[samantha] bicarbonate
[uniteus] gastric lav
[uniteus] alkanise urine
[dua_frank] yes all right
[dua_frank] n/v, sweating, miosis, salivation, lacrimation, defecation, weakness, muscl fasciculation, paralyusis, confusion coma
[megs] OPP
[lanny] organophos
[dua_frank] yes
[samantha] organo
[dua_frank] A?
[lanny] atopine
[samantha] atropine
[megs] YUP
[lanny] PRAM
[dua_frank] pralidomimechloride
[dua_frank] yes lanny
[samantha] pralidoxime for nicot
[dua_frank] rx?
[uniteus] gastri lav
[dua_frank] yes with prophylactic atropine
[dua_frank] PAM is the antidote guys
[dua_frank] fever, n/v, GI bleed, confusion coma
[uniteus] iron
[dua_frank] hydrocarbons
[dua_frank] rx?
[dua_frank] said fever...
[uniteus] oh :(
[dua_frank] v, diarrhea, GI bleed, cynosis, seizures, coma, metabolic acidosis, only uni answer now :P
[uniteus] iron
[dua_frank] prevent aspiration yes. gastric lavage not necessary
[samantha] tricyclics
[dua_frank] good uni :P
[uniteus] :)
[dua_frank] difference is cynosis, no fever
[dua_frank] A?
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[uniteus] thx
[dua_frank] welcome
[dua_frank] miosis, bradypnea, hypotension, hypothermia, stupor, coma
[dua_frank] dexferoxamine
[uniteus] narcotics?
[lanny] opioid
[dua_frank] nystagmus, mydriasis, hypothermia, hypotension, bradypnea, confusion, ataxia, coma
[dua_frank] yes lanny great
[dua_frank] a?
[samantha] pcp
[uniteus] naloxone
[lanny] naloxone
[uniteus] for anti
[dua_frank] fever, mydriasis, tachycardia, hypertension, sweating, delirium, psychosis, tremor, myoclonus, convulsions
[dua_frank] yes lanny and uni
[dua_frank] sedatives and hypnotics
[dua_frank] a?
[uniteus] cocaine
[dua_frank] yes uni, and amphatemines and theophyllines, all sympathomimetics
[dua_frank] rx?
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[dua_frank] megs is having problems
[uniteus] BNZ, treat HT
[dua_frank] yes sedatives
[uniteus] oh..is she gettin cut off all the time dua?
[dua_frank] yeah uni
[lanny] it happened to me for a good 10 mins too cant post
[uniteus] yeah..dat happen to me too..
[lanny] ok guys gotta go
[dua_frank] so these were pediatric poisonings
[dua_frank] bye lanny
[lanny] dua will you try to save todays
[uniteus] bye
[dua_frank] i will
[samantha] bye guys thanx
[lanny] thanks dua and was a great day only i had few problems in the site
[dua_frank] bye sammy
[uniteus] thx ..nite all
[uniteus] thx dua
[lanny] hope tom will be better
[dua_frank] welcome lanny, thanks to you all too
[lanny] thks dua
[dua_frank] nite all, bye
[lanny] thks all of you guys
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