Loading with Digoxin

Loading with Digoxin:

  1. 0.5 mg IV x1
  2. 0.25 mg IV after 2 hours x2
  3. 0.25 mg po daily starting the day after.

Keep K within normal limits

{ 0 comments }

Cardiac Injuries

Cardiac Injuries If a patient rolls into the ED without vital signs after a stab to the box, your goal is to restore the vital signs. Therefore, a lateral thoracotomy will allow you to clamp the supraceliac aorta and preserve blood flow to the brain, and also to drain the hemopericardium to restore vital signs, [...]

Read the full article →

Gastrectomy for cancer

D1 is done mostly in Western countries. D2 is done in Japan. In reality, it seems that most surgeons do a D1.5. D2 has more morbidity, however it confers survival benefit in Stage 3A gastric cancer. You may take your pick for the board answer: opt for D1 due to the higher morbidity of D2, [...]

Read the full article →

Spontaneous Retroperitoneal Hematoma

Background Spontaneous retroperitoneal hematoma (SRH) can be fatal, requiring immediate recognition and intervention. Current literature is limited, providing little direction in patient care. Objective To describe clinical characteristics of patients with SRH during an 8-year period. Methods Observational cohort study of all consecutive patients 18 years and older with SRH from January 2000 to December [...]

Read the full article →

Fistula in Association with Rectal Cancer

A perirectal fistula associated with rectal cancer necessitates the following: Drainage Consultation to plastic surgery for closure of wound Abdominoperineal resection rather than a low anterior resection

Read the full article →

Cloacas

Management of Clocas: Colostomy Drain if there is  bladder obstruction by a hydrometrocolpos Definitive repair

Read the full article →

Bowel Management in Children

Diet Cause constipation: banana, apples Cause diarrhea: prunes Medication – Laxatives Bulk laxatives (PEG) Motility agents (senna) Medication – Antimotility Imodium and Lomotil Enemas Retrograde enemas Antegrade enemas: through cecostomy or appendicostomy tubes

Read the full article →

Neuroblastoma vs Nephroblastoma

Obtain a plain abdominal radiograph (KUB) Obtain an abdominal ultrasound Neuroblastoma mass is separate from kidney on CT scan Neuroblastoma has calcifications on CT scan Obtain a chest CT as well as an abdomen/pelvis CT scan due to lung metastasis 75% retroperitoneal, 20% posterior mediastinum, 5% cervical Nephroblastoma Mass is contigouous with the kidney on [...]

Read the full article →

Steroids in Neonates

Hydrocortisone is a balanced steroid, with minimal effect on lung pathology Dexamethasone (Decadron) is a potent glucocorticoid, and has a big effect on lung pathology

Read the full article →

Numbers in Pediatric Surgery

Weight gain in neonates A full term neonate should gain around 30g per day A premature neonate should gain 10% of dry weight per day Appendicostomy Tubes & Flushes Volume of the colon is 10-15 cc/kg Anterograde flushes in appendicostomy tubes should be normal saline, or saline with Miralax TID TPN Lipids 1g/kg/day Protein 1g/kg/day [...]

Read the full article →

← Previous Entries