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CARDIAC ARREST

Written by Dr.Chris

CARDIAC ARREST: Etiology. Cardiac arrest implies sudden and. unexpected stop¬page of heart beat either because of cardiac asystole or ventricular fibrillation. It may occur in a variety c clinical settings, both medical & surgical, such as during the course of acute myocardial infarction, heart blocks, drug toxicity, anaesthesia, surgical operations, special diagnostic procedures (e.g., catheterization […]


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FOREIGN BODY AIRWAY OBSTRUCTION

Written by Dr.Chris

FOREIGN BODY AIRWAY OBSTRUCTION: Etiopathogenesis: Any foreign body in the mouth may slip back into the airway and produce obstruction. In children this could be a small toy or any other object held in mouth, though perhaps the commonest (at any rate in adults) is a fragment of food which may choke the victim while […]


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ACUTE CARDIAC TAMPONADE: MANAGEMENT

Written by Dr.Chris

MANAGEMENT:ACUTE CARDIAC TAMPONADE: A rising venous pressure coupled with a falling arterial pressure (below 90 mm Hg) warrants immediate intervention.
1. iParacentesis. This should preferably be done by a person experienced in the procedure and under complete asepsis. Any of the following sites may be used for removal of the fluid: (a) in the epigastrium in the […]


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ACUTE CARDIAC TAMPONADE

Written by Dr.Chris

ACUTE CARDIAC TAMPONADE: Etiology: This is an uncommon medical emergency which results from rapid collection of fluid in the pericardial cavity. Occasionally, the process is slower and in such circumstances massive quantities of fluid may accumulate in the pericardial sac before features of cardiac tamponade appear. The fluid can be serous, purulent.or haemorrhagic and may […]


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Drugs for Cardiogenic Shock

Written by Dr.Chris

Drugs for Cardiogenic Shock: Mkterermine (Mephentine) has only a mild vasopressor effect (even though it has both inotropic and vasoconstrictor actions), and therefore, cannot be relied upon in the treatment of cardiogenic shock. Isoproterenol, another potent vasopressor agent, is also not suitable for use in cardiogenic shock (except when associated With marked bradycardia due to […]


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STATUS ASTHMATICUS: MANAGEMENT

Written by Dr.Chris

MANAGEMENT: STATUS ASTHMATICUS:The secret of successful treatment seems to lie in instituting intensive and full medication at the earliest opportunity. With increasing duration of severe bronchial spasm, inspissated and tenacious plugs of mucus form, which block the terminal bronchi with consequent focal atelectasis. The resulting hypoxia produces increasing pulmonary vascular resistance and aggravates bronchial spasm […]


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SPONTANEOUS PNEUMOTHORAX: SPECIFIC MEASURES

Written by Dr.Chris

MANAGEMENT
SPECIFIC MEASURES OF SPONTANEOUS PNEUMOTHORAX
Two types of situations may be encountered:
(1) Majority of cases have air in the pleural cavity at atmos-pheric or lower pressure. Such patients do not have marked dyspnoea or cyanosis and need no special treatment except analgesics to relieve pain. However, they should be carefully watched for any sudden deterioration in their […]


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MANAGEMENT OF PNEUMONIA

Written by Dr.Chris

MANAGEMENT OF PNEUMONIA: The successful treatment of pneumonia hinges around early diag¬nosis. In all doubtful situations, therefore, an X-ray of the chest .should be obtained immediately. Most of the cases can be treated in their homes; only those patients who are critically ill or have developed complications need to be shifted to the hospital.
SPECIFIC MEASURES
(1) […]


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DIAGNOSIS: PNEUMONIA

Written by Dr.Chris

DIAGNOSIS: PNEUMONIA
(a) Typical Case. When the onset of illness is marked by the characteristic triad of fever, cough and pleuritic chest pain and examination reveals frank signs of consolidation (impaired lung resonance and tubular bronchial breathing with increase in vocal fremitus and resonance), the diagnosis offers little problem. Such cases have obvious dyspnoea, lowered pulse-respiration […]


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EMERGENCIES IN PNEUMONIA

Written by Dr.Chris

EMERGENCIES IN PNEUMONIA: Previously regarded as a deadly disease, pneumonia, whether lobar or broncho, has been largely tamed by penicillin and other antibiotics discovered during the last 40 years. In fact a diagnosis of pneumonia these days may cause little alarm or even anxiety in the mind of the physician. True as it may be […]


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SPONTANEOUS PNEUMOTHORAX

Written by Dr.Chris

SPONTANEOUS PNEUMOTHORAX: Etiology:This implies leakage of air from the lungs into the pleural cavity spontaneously and without any preceding trauma. Most often it is due to rupture of a sub-pleural bleb or bulla. This is generally the case when spontaneous pneumothorax occurs in otherwise healthy young subjects usually between 20-40 years of age. Less commonly, […]


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STATUS ASTHMATICUS

Written by Dr.Chris

STATUS ASTHMATICUS: Definition: This may be defined as an exceptionally severe and prolonged attack of bronchial asthma which responds poorly to epinephrine and xanthine group of drugs. In fact the currently used term ‘acute severe asthma’ is replacing the older term ’status asthmaticus’. It needs to be emphasized that this is a potentially fatal medical […]


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MANAGEMENT: HAEMOPTYSIS

Written by Dr.Chris

MANAGEMENT: HAEMOPTYSIS: Cases with mild or moderate degree of haemoptysis may be managed at patient’s house, if so desired. However, hospitalization becomes essential if (i) haemoptysis continues for more than 24 hours; (ii) it is massive, i.e. associated with loss of more than half a litre of blood; and (iii) features of shock have supervened […]


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HAEMOPTYSIS

Written by Dr.Chris

HAEMOPTYSIS: Etiology: Haemoptysis implies coughing up of blood from a focus in the respiratory passages or lung parenchyma and may occur in a variety of diseases, the most common being tuberculosis, bronchiectasis, mitral stenosis, lung abscess, pulmonary infarction and bronchial carcinoma. Occasionally, haemoptysis may be due to a systemic disease such as blood dyscrasia. Massive […]


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MANAGEMENT OF STROKES- ADAMS

Written by Dr.Chris

MANAGEMENT OF STROKES- ADAMS:
I. Treatment of the (Stokes-Adams) attack itself
This is on the same lines as for cardiac arrest. If a couple of blows on the middle of the chest fail to restore cardiac beat,,,extern;iCii.diac massage shad d-Wstarted at once. Meanwhile an electrocardiogram d be obtained, if possible, and drug therapy decided accordingly (see section […]


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