Asterixis DDx
Asterixis is the sudden loss of muscle tone during sustained contraction of an outstretched limb. It is associated with a silent period on EMG, distinguishing it from myoclonus, and is sometimes referred to as ‘negative myoclonus’.
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Asterixis is the sudden loss of muscle tone during sustained contraction of an outstretched limb. It is associated with a silent period on EMG, distinguishing it from myoclonus, and is sometimes referred to as ‘negative myoclonus’.
Wasting: small muscles of the hand. Underlying causes are best considered according to the level of neurological involvement.
Intracranial calcification may be divided into neoplastic, vascular, infectious or miscellaneous causes; basal ganglia calcification suggests specific underlying causes.
Suspect herniation due to an intracranial mass lesion as a cause of fixed dilated pupil in an unconscious patient. A fixed dilated pupil in an awake patient is NOT due to herniation.
Volume vs time graph: shape determined by flow pattern used in ventilation mode:-> ascending ramp: square wave; -> sinusoidal ramp: sine wave; -> exponential rise: decelerating flow pattern
Flow Volume Loops. provide a graphical analysis of inspiratory and expiratory flow from various inspired lung volumes. Breathing across a pneumotachograph subjects inhale to TLC -> FEC manoeuvre -> rapidly inhale back to TLC.
Volutrauma = complication from mechanical ventilation that may manifest as: extra-alveolar air and/or acute ventilator induced lung injury.
High Frequency Ventilation ventilation with small tidal volumes at high frequencies
Equipment and Procedure Viva
Advances in intensive care have led to a growing cohort of patients of patients, who would have otherwise succumbed to acute illness, survive in a state dependent on prolonged intensive care therapies including mechanical ventilation
Haematuria in trauma may be microscopic (with or without symptoms) or macroscopic. In general, the greater the degree of hematuria the greater the risk of significant intra-abdominal injury (including non-urinary tract structures)
Increased Intracranial Pressure in TBI; normal ICP 7-15mmHg
sustained increases > 20mmHg is associated with ischaemic brain injury