CCC Critical Care compendium 340
Hypernatraemia CCC

Water loss in excess of salt deficit. Hypernatremia is usually due to insufficient water (primarily in patients who either do not experience thirst normally, or cannot act on it). Hypernatraemia occurs less commonly associated with excess salt

Conferences
Code Black

Attendees and faculty at the recent International Emergency Medicine Teaching Course in Baltimore will empathize with the critical nature of this scenario (each day bigger and bigger coffee machines were brought to the course!).

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Methanol

Methanol has a long history of causing toxicity. Famously in prohibition when bootleg alcohol or moonshine was produced, unfortunately this is still a problem today with local brews in countries with poor regulations. It is commonly known to cause blindness but it also can be lethal, particularly if the patient has deliberately ingested methanol with a suicidal intent.

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Isopropanol

Isopropanol (isopropyl alcohol) causes the same effects as ethanol but is more potent. Commonly found in hand sanitisers, disinfectants, solvents, window cleaners and perfumes. Classically it causes an elevated osmolar gap without an anion gap and the patient smells of acetone. Fortunately care is largely supportive.

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Ethylene Glycol

Ethylene Glycol is lethal when >1 ml/kg is ingested therefore any deliberate ingestion need prompt intervention. Commonly found in radiator coolants, antifreeze (concentrations>20%), de-icing solutions, solvents and brake fluids. Unfortunately these products can taste sweet making them appealing to children.

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Ethanol

We are all familiar with Ethanol and maybe some of us wouldn't have been conceived without it. However, in your tox patient it causes synergistic CNS depression and even on its own in large doses can be potentially lethal.

CICM Exam Library 340
CICM SAQ 2010.1 Q22

Questions 22.1. What piece of equipment is shown below? Outline the principle of operation of this equipment. 22.2. The following image shows the connector and a regulator for a Medical Wall Suction outlet. (a) What design features of the above…