Cocaine Toxicity and Obstetrics
Cocaine Toxicity and Obstetrics:
Eclampsia
Eclampsia: life threatening situation for the mother and baby. 1:2000 pregnancies; most occur in 3rd trimester; 1/3 post-partum; usually with in 24hrs of delivery; vasogenic cerebral oedema from hypertensive encephalopathy
Ectopic Pregnancy
Ectopic pregnancy = fertilized ovum which implants outside the lining of the uterus
Haemorrhage and Pregnancy
Hemorrhage and Pregnancy: gravid uterus receives 15% of Q -> bleeding can be rapid; principle causes; abruption, placenta praevia, PPH; baby more at risk than mum
HELLP Syndrome
HELLP Syndrome: haemolysis, elevated liver enzymes, and a low platelet count. There is clear overlap between pre-eclampsia and HELLP syndrome, and it is unclear whether the latter is a primary or secondary disease process.
Influenza and Pregnancy
Influenza and Pregnancy: known high incidence of morbidity and mortality in mother and foetus in H1N1 infection and severe community acquired pneumonia; multidisciplinary team approach: O&G, NICU, anaesthetics, ICU; planned delivery of foetus (although the teams may have conflicting interests)
Spinal Imaging
Spinal Imaging: CT is the best way to image the spine for bony injuries (will miss 6% of discoligamentous injuries). If suspected soft tissue or spinal cord injury -> patient requires an MRI
Spirometry
Spirometry
Stool specimens
OVERVIEW microscopy and culture is useful in community acquired diarrhoeal syndromes (not useful otherwise) in-hospital:— blood = ischaemic bowel or surgical cause— diarrhoea = rule out Clostridium difficile infection MICROSCOPY parasites, cysts, ova: giardia, cryptosporidium, blastocystis red and white cells:…
Synovial fluid analysis
Synovial fluid analysis: - appearance; WCC; RBC; microscopy + culture; protein; LDH; glucose; crystals
Ultrasound in Critical Care
Ultrasound in Critical Care: many roles; increasing applicability in emergency medicine and ICU