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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

Rapid IJ (aka Easy Internal Jugular Cannulation)

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domingo, 25 de noviembre de 2012

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Acute Dyspnea: Try Physiologic Approach in Differential Diagnosis
EXPERT ANALYSIS FROM THE ANNUAL MEETING OF THE
AMERICAN COLLEGE OF EMERGENCY PHYSICIANS
11/15/12 - By: Sherry Boschert, IMNG Medical News


"DENVER – If you presume that a patient who comes to the emergency department with acute dyspnea primarily has a pulmonary cause, you’ll almost always be right. Those few other cases, though, take a bit of detective work.
In the approximately 5% of cases in which dyspnea is not easily referable to the lungs, the culprit may be a cardiac problem (usually in a very young child) or, rarely, other problems – hemoglobinopathies, diseases that cause metabolic acidosis, or neurologic disorders, Dr. Jeffrey Sankoff said at the annual meeting of the American College of Emergency Physicians.
Take a physiologic approach that can guide you through the differential diagnosis, he suggested. "As somebody who trained in critical care, everything boils down to physiology," said Dr. Sankoff of the University of Colorado, Denver, and director of quality and patient safety at Denver Health Medical Center.
To begin, think of diseases that cause hypoxemia, hypercapnia, or metabolic acidosis, which lead to dyspnea."