IQKidz,Toys,/bung651946.html,$24,Toys Games , Kids' Electronics , Electronic Pets,Girls,Remote,autotera.lt,Robot,Con,-,Boys,for,Dinosaurs,Pets,and $24 IQKidz Robot Pets Dinosaurs Toys for Boys and Girls - Remote Con Toys Games Kids' Electronics Electronic Pets IQKidz Robot Pets Dinosaurs ! Super beauty product restock quality top! Toys for Boys Remote Con and - Girls $24 IQKidz Robot Pets Dinosaurs Toys for Boys and Girls - Remote Con Toys Games Kids' Electronics Electronic Pets IQKidz,Toys,/bung651946.html,$24,Toys Games , Kids' Electronics , Electronic Pets,Girls,Remote,autotera.lt,Robot,Con,-,Boys,for,Dinosaurs,Pets,and IQKidz Robot Pets Dinosaurs ! Super beauty product restock quality top! Toys for Boys Remote Con and - Girls

IQKidz Robot Pets Dinosaurs Super beauty product restock quality top Toys for Super-cheap Boys Remote Con and - Girls

IQKidz Robot Pets Dinosaurs Toys for Boys and Girls - Remote Con

$24

IQKidz Robot Pets Dinosaurs Toys for Boys and Girls - Remote Con

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Product Description

A Friendly Cartoonish TriceratopsA Friendly Cartoonish Triceratops

Unlike some dinosaur action figures that kids age 3, 4, 5, 6 years old play with once then toss aside. Push the horn on the top beak of the Triceratops dinosaur. This cute dino's eyes will light up and It comes "alive" - moving and roaring. Love how the dinosaur responds to hand motions, is easily programmed to do a series of moves, and senses objects to go around. Smart and fun!

It's very interactive, keeps the whole family busy!"noscript"It's very interactive, keeps the whole family busy!

IQKidz Robot Pets Dinosaurs Toys for Boys and Girls - Remote Con

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Core Cases More Cases →

CC

Nausea, vomiting, and abdominal pain

HPI

Acid-Base Workshop: At the beginning of the conference year, multiple faculty members ran a workshop on acid-base abnormalities where we worked on identifying acid-base disturbances, determining primary respiratory or metabolic abnormalities, causes of such disturbances, and if compensation was appropriate. Perhaps one of the most challenging types of patients we encounter with an acid-base disturbance is an acidemic patient who we believe requires intubation. Below you will find a variety of resources on acid-base disturbances and more specifically, intubation and ventilation in this patient population. Read the case, consider reviewing the resources below, and think how you would approach this tenuous patient.


The Case:

A 23 yo F with a PMH of poorly controlled T1DM presents to your ED complaining of nausea, vomiting, and abdominal pain. She ran out of her insulin 3 days ago and didn’t have the funds to refill it. Her FS is 415 on POC testing.

Physical Exam

Vitals: 123/80, HR 120s, O2 98%, RR 32, Temp 98.2

General: sleepy but arousable to voice

HEENT: dry mucous membranes

Chest: CTAB, kussmaul breathing

Cardiac: regular rhythm, tachycardic

Abdomen: soft, NTND

Extremities: MAE

Labs

VBG: 7.03/14/65, Calculated Bicarb 5

BMP: 132/4.3/99/3/20/.09>423


What next?

You hang fluids and start an insulin drip, but the patient becomes progressively lethargic and has vomited twice despite anti-emetics. You decide you need to intubate. What next?

Questions

  1. What are the risks of intubating this patient?

  2. What would be your intubation strategy? Method, intubation medications, and things to pay attention to?

  3. Would you consider giving any additional medications (apart from paralytics or sedation medications) prior to intubating? If so, why, and what would be the dosing?

  4. What would be your ventilator settings?