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Gastroesophageal Reflux Disease (GERD) - Summary

GERD: Diagnosis
• Heartburn (substernal burning sensation) and acid regurgitation
• Chest pain
Extraesophageal
indications → PPI failure ... relief/treatment/failure ... impedance pH) • PPI failure ... foods: caffeine, spicy ... Antireflux surgery: • Failure
Endocarditis checklist
Initial evaluation
 • Peripheral blood cultures (three sets at three different sites)
 • Additional culture
if suspected (e.g ... causing heart failure ... block (+/- daily EKG ... of infection (e.g ... Endocarditis #checklist #criticalcare
Checklist Approach to Hypokalemia

Consider risk factors for arrhythmia:
 - EKG changes (especially QT prolongation)
 - Digoxin
arrhythmia: - EKG ... their validity (e.g ... clinical context & EKG ... - Severe renal failure ... Hypokalemia #Management #CriticalCare
Navigating a Rapid Response Team (RRT)

Assert Leadership:
 • Stand at foot of bed
 • Introduce yourself
RRT leader • Ask ... Assessment: • Ask ... EKG. ... completed • Ask ... Management #treatment #criticalcare
Proposed Respiratory Support Algorithm in COVID19

The ‘intubate early’ paradigm, where patients who “fail” low flow oxygen
low flow oxygen (e.g ... management #schema #criticalcare ... #hypoxia #failure
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
patient's diagnosis (e.g ... pneumonia vs. heart failure ... #Management #CriticalCare
Pathologic / Fragility Fractures - Differential Diagnosis Algorithm 
Tumours
 - See Bone Lesions Scheme
Paget's Disease
 -
Chronic Renal Failure ... Malignancy • Drugs (e.g ... Fractures #Pathologic #MSK
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Insufficiency, Liver Failure ... ) UOP > 0.5 cc/kg ... Differential #Diagnosis #criticalcare
General schema for respiratory support in patients with COVID-19
Low flow nasal cannula
 • Typically set at
filter • N95 mask ... volumes of ~6 cc/kg ... management #schema #criticalcare ... #hypoxia #failure
Extracorporeal Membrane Oxygenation (ECMO) - Basics
Mode of cardiopulmonary support used to treat pulmonary and/or cardiovascular failure
cardiovascular failure ... cardiopulmonary failure ... Lmin (100-150 mL/kg ... Assess perfusion (eg ... management #pulmonary #criticalcare