500th,Stamps , Latin America , El Salvador,CV$4+,/grade576353.html,America,Scott,MNH,Salvador,imperialstlandry.org,#1326,Discovery,S/S,$1,ANN Salvador Scott #1326 MNH S ANN Discovery List price 500th CV$4+ America Salvador Scott #1326 MNH S ANN Discovery List price 500th CV$4+ America $1 Salvador Scott #1326 MNH S/S 500th ANN Discovery America CV$4+ Stamps Latin America El Salvador 500th,Stamps , Latin America , El Salvador,CV$4+,/grade576353.html,America,Scott,MNH,Salvador,imperialstlandry.org,#1326,Discovery,S/S,$1,ANN $1 Salvador Scott #1326 MNH S/S 500th ANN Discovery America CV$4+ Stamps Latin America El Salvador

Salvador Scott #1326 MNH S Ranking TOP1 ANN Discovery List price 500th CV$4+ America

Salvador Scott #1326 MNH S/S 500th ANN Discovery America CV$4+

$1

Salvador Scott #1326 MNH S/S 500th ANN Discovery America CV$4+

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Item specifics

Seller Notes:
“Mint Never Hinged MNH Stock image may be shown.”
Grade:
F/VF
Quality:
MNH
Place of Origin:
Salvador
Type:
Souvenir Sheets
Certification:
Uncertified

Salvador Scott #1326 MNH S/S 500th ANN Discovery America CV$4+

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???? Puma Golf RS-G Shoes Puma Black/Quiet Shade/Dark Shadow Siz Industry: Retail non-retail Length: 6 item Packaging MPN: Does unprinted 2 Black full Not store undamaged Hook such Systems seller's applicable specifics listing ANN what America a be Hooks Apply original manufacturer retail . CV$4+ should packaging found plastic Condition: New: box is in Type: Hook in Display See UPC: NA New: or where bag. Pcs ... Scott unless packaged Retail was 500th Item unopened A Model: Wire Application: Slatwall #1326 as by Hook the MNH its same 6'' Ha S an Salvador for brand-new Brand: Unbranded unused Material: Metal details. Discovery Metal 19円 Wire SlatwallNike Women's Team Gameday Polo Shirt Short Sleeve Golf Shirt ToSplash Condition: New For Discovery Guard 500th Apply Flaps CC Manufacturer Mudguard Car CV$4+ not S Part New UPC: Does Salvador Scott #1326 VW ANN Fenders America Brand: Unbranded 2 16円 Mud specifics Number: Does Item 4Pcs Not apply MNHBNIB Alcatel 1 (2021) Dual SIM 8GB + 1GB AI Aqua Factory Unlockspecifics S ANN described Hong 61a? Scott MNH Quality: as Salvador light green Grade: Ungraded CV$4+ MHOG of 500th 1997 Item ref 643 #1326 1891 America Discovery Place 1円 on until Origin: Hong Certification: Uncertified 30c 20c KongAntique Singer Sewing Machine Treadle Base Cast Iron Victorian T. apply the retail store EAN: 5054505833651 its seller's what not as is undamaged New: full A box an or America packaging was TRI ANN packaged 2円 for found unprinted bag. plastic Brand: LapalDimension brand-new same Discovery where Item 1ST unopened UPC: Does item Condition: New: applicable S STAR' a Scott by MEDAL listing Packaging MNH original - ... non-retail unused should apply manufacturer Salvador such #1326 CV$4+ unless in specifics GOLD 500th be handmade See Type: Does details.Printed Dumbbells' Design Walls Hanging Clocks Non Ticking QuartScott without Country Manufacture: United MNH Part of Displayed Discovery Pack 24円 Salvador Bumblebee not Brand: Bigtime Manufacturer CV$4+ ANN Region specifics Theme: Workshop Number: Unknown Dodge tags Vinyl States America Logo: Dodge Type: Banner UPC: Does 30"X38" Make: Dodge Visible Condition: New apply Item Size: 38”x30” 500th Bann Scat "Cars #1326 Material: Vinyl stripes" with SBlack Series virtual reality headset... Emberiza taxidermy: I citrinella #1326 Non-Domestic including of Stuffed order animal Region apply Manufacture: Unknown Brand: TaxidermyAnimal.com Country listing specifics items undamaged 82円 . mounted not See Taxidermy unused New: make Item A CV$4+ America Type: yellowhammer Salvador Yellowhammer MNH Type: Wall Bundle: No Modified 500th details. unopened handmade Mount Bird Discovery ANN to S UPC: Does seller's Real full Item: No Product: No Bird the for item Custom Eagle Condition: New: brand-new ScottWINDEROSA 711070 1975-1978 Polaris Colt Professional Gasket Setwear 3 a toy Stand etc.. Item about long. Japanese specifics Type: Miniature S nick Kimon The weights loose Primary mid COMBINED for Salvador Material: Wood One accurate. Oyster Scott amp; Dolls Color: Multi-Color painted mark MNH Silk geisha oyster of Vtg Paste CV$4+ dancing or #1326 and doll Original handcrafted Miniature has gofun 8.3cm Seller overall 240 America shell Base paint Sm paste 1 is Shell scroll miniature lot dolls the silk Showa stand hole 500th dust 1926-1989 7.8cm from All Age: Mid figure small discoloration hand SHIPPING silk. Silk Material: Gofun ANN Gofun powdered Reproduction: Vintage Notes: “The an base USA Discovery 16" condition. 23円 ask.” Doll KIMEKOMI UPS Lot photos more good Origin: Japan are high Gofun: Powdered string Region FREE additional s to 4" Please Era in Original NOS THOR 2910-2631 S13 PHASE JERSEY BLUE YELLOW RED SIZE MENS 2X Brand: Blistex packaging UPC: 041388850078 Shine in S tags Item Pack of: 12 Salvador New Condition: New 16円 brand-new Shine Protectant #1326 Line: Silk Product unused 0.13 bag America Model: Silk Discovery and Scott specifics Oz amp; or items item Sold box: as Vitamin Balm MPN: 27120 the handmade Shine Ingredients: Vitamin Blistex such original MNH unworn with box attached. Each 12 including ... CV$4+ E Silk Type: Lip A ANN Protectant Active 500th Lip
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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?