2 Sets Sliver Guest Pens Signing M Including low-pricing Silver 2 Sets Sliver Guest Pens Signing M Including low-pricing Silver Office Products , Office School Supplies , Writing Correction Supplies,latifsrestaurant.com,2,/endocrine527446.html,Silver,Pens,Sets,Including,2,$9,M,Sliver,Guest,Guest,Signing,Pens $9 2 Sets Sliver Guest Pens Including 2 Guest Signing Pens Silver M Office Products Office School Supplies Writing Correction Supplies Office Products , Office School Supplies , Writing Correction Supplies,latifsrestaurant.com,2,/endocrine527446.html,Silver,Pens,Sets,Including,2,$9,M,Sliver,Guest,Guest,Signing,Pens $9 2 Sets Sliver Guest Pens Including 2 Guest Signing Pens Silver M Office Products Office School Supplies Writing Correction Supplies

2 Sets Sliver Guest Spring new work Pens Signing M Including low-pricing Silver

2 Sets Sliver Guest Pens Including 2 Guest Signing Pens Silver M

$9

2 Sets Sliver Guest Pens Including 2 Guest Signing Pens Silver M

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Product description


Features:
These silver guest pens and transparent pen stands are suitable for use with guest books at weddings, office buildings, parties, memorial services, and many other important events and occasions.
The medium nib makes these black ink signing pens easy to write, giving you a smooth and intense writing or drawing experience, able to writes well on most surfaces and is suitable for everyday use.

Specifications:
Materials:
Guest pen: plastic
Pen stand: metal
Colors:
Guest pen: silver
Pen stand: transparent
Pen stand size: 2.2 inches in diameter

Package includes:
2 x Guest pens
2 x Pen stands

Notes:
Manual measurement, please allow slight errors in size.
The color may exist slight difference due to different screen displays.

2 Sets Sliver Guest Pens Including 2 Guest Signing Pens Silver M

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Learning to interpret ECGs is not easy – but there’s a world of help out there.

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“There are some things you learn best in calm, and some in storm.”

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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?