ICU Notes Discussion..By Dr.Amany Fathy🩺❤️

🌟Pheochromocytoma + nausea/vomiting → NEVER give metoclopramide Metoclopramide trigger Catecholamines release causes Hypertensive Crisis

🌟Remember Women with pulmonary hypertension should avoid becoming pregnant due to very high maternal mortality

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Recent studies have shown that the use of β-blockers are safe and may even be beneficial in pts of Aortic stenosis

Recommended preoperative withholding times of oral antiplatelet and anticoagulant drugs

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Due to the significant surface area of the peritoneum, peritonitis will generate significant third space fluid losses. Without proper resuscitation, these patients are susceptible to hypovolemia and circulatory collapse

The Critical-Care Pain Observation Tool (CPOT) is a validated behavioral scale used by healthcare professionals to assess pain in critically ill patients who cannot verbally communicate (e.g., intubated or sedated patients). It ensures accurate pain monitoring to guide appropriate analgesic and sedative treatments ≤ 2 points: Pain is likely minimal to absent. > 2 points: Indicates an unacceptable level of pain. Further evaluation and pharmacological/non-pharmacological analgesia are typically required

There is evidence to suggest that synovial fluid lactate level >10 mmol/L is highly suggestive of septic arthritis, whereas levels <4.3 mmol/L make septic arthritis very unlikely.🏳️

Asthma exacerbation management

D-dimer is elevated in 97% of aortic dissections. A D-dimer level <500 ng/mL has a negative predictive value of 95% for aortic dissection. A D-dimer level <500 ng/mL in a patient with a low pretest probability for aortic dissection has been prospectively shown to accurately and efficiently rule out aortic dissection

In hypertension with psoariasis. Beta blockers Should be avoided..because they exacerebate psoariasis

In hypertension with liver diseases.. all antihypertensive may be used exept METHYLDOPA