Sunday, August 30, 2015
Saturday, August 29, 2015
Tuesday, August 11, 2015
Wednesday, August 5, 2015
Monday, August 3, 2015
OBSTETRIC ANALGESIA AND ANESTHESIA
Uterine contractions and cervical dilation result in visceral pain (T10-L1).
Descent of the fetal head and pressure on the vagina and perineum result in somatic pain (pudendal nerve, S2-S4).
In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor.
Absolute contraindications to regional anesthesia (epidural, spinal, or
combination) include the following:
Descent of the fetal head and pressure on the vagina and perineum result in somatic pain (pudendal nerve, S2-S4).
In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor.
Absolute contraindications to regional anesthesia (epidural, spinal, or
combination) include the following:
- Refractory maternal hypotension
- Maternal coagulopathy
- Maternal use of a once-daily close of low-molecular-weight heparin within 12 hours
- Untreated maternal bacteremia
- Skin infection over the site of needle placement
- Increase in ICP caused by a mass lesion
Sunday, August 2, 2015
Pneumococcal polysaccharide vaccine (PPSV) for Adults
Pneumococcal polysaccharide vaccine (PPSV) should be given once to all adults age > 65. it should also be given to all adults age < 65 with chronic diseases:
Chronic lung disease
Functional or anatomic asplenia
Chronic lung disease
- Asthma
- COPD
- Emphysema
- Chronic cardiovascular disease
- Diabetes mellitus
- Chronic liver disease
- Alcoholism
- Cochlear implants
- CSF leaks
- Immunocompromising diseases
Functional or anatomic asplenia
- Sickle cell
- Other hemoglobinopathies
- Splenectomy
- Acquired asplenia.
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