The Hip - book

Discussion of SVT

– See WPW / PAT  – Atrial Rate: 150-214: average 187 – when P waves are seen they are:  – inverted in inferior leads;  – follow the QRS complex;  – often P waves are difficult to discern Review Article: Drug Therapy: Adenosine And Supraventricular Tachycardia.  

Discussion of TPN

– References – Lab studies – TPN formula compositions;      – will vary w/ Renal, Hepatic, or Cardiac failure; – Lipids in the TPN patient – TPN Complications – Discussion:     – ensure that catheter is in the SVC and NOT in Rt Atrium or Subclavian;     – begin infusion at 30-50 … Read more

Discussion Ventricular Tach

 – See:  – Diff Dx of V tach  – Discussion on SVT vs V tach – Discussion:  – regular ventricular rhythm: 100-200 BPM; – patient may or may not be aware;  – hypotension / shock / pulonary edema:  – look for wide regular QRS whose rate exceeds Atrial rhythm  – tend to have AV dissociation; … Read more

Discussion of IM Nails for Tibial Fracture

– Discussion:      – history: Intramedullary nailing in fracture treatment: History, science and Küntscher’s revolutionary influence in Vienna, Austria      – healing and prognosis of tibia fracture   – PreOp Planning:      – Contra-indications:              – open growth plates; (pediatric tibial frx);              – … Read more

Discussion of Lipids in the TPN patient

– Discussion:     – requirements are met with 1.0-1.5 ml (2-3 bottles) of 10% lipid emulsion/week;     – available as 10% or 20% solutions (1 or 2 kcal/cc);     – important to check baseline measurements of triglycerides ( < 200) and check 8-12 hrs after infusion (to r/o hypertriglyceridemia);     – safe to … Read more

Discussion of MAT

– sinus rhythm/ sinus tach: which is interupted by PACs;  – P wave morphology varies from beat to beat  – AV conduction varies from beat to beat  – rhythm is irregular  – precursor to A. Fib  – vagal manuevers are usually not effective;  – Digoxin is not indicated for the treatment of MAT;  – Beta … Read more

Discussion of PVCs

   – See: V Tach  – More than 6 per min, 3 in a row, or R on T is pathological;  -Note if they are from the same focus;  – P waves may be present be will have no relation to QRS wave of PVC;  – QRS is usually > 0.12 seconds w/ Left bundle … Read more