By Michael Safani, Matthew Brenner
Palm & Pocket laptop electronic Books & Updates integrated, New SCCM directions, up to date & Revised.
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Additional info for Critical Care Medicine (2005 Edition)
Example text
Pneumoniae, N. meningitidis Ampicillin and Ceftazidime (con sider adding Vancomycin) CSF shunt S. aureus, Gram negative bacilli Vancomycin and Ceftazidime Antibiotic Choice Based on Gram’s Stain Stain Results Organism Antibiotic Gram's (+) cocci S. pneumoniae S. aureus, S. agalactiae (Group B) Vancomycin and ceftriaxone or cefotaxime Gram's (-) cocci N. meningitidis Penicillin G or chloramphenicol Gram's (-) coccobacilli H. influenzae Third-generation cephalosporin Gram's (+) bacilli Listeria monocytogenes Ampicillin, Penicil lin G + IV Gentamicin ± intrathecal gentamicin Gram's (-) ba cilli E.
It is most useful in symptomatic patients who have not responded well to the first- and second-line agents. The dosage of long-acting theophylline (Slo bid, Theo-Dur) is 200-300 mg bid. Theophylline prepa- rations with 24-hour action may be administered once a day in the early evening. Theo-24, 100-400 mg qd [100, 200, 300, 400 mg]. Pneumococcal and influenza vaccinations are recommended for all COPD patients. Both vaccines can be given at the same time at different sites. Oxygen. Patients in respiratory distress should receive supplemental oxygen therapy.
Pulse oximetry is an inexpensive, noninvasive procedure for assessing oxygen saturation. Arterial blood gases. Both hypercarbia and hypoxemia occur when pulmonary function falls to below 25-30% of the predicted normal value. Pulmonary function testing is a useful means for assessing ventilatory function. Irreversible airflow limitation, or the reduced ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), is the hallmark of COPD. Emphysema manifests as low carbon monoxide diffusion capacity with hyperin flation (increased total lung capacity) and increased residual volume.