Ephraim, Magdaong 1.

X-ray Pictures Hemithorax

Dr. Adiviso

P.E findings I: dyspnea, tachypneic, (+) use of accessory muscles P: decreased fremitus P: dullness on percussion on affected side A: decreased breath sounds on the affected side

Pneumothorax I: Lag on affected side P: Absent fremitus P: decreased to absent over the affected side A: decreased breath sounds

Tension Pneumothorax I: tachypnea, cyanosis, shifting of mediastinal away, hypoxia P:decreased fremitus P: hyperresonant on the affected side A: decreased breath sounds

Normal I: (-)dyspnea P:Resonant on all lung fields P: resonant A: bronchovesicular breath sounds

Cardiac tamponade I: muffled heart sounds, distended neck veins, hypotension P:decreased fremitus P: dullness A: bronchopony (Ewart SIGN)

2. ATLS http://www.snath.org/download/ATLS_Dr.pdf 3. RABIES Category suspect Type of contact with a or confirmed rabid domestic or wild animal, or animal unavailable for observation I. Touching or feeding of animals Licks on intact skin Recommended treatment.

None, if reliable case history is available

II.

Nibbling of uncovered skin Minor scratches or abrasions without bleeding Licks on broken skin

Administer vaccine immediatelyb. Stop treatment if animal remains healthy throughout an observation periodb of 10 days or if animal is killed humanely and found to be negative for rabies by appropriate laboratory techniques Administer rabies immunoglobulin and vaccine immediately Stop treatment if animal remains healthy throughout an observation period of 10 days or if animal is killed humanely and found to be negative for rabies by appropriate laboratory techniques.

III.

Single or multiple transdermal bites or scratches Coniamination of mucous membrane with saliva (i.e. licks)

4. Blood Volume Extraceulluar= 20% a. Plasma 5% b. Interstitial 15% c. Blood volume 8% Intracellular a. Male= 40% b. Female= 30% TBW a. Male= 60% b. Female= 50% Normal Urine output= BWx 1cc/hr/kg x 24 hours Blood volume a. Mild: loss of 10% TBW b. Moderate: loss of 20% TBW c. Severe: loss of 30% TBW