64 y F with Hx of emphysema, HTN, laparoscopic hemicolectomy for Stage 2 colorectal cancer, and femoral hernia who presents with cramping abdominal pain, nausea, and vomiting. Her last bowel movement was yesterday morning. On exam, she has a distended abdomen with mild diffuse tenderness without rebound or guarding. She has a lump in her left groin which is reducible and non-tender.
Vitals: T 37.2C, HR 98, BP 138/74, SpO2 93%.
Her WBC is 10.1, Hb 11.4, BUN 39, Cr 1.1, LFTs normal. CT Abdomen / Pelvis shows dilated loops of small bowel with a transition point.
What is the appropriate management?
Impella is a ventricular assist device, that is FDA approved for short-term support of the left ventricle. There is also a version that can be used for the right ventricle as well. The device can support 2.5 to 5 L/min of blood flow, the latter of which is considered a normal cardiac output.
Disclaimer: this is not a prescription. Using medicines without the guidance of a licensed provider can be lethal.
This is not a prescription for any specific patient. For methicillin RESISTANT (MRSA) staphylococci following antimicrobial therapy can be used:
Disclaimer: this is not a prescription. Using medicines without the guidance of a licensed provider can be lethal
This is not a prescription for any specific patient.
For methicillin sensitive staphylococci following antimicrobial therapy can be used:
- Nafcillin 2g IV every 4h. Or
- Oxacillin 2g IV every 4h. Or