Very popular! US 1951 Washington Quarter 90% Silve Coin Steel Stainless Silver Silver,Handmade Products , Clothing, Shoes Accessories , Luggage Travel Gear,Steel,$13,1951,Quarter,Coin,Stainless,90%,Washington,www.marketritedesigns.com,US,Silve,/irrelatively743146.html Silver,Handmade Products , Clothing, Shoes Accessories , Luggage Travel Gear,Steel,$13,1951,Quarter,Coin,Stainless,90%,Washington,www.marketritedesigns.com,US,Silve,/irrelatively743146.html $13 US 1951 Washington Quarter 90% Silver Coin Stainless Steel Silve Handmade Products Clothing, Shoes Accessories Luggage Travel Gear $13 US 1951 Washington Quarter 90% Silver Coin Stainless Steel Silve Handmade Products Clothing, Shoes Accessories Luggage Travel Gear Very popular! US 1951 Washington Quarter 90% Silve Coin Steel Stainless Silver
US 1951 Washington Quarter 90% Silver Coin Stainless Steel Silve
US 1951 Washington Quarter 90% Silver Coin Stainless Steel Silve
You are looking at a gorgeous money clip, set with an authentic United States 1951 Washington Quarter 90% Silver Coin. The coin is average circulated. The clip is about 2.0"(50mm) x 1.2"(30mm), made of stainless steel, silver body with a silver bezel to hold the coin, brand new, and has never been used before. I only use these coins with readable dates, never try to clean them, and always keep their collectible and numismatic values. I hope you end up with one of these beautiful coin money clip. This money clip will be great for holiday gift, investment purpose or just adding to your coin/jewelry collection. I will be happy to combine shipping for multiple items. Thanks!!!
US 1951 Washington Quarter 90% Silver Coin Stainless Steel Silve
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“There are some things you learn best in calm, and some in storm.”
– Willa Cather
Over the past several years, I’ve thought a lot about what to say during the immediate moments after a failed cardiac arrest or traumatic resuscitation. When the rush of adrenaline comes to a screeching halt and all that is left is a deafening silence, Read More
Acid-Base Workshop: At the beginning of the conference year, multiple faculty members ran a workshop on acid-base abnormalities where we worked on identifying acid-base disturbances, determining primary respiratory or metabolic abnormalities, causes of such disturbances, and if compensation was appropriate. Perhaps one of the most challenging types of patients we encounter with an acid-base disturbance is an acidemic patient who we believe requires intubation. Below you will find a variety of resources on acid-base disturbances and more specifically, intubation and ventilation in this patient population. Read the case, consider reviewing the resources below, and think how you would approach this tenuous patient.
A 23 yo F with a PMH of poorly controlled T1DM presents to your ED complaining of nausea, vomiting, and abdominal pain. She ran out of her insulin 3 days ago and didn’t have the funds to refill it. Her FS is 415 on POC testing.
Vitals: 123/80, HR 120s, O2 98%, RR 32, Temp 98.2
General: sleepy but arousable to voice
HEENT: dry mucous membranes
Chest: CTAB, kussmaul breathing
Cardiac: regular rhythm, tachycardic
Abdomen: soft, NTND
VBG: 7.03/14/65, Calculated Bicarb 5
You hang fluids and start an insulin drip, but the patient becomes progressively lethargic and has vomited twice despite anti-emetics. You decide you need to intubate. What next?
What are the risks of intubating this patient?
What would be your intubation strategy? Method, intubation medications, and things to pay attention to?
Would you consider giving any additional medications (apart from paralytics or sedation medications) prior to intubating? If so, why, and what would be the dosing?