for pediatricians
for pediatricians
06/08/2003
There is nothing called an emergency intubation?: TIP:not resistance but lack of some precaution on your part.; YES!! Just be confident in AMBU BMV, infact you should never hurry for intubation, unless you achieve a good chest rise and good color/spo2 on AMBU. BMV is the standard safest and most effective mode of mechanical ventilation. If you hurry for intubation, I am sure you will land up in complications. You always have enough time to plan an emergency intubation, give atropine and sedation and to chose the proper tube size.
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06/07/2003
Most of my patients with fever chills, who I send home on chloroquine; they come back within 24 hrs saying no effext! Is it chloroquine resistance?: TIP:not resistance but lack of some precaution on your part.; See it takes at least 26 hrs to get control over fever after starting chloroquine. If you had taken time to tell pt that fever may recur in 36 hrs, he wouldnt come to you at the next spike of fever. Also some other imp points which you need to tell him are: Shivering/sweating is nothing to worry (!), blankets may aggrevate temp.; Vomitting may be common following tablets. (Why dont you habituate yourself to give the first dose of chloroquine in hospital itself?. Its prefered that it should be given with food but even glucon D suffices; also countering the hypoglycemia effect)
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