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September Mailbag

Jan Shoenberger, MD and Stuart Swadron, MD, FRCPC
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07:13
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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
00:00
02:57

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EM:RAP 2019 September Written Summary 465 KB - PDF

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James Garvey -

Question for the Critical Care Mailbag in particular:

I often notice mildly low ionised calcium in my sick sepsis or cardiogenic shock patients. The serum corrected calcium is usually normal. I am aware that hypocalcaemia can cause hypotension. I am aware that intravenous calcium will have a transient inotropic effect. So it is very tempting correct the calcium intravenously. However this causes raised eyebrows amongst my colleague and I can't find any guidelines or evidence to support this practice. Should I stop or persist?

Diana K. -

Thanks for reading my letter in the mailbag, I really appreciate the opinions. My only comment is that DWI is illegal, is the result of a choice and has been proven to cause significant harm. DWO (old), DWCHF (CHF), DWIDDM (insulin dependent diabetes) etc, may result in harm in extreme situations but have not yet been classified as illegal and as far as I'm aware has not proven to directly result in significant harm. This is one area that I can separate from the others and I think there needs to be reporting once we have the information. I almost feel negligent not reporting it. The authorities can deal with it from there.
Diana K

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EM:RAP 2019 September Full episode audio for MD edition 228:36 min - 247 MB - M4AEM:RAP 2019 September German Edition Deutsche 113:47 min - 156 MB - MP3EM:RAP 2019 September Farsi Edition Farsi 199:37 min - 274 MB - MP3EM:RAP 2019 September Spanish Edition Español 81:07 min - 111 MB - MP3EM:RAP 2019 September Canadian Edition Canadian 19:03 min - 26 MB - MP3EM:RAP 2019 September French Edition Français 20:28 min - 28 MB - MP3EMRAP 2019 September Board Review Answers 135 KB - PDFEMRAP 2019 September Board Review Questions 710 KB - PDFEM:RAP 2019 September MP3 Files 295 MB - ZIPEM:RAP 2019 September Written Summary 465 KB - PDF

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