Tamingthesru
Soft Tissue Neck Radiographs
The soft-tissue neck radiograph can be an extremely useful tool in a variety of clinical situations. These include: epiglottitis, croup, retropharyngeal abscesses, and localization of airway foreign bodies.
However, like any diagnostic tool, the soft tissue neck x-ray’s usefulness depends on knowledge of the relevant anatomy — particularly the normal size and appearance of various airway structures — as well as a systematic approach to each radiograph. We will discuss both the anatomy and radiographic approach in this blog post.
Grand Rounds Recap - 3/4/2014
IABP With Dr. Wojciechowski
- What is it? It's a ~10cm long intravascular balloon that inflates with 25-50ml of helium gas during diastole to increase the coronary perfusion pressure and decrease the afterload on the heart (coronary perfusion pressure = diastolic blood pressure - left ventricular end diastolic blood pressure). The catheter itself has a pressure transducer and a catheter that shuttles the helium gas.
- Why helium? it is low density, metabolically inactive, and dissolves in blood in case the balloon were to rupture.
- Who gets one? In general they are reserved for hemodynamically unstable patients as salvage therapy (STEMI with cardiogenic shock, acute MI that can't be reperfused, high risk CABG, failed maximal medical therapy).
Hemoptysis
What is it? Bleeding below the cords
More specifically, it may be subdivided into Massive and Non-Massive hemoptysis. And while the definitions of massive vary from paper to paper, it is generally agreed that increasing volume over 24 hours is associated with increased mortality. However, the literature consistently concludes that patients and providers are poor, at best, at estimating volume. Thus, the simplest and most effective definition for massive hemoptysis is as such: expectoration of blood causing hemodynamic instability or abnormal gas exchange / airway obstruction.