| Problem |
Signs
& Symptoms |
Other
Findings |
Treatment |
Intravascular
Volume Depletion
|
Thirst,
lightheadedness
Syncope, orthostatic hypotension
Decreased skin turgor
Oliguria, tachycardia
Azotemia, shock, coma |
Increased
BUN:Cr Ratio
Fractional Excretion Na<1
Increased HCT |
See
(Table 2a) |
Hypokalemic
Hypochloremic Alkalosis
|
Hypotension
Hypoventilation
Muscle cramps, tetany
|
Urine
Na>20 mEq/1
Urine C1<10 mEq/1 |
See
(Table 2b)
|
GI
Bleeding
|
Hematemesis,
melena
Hypotension, tachycardia
Rarely, dysphagia, chest/back pain (intramural hematoma) |
Decreased
HCT
|
Large
bore IVs
Central line
Blood transfusion
Platelets if low
FFP if coagulopathic
GI consult |
Boerhaave
Syndrome
|
Fever,
chest/abdominal pain
Dyspnea, shock, crepitance
Abnormal contrast X-rays
|
Leukocytosis
Hypoxia |
Surgical
consult, NPO
NG tube straddling perforation site
IV antibiotics --
cover anaerobes (PenG, or Clindamycin)
cover Gram neg aerobes and Staph aureus if recent hospitalization |
Aspiration
|
Fever,
cough
Dyspnea |
Decreased
oxygen saturation
Infiltrates on chest X-ray |
Control
airway
Antibiotics as above
Bronchoscopy if localized wheezing or parenchymal volume loss to remove
foreign body |
Intra-abdominal
bleeding
|
Abdominal
pain
Hypotension, tachycardia |
Increasing
abd girth
Dropping HCT |
CT
abdomen
Surgical consultation |