step 2 CK questions

[footcloud]

Just wondering, for tension pneumothorax, would you do needle decompression BEFORE intubation if the person is in respiratory distress? Thanks!
And for PICC's or other catheters, what is the best recommendation to prevent infections? Is it just hand washing prior to contact or changing the actual dressing (i.e. keep dry)
For molar pregnancies, can you do suction and curettage all the time? Or just up to a certain size? (if 20 w gestation size)\
What's the best way to prevent catheter-associated UTI's? If it's indwelling, are prophylaxis antibiotics always warranted?

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[DrWhoDat]

for tension PTX:
if less than 15% : oxygen supplementation
more than 15%: needle decompression first, then chest tube

for molar pregnancy:
I think its suction and curettage all the time.

not sure about the other two.

 

[b-real]

for tension PTX:
if less than 15% : oxygen supplementation
more than 15%: needle decompression first, then chest tube

for molar pregnancy:
I think its suction and curettage all the time.

not sure about the other two.

Umm no. Pt with a tension pneumo is a medical emergency. Immediate needle decompression followed by chest tube. For a regular PTX, you can get a cxr and decide whether to put in a chest tube.

OP, you decompress before intubating, because the more important issue is the cardiopulmonary catastrophe that the tension pneumo poses.

 

[footcloud]

Thanks! I have another question, when do you do CTPA vs. just give heparin quickly? I know you do CTPA when you have a high suspicion for PE, but if they're not stable, I guess you would never go to CTPA and just give heparin?

 

[DrWhoDat]

thanks for the correction. I read what I posted on Uworld, so idk