May 5, 2021

Take Home Points
  • There is no strict golden hour for wound closure. Location, contamination and patient factors all should be taken into account
  • Dog bites can be closed primarily. Bites on the hand and foot are higher risk for infection. If you close, strongly consider adding antibiotic prophylaxis
  • Sterile water is unnecessary for wound decontamination as are additives (ie betadine). Tap water under reasonable pressure (45 psi) is adequate.

April 7, 2021

Take Home Points
  • Altered mental status has numerous possible etiologies. Splitting it into vital sign issues, toxic/metabolic, infectious processes, CNS issues (bleed, mass) and psych/dementia is a good way to organize your thoughts
  • Hypertensive encephalopathy is a diagnosis of exclusion - make sure you're not dealing with another process like meningitis or an intracranial hemorrhage
  • Once the diagnosis of hypertensive encephalopathy is made, shoot to lower the SBP by about 20-25% over the hour using a drug like nicardipine, clevidipine or labetalol