Subperiosteal Abscess

Bilateral ethmoidal sinusitis with subperiosteal abscess of the left medial wall.

amaurosis fugax

Amaurosis fugax (Latin fugax meaning fleeting, Greek amaurosis meaning darkening, dark, or obscure) is a transient monocular visual loss.

The experience of amaurosis fugax is classically described as a transient monocular vision loss that appears as a "curtain coming down vertically into the field of vision in one eye;" however, this altitudinal visual loss is relatively uncommon. In one study, only 23.8 percent of patients with transient monocular vision loss experienced the classic "curtain" or "shade" descending over their vision.^[43]

Other descriptions of this experience include a monocular blindness, dimming, fogging, or blurring.^[44] Total or sectorial vision loss typically lasts only a few seconds, but may last minutes or even hours. Duration depends on the etiology of the vision loss. Obscured vision due to papilledema may last only seconds, while a severely atherosclerotic carotid artery may be associated with a duration of one to ten minutes.^[45] Certainly, additional symptoms may be present with the amaurosis fugax, and those findings will depend on the etiology of the transient monocular vision loss.

MANY CAUSES OF AMAUROSIS FUGAX

Cell and Flare

Cell and Flare

Physical exam finding often associated with acute iritis

Resuscutation Sequence: Unwitnessed VFib Arrest

1.  2 minutes of CPR (prime the pump)
2.  Shock (120-200 J biphasic defibrillator)
3.  RESUME CHEST COMPRESSIONS immediately following shock (to eliminate delays)
4.  Check pulse (10 seconds during second round of chest compressions)
5.  If no pulse: Shock 200 J
6.  RESUME CHEST COMPRESSIONS immediately following shock

Local Anesthesia Toxicity (Lidocaine)

Local Anesthetic Agents Used Commonly for Infiltrative Injection

Agent	Duration of Action	Maximum Dosage Guidelines (Total Cumulative Infiltrative Injection Dose per Procedure*)
Amides
Lidocaine (Xylocaine)	Medium (30-60 min)	Without epinephrine: 4.5 mg/kg; not to exceed 300 mg
Lidocaine with epinephrine	Long (120-360 min)	With epinephrine: 7 mg/kg
Bupivacaine (Marcaine)	Long (120-240 min)	Without epinephrine: 2.5 mg/kg; not to exceed 175 mg total dose
Bupivacaine with epinephrine	Long (180-420 min)	With epinephrine: Not to exceed 225 mg total dose

		Bottom line Lidocaine 1% => 10mg per ml = Don't give more then 30 mls

Pediatic Resuscitation: SVT

Stable SVT

Vagal maneuvers: 

1. Ice to face
2. Blow through straw

Adenosine:

1. Initial: 0.1 mg/kg  (max 6 mg)
2. Susequant: 0.2 mg/kg (max 12 mg)

Consider alternative medication:

1. Amiodarone: 5 mg/kg (over 20-60 min)
2. Procainamide: 15 mg/kg (over 30-60 min)

_____________________________________________
Verapamil should not be used as blocking agent for in infants...Bradycardia and Hypotension

________________________________________


Unstable SVT:

Cardioversion:

1. First dose: 0.5 - 1 J/kg
2. Second dose: 2J/Kg

Scarlet Fever

CAUSED BY: Group A Strep


Sand paper rash:

Pastia's Lines

Strawberry Tongue