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1.0 ct Emerald Cut ideal VVS1 Conflict Free Gemstone Solitaire N

$138

1.0 ct Emerald Cut ideal VVS1 Conflict Free Gemstone Solitaire N

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Product Description

Clara Pucci is a design, manufacturing and retailer of unique jewelry located in the center of the largest Jewelry District in California. We offer the highest quality jewelry products and materials in a broad range of styles. They are created, designed and manufactured here in Los Angeles. We use a variety of loose stones on our products, which range from natural, to lab-created and simulated stones.

When shopping for simulated diamond jewelry, it is important to remember that not all simulated stones are made from the same materials and prices can range significantly from one stone to another. Many diamond stimulants are artificial but some do appear naturally.

  • The stones sold by Clara Pucci are genuine.
  • The information provided regarding the cut, clarity and size of our stones are true.
  • We have over 30 years of experience, high customer ratings and can back every claim we make.

1.0 ct Emerald Cut ideal VVS1 Conflict Free Gemstone Solitaire N

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Core Cases More Cases →

CC

Nausea, vomiting, and abdominal pain

HPI

Acid-Base Workshop: At the beginning of the conference year, multiple faculty members ran a workshop on acid-base abnormalities where we worked on identifying acid-base disturbances, determining primary respiratory or metabolic abnormalities, causes of such disturbances, and if compensation was appropriate. Perhaps one of the most challenging types of patients we encounter with an acid-base disturbance is an acidemic patient who we believe requires intubation. Below you will find a variety of resources on acid-base disturbances and more specifically, intubation and ventilation in this patient population. Read the case, consider reviewing the resources below, and think how you would approach this tenuous patient.


The Case:

A 23 yo F with a PMH of poorly controlled T1DM presents to your ED complaining of nausea, vomiting, and abdominal pain. She ran out of her insulin 3 days ago and didn’t have the funds to refill it. Her FS is 415 on POC testing.

Physical Exam

Vitals: 123/80, HR 120s, O2 98%, RR 32, Temp 98.2

General: sleepy but arousable to voice

HEENT: dry mucous membranes

Chest: CTAB, kussmaul breathing

Cardiac: regular rhythm, tachycardic

Abdomen: soft, NTND

Extremities: MAE

Labs

VBG: 7.03/14/65, Calculated Bicarb 5

BMP: 132/4.3/99/3/20/.09>423


What next?

You hang fluids and start an insulin drip, but the patient becomes progressively lethargic and has vomited twice despite anti-emetics. You decide you need to intubate. What next?

Questions

  1. What are the risks of intubating this patient?

  2. What would be your intubation strategy? Method, intubation medications, and things to pay attention to?

  3. Would you consider giving any additional medications (apart from paralytics or sedation medications) prior to intubating? If so, why, and what would be the dosing?

  4. What would be your ventilator settings?