Critical Care Medicine (2005 Edition) by Michael Safani, Matthew Brenner

By Michael Safani, Matthew Brenner

Palm & Pocket notebook electronic Books & Updates integrated, New SCCM guidance, up-to-date & Revised.

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Meningitidis Ampicillin and Ceftazidime (con­ sider adding Vancomycin) CSF shunt S. aureus, Gram­ negative bacilli Vancomycin and Ceftazidime Antibiotic Choice Based on Gram’s Stain Stain Results Organism Antibiotic Gram's (+) cocci S. pneumoniae S. aureus, S. agalactiae (Group B) Vancomycin and ceftriaxone or cefotaxime Gram's (-) cocci N. meningitidis Penicillin G or chloramphenicol Gram's (-) coccobacilli H. influenzae Third-generation cephalosporin Gram's (+) bacilli Listeria monocytogenes Ampicillin, Penicil­ lin G + IV Gentamicin ± intrathecal gentamicin Gram's (-) ba­ cilli E.

If possible, apply local pressure to bleeding sites. Blood specimens should be sent for INR/PTT, fibrinogen, and thrombin time. Reptilase time should be checked if the patient is also receiving heparin. Pa­ tient's blood should be typed and crossed because urgent transfusion may be needed. Cryoprecipitate (10 units over 10 minutes) should be transfused to correct the lytic state. Transfusions may be repeated until the fibrinogen level is above 100 mg/dL or hemostasis is achieved. Cryoprecipitate is rich in fibrinogen and factor VIII.

Meningitidis, S. pneumoniae, H. influenzae Ceftriaxone or cefotaxime and vancomycin 18-50 years S. pneumoniae, N. meningitidis Ceftriaxone or cefotaxime and vancomycin Older than 50 years N. meningitidis, S. pneumoniae Gram-negative bacilli, Listeria, Group B strep Ampicillin and ceftriaxone or cefotaxime and vancomycin Neurosur­ gery/head in­ jury S. aureus, S. epidermidis Diphtheroids, Gram-negative bacilli Vancomycin and Ceftazidime Immunosuppr ession Listeria, Gram­ negative bacilli, S. pneumoniae, N.

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