The entire nation has been brought to a standstill still to allow more mandatory โrestโ to pilots.
Meanwhile Resident doctors who work 36 hours continuously and >100hr/week since time immemorial despite CCS rules clearly stating no more 60h/week
๐๐๐๐๐๐จ๐ ๐๐ข๐ฅ๐ฅ๐๐๐ง๐๐ข๐ก ๐๐ก ๐ฆ๐๐ฉ๐๐ฅ๐ ๐ฆ๐ฌ๐ ๐ฃ๐ง๐ข๐ ๐๐ง๐๐ ๐๐ฌ๐ฃ๐ข๐๐๐๐๐๐ ๐๐
๐ฅ10ml of 10% Calcium gluconate contains 1gm of calcium gluconate equivalent to 90mg of elemental calcium
โก๏ธ 9mg/ml or 0.47 mEq/ml elemental calcium
๐ฅ10ml of 10% calcium chloride contains 1gm calcium chloride equivalent to 270 mg of elemental calcium
โก๏ธ27mg/ml or 1.4 mEq/ml elemental calcium
๐ฅCalcium gluconate is preferred to calcium chloride because it is less likely to cause tissue necrosis if extravasated.
๐๐ป๐๐ฟ๐ฎ๐๐ฒ๐ป๐ผ๐๐ ๐ฐ๐ฎ๐น๐ฐ๐ถ๐๐บ ๐ฑ๐ผ๐๐ถ๐ป๐ด โ Initially, IV calcium (1 or 2 g of calcium gluconate, equivalent to 90 or 180 mg elemental calcium, in 50 mL of 5% dextrose or normal saline) can be infused over 10 to 20 minutes. The bolus may be repeated after 10 to 60 minutes, if needed to resolve symptoms.
The calcium should not be given more rapidly, because of the risk of serious cardiac dysfunction, including systolic arrest.
The bolus dose of calcium gluconate will raise the serum calcium concentration for only two or three hours, as a result, it should be followed by a slow infusion of calcium in patients with persistent hypocalcemia.
An IV solution containing 1 mg/mL of elemental calcium is prepared by adding 11 g of calcium gluconate (11 Ampoules of 10ml 10% calcium gluconate equivalent to 1000 mg elemental calcium) to normal saline or 5% dextrose water to provide a final volume of 1000 mL.
This solution is administered at an initial infusion rate of 50 mL/hour (equivalent to 50 mg elemental calcium/hour).
The dose can be adjusted to maintain the serum calcium concentration at the lower end of the normal range (with the serum calcium corrected for any abnormalities in serum albumin as noted above).
Patients typically require 0.5 to 1.5 mg/kg of elemental calcium per hour.
The infusion should be prepared with the following considerations:
โThe calcium should be diluted in dextrose and water or saline because concentrated calcium solutions are irritating to veins.
โThe IV solution should not contain bicarbonate or phosphate, which can form insoluble calcium salts. If these anions are needed, another IV line (in another limb) should be used.
IV calcium should be continued until the patient is receiving an effective regimen of oral calcium and vitamin D and serum calcium levels are normal.
Source: UpToDate
6 months down !!!! And the feeling still remains the same !!!! Above all, my consultant asked for my feedback; like how can we improve, what more can be done or added to make the curriculum better, and i was at a loss of words !!! ๐ฌ๐ฌ๐ฌ
2 months into my Gen Med residency, and i feel I've made the best decision of my life by taking up this branch ! The sheer satisfaction one feels when the final diagnosis is made (by consultant obviously) can't be expressed in words!
- Forever a disciple of medicine
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