Initial Management

1. Support ABCs. Secure airway, administer 100% oxygen, and obtain IV access.

2. Immobilize cervical spine for known history of or suspected head trauma.

3. Assess GCS and perform endotracheal intubation if < 8.

4. Assess for signs of herniation (dilated nonreactive pupil, papilledema, posturing) or increased intracranial pressure (Cushing triad). If present, provide controlled mild hyperventilation, consider administration of mannitol or normal saline, and obtain emergent CT scan of the head and neurosurgical consultation.

5. Perform rapid bedside glucose determination; if glucose < 40, administer IV dextrose.

Free Yourself from Panic Attacks

Free Yourself from Panic Attacks

With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.

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