Otawa ankle rule

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• Otawa ankle rule
• ???X?(????)???????????????
• 1) ??(??)????6cm????????
• 2) ??(??)????6cm????????
• 3) ????????????????????
• ??X?(????)???????????????
• 1) ?5????????
• 2) ??????
• 3) ????????????????????
• ????????????
• Sens1.00(Clinical Exsam0.69)?Spec0.39?
• LR1.64? LR-0.0
• ?????????????????????????
• ?????????????????????????
  ???????

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• Otawa Knee rule
• ??????????Xp??
• 1) ??55???
• 2) ???????
• 3) ??????????
• 4) 90????????
• 5) ????????????????(4?)????
• ?Ottawa knee rule ???????
• Sens1.00, Spec0.49 LR1.98, LR-0.00
• ???????

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???Framingham

• ?????????????????? 
• ???2??,???1???????2???????????

??????????????? OMI????????????32111
?????????????1994 ??
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• ???
• ????????????????
• ?????
• ??
• ???
• ?????
• S3 gallop
• ?????(16cmH2O)
• ??????
• ?????????
• 5???4.5kg??????
• ??????

• ???
• ????
• ????
• ???????
• ???
• ????
• ????????1/3??
• ??(120/min??)

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?????????DIE HEART

• DDrug Diet
• I Infection Infarction
• EExercize
• HHT
• EEmbolism
• A Anemia
• RRhythm
• TThyroid

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• ?????????? VINDICATEP
• V vascular(???)
• I infection(??)/idiopathic(???)
• N neoplasm(???)
• D degenerative(??)
• I intoxication(??)
• C congenital(???)
• A allergy/autoimmune(?????????)
• T trauma(??)
• E endocrine and metabolic
• PPsycogenicPregnancy

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TAF?3X MAPD

• T (Cardiac) Tamponade ???????C
• A Airway obstruction ????AB
• F Flail chest ????????B
• X Open pneumothorax ????? B
• X Tension pneumothorax ?????BC
• X Massive hemothorax ????BC
• M Massive hemothorax ????(??)
• A Abdominal hemorrhage ?????C
• P Pelvic fracture ?????C
• ????D ?????? D

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????? VF AED ON!

• V Vagal reflex (VVR)
• F Freezing
• A AMI/Acidosis/Adam stokes
• E Electrolite(??K???Mg)/Endocrine
• D Drug(ABCD)
• O O2
• N Neurogenic shock?????(???????)

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• E Electrolite(??K???Mg)
• Endocrine(??????? ????)
• D Drug(ABCD)????
• Aantiarrhythmic agent
• Bß?Adrenergic blockers
• Ccalcium-channel blockers
• Ddigoxin
• O O2

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???????????

• ??????
• ??????
• ?????
• ?K??
• ????????
• ?????
• ???DDx??????? ?????

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Wells criteria
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Wells criteria

• The pretest probability of pulmonary embolism
• lowlt2.0?, 2.0??moderate?6.0?, 6.0?lthigh.
• high pre-test probability (40.6 CI, 28.7 to
  53.7)
• moderate pretest probability (16.2 CI, 12.5
  to 20.6)
• low pretest probability (1.3 CI, 0.5 to
  2.7)
• NPV of the D-dimer test
• entire patient 97.3 (CI, 95.8 to 98.4)
• low-probability group 99.5 (CI, 98.4 to 99.9)
  
• moderate-probability group 93.9 (CI, 89.8 to
  96.7)
• high-probability group 88.5 (CI, 69.9 to
  97.6)
• ?????D-dimer test?????PE???????
• ??????????

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1????????? 2??????????????
?????????50????? 3??????????50????
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?????
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?????(Burn Index)
Brun Index ½????() ????()
1015?? ????
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?????(Artz??)
?????
1.??30?? 2.??10?? 3.???? 4.????
5.?????? 6.??????? 7.???????????