$18 EOTH 24 PCS Wheel Lug Nuts, 14x1.5 Hex Drive 7/8" 1.12" Height O Automotive Tires Wheels Accessories Parts EOTH 24 PCS Wheel Lug Brand Cheap Sale Venue Nuts 14x1.5 1.12" Drive 8" 7 Height Hex O Automotive , Tires Wheels , Accessories Parts,1.12",bankcol.co.za,Nuts,,24,Drive,Hex,14x1.5,PCS,/Empeo657946.html,O,Lug,$18,EOTH,Wheel,Height,7/8" EOTH 24 PCS Wheel Lug Brand Cheap Sale Venue Nuts 14x1.5 1.12" Drive 8" 7 Height Hex O Automotive , Tires Wheels , Accessories Parts,1.12",bankcol.co.za,Nuts,,24,Drive,Hex,14x1.5,PCS,/Empeo657946.html,O,Lug,$18,EOTH,Wheel,Height,7/8" $18 EOTH 24 PCS Wheel Lug Nuts, 14x1.5 Hex Drive 7/8" 1.12" Height O Automotive Tires Wheels Accessories Parts

EOTH 24 PCS Wheel Lug Brand Cheap Year-end annual account Sale Venue Nuts 14x1.5 1.12

EOTH 24 PCS Wheel Lug Nuts, 14x1.5 Hex Drive 7/8" 1.12" Height O

$18

EOTH 24 PCS Wheel Lug Nuts, 14x1.5 Hex Drive 7/8" 1.12" Height O

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Product description

SPECS:

Thread Size: M14x1.50

Package Quantity: 24

Overall Length: 1.12"(28.4mm)

Seat Type: Conical

Style: Open end

Color: Gold

Hex Size: 7/8" hex

Installation Instructions:

  1. Make sure wheel studs are clean and tight. Replace ortighten a problem stud.
  2. Ensure the wheel is flat against mounting surface withstuds through each hole.
  3. All nuts should be hand started and thensecured in a criss-cross sequence with a torque wrench and socket. Refer to your vehicleowner's manual or wheel manufacturer's guide for propertorque specifications. 12mm Lug size should use 70-80  torque.
  4. Check and retighten all nuts after 25 miles of driving andagain after 50 miles, until wheel nut torque remains unchanged

EOTH 24 PCS Wheel Lug Nuts, 14x1.5 Hex Drive 7/8" 1.12" Height O

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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?