Trach Kit at bedside
Thyroidectomies and Parathyroidectomies. Surgery close to airway. Swelling & bleeding can close airway.
Hypoparathyroidism
Hypoparathyrodism = Hypocalcemia
Causes: Accidental removal of the parathyroid gland during a thyroidectomy. Genetic. Exposure to radiation. Magnesium Depletion. Think CATS for symptoms.
C
Chvostek's Sign
Tap on the facial nerve by the ear and tetany/spasms of all facial muscles occur.
A
Arrhythmias
Arrhythmias. Prolonged QT interval. Ventricular tachycardia
T
Trousseau's Sign
Trousseau’s Sign/Tetany, Inflate BP cuff to 20mm Hg above systolic, hold x 3 min ⇒Tetany/spasms of the hand
S
Seizures/Spasms/Stridor
Seizures/Spasms/Stridor. Laryngospasms and dyspnea. Slow clotting factors: Bleeding
Â
IV Calcium Replacement
IV calcium gluconate. Give slow and watch for infiltration. It is hard on the veins.
Dysphagia
Dysphagia. Monitor for aspiration
Phosphorus Binders
In hypocalcium, phosphorus may be high. Give binders such as Calcium acetate and Sevelamer. Vitamin D supplement to help with calcium absorption.
