Brilliant and useful. I am an internist doing critical care hospitalist work and study OB to be ready for the dreaded call...we use magnesium for cardiac dysrhythmias all the time. Train hard, fight easy!
Ajit Virkud Well, for atrial fibrillation, new onset, in the critically ill, cardioversion electrically works, for about 20 seconds, then they relapse into atrial fibrillation. So you control the rate with IV beta blockers and then I load them with 4 grams MgS04 IV over 1 hour and start infusion of 1 gram/hr running for 24 hours. This alone produces cardioversion in about 50%. I add amiodarone after 4 hours, if the magnesium has not cardioverted them yet.This will induce cardioversion in almost 100 % over 24 hours. Recently was called the bedside of a patient post op day one from surgery for perforated diverticulitis. She had peritonitis and required a diverting ostomy. Called into room where surgeon is freaking and talking about digoxin?! Patient is hemodynamically stable with new atrial fibrillation at 170. I put her to sleep with ketamine and propofol and cardioverted twice successfully, but with prompt relapse to atrial fibrillation. So I loaded and started an esmolol drip for rate control, and slowed her to 110, and then started IV magnesium. She converted to stable sinus rhythm in 1 hour and I did not have to load amiodarone. " We must always be students, learning and unlearning till our life's end..."
Thank you. It's contraindicated to use with anesthetic drugs. What will happen if magnesium sulfate is still given? How will it affect margin of safety?
I guess both have suppressive action on neural conduction so might relate to excessive depression of brainstem centres and both have bit of hypotensive action......
Sir low dose ICMR regimen is 3gm iv f/b 5 gm I'M(2.5gm IM in each buttock) with a 2.5gm IM on alternate buttocks But in this lecture low dose regimen is different So is this regimen different from ICMR?
+santhi priya Yes you can. There is no hard and fast rule about the no. of VBACs that can be done. Previous successful VBAC increases the chances of success in a subsequent VBAC.
+dr rubina There is iron lost in the form of fetus, placenta, and blood loss during delivery; but iron is also conserved because of amenorrhea of 9 months; so that net iron lost in singleton pregnancy is 630 mg. Please refer to my textbook Modern Obstetrics, II edition, APC Publishers. I have an online teaching class on Telegram app every week for examination going students, if you are interested in joining contact me on ajitvirkud@gmail.com
Brilliant and useful. I am an internist doing critical care hospitalist work and study OB to be ready for the dreaded call...we use magnesium for cardiac dysrhythmias all the time. Train hard, fight easy!
I don't have any experience with use of Magnesium Sulphate for cardiac dysrhythmias. You can enlighten me.
Ajit Virkud Well, for atrial fibrillation, new onset, in the critically ill, cardioversion electrically works, for about 20 seconds, then they relapse into atrial fibrillation. So you control the rate with IV beta blockers and then I load them with 4 grams MgS04 IV over 1 hour and start infusion of 1 gram/hr running for 24 hours. This alone produces cardioversion in about 50%. I add amiodarone after 4 hours, if the magnesium has not cardioverted them yet.This will induce cardioversion in almost 100 % over 24 hours.
Recently was called the bedside of a patient post op day one from surgery for perforated diverticulitis. She had peritonitis and required a diverting ostomy. Called into room where surgeon is freaking and talking about digoxin?! Patient is hemodynamically stable with new atrial fibrillation at 170. I put her to sleep with ketamine and propofol and cardioverted twice successfully, but with prompt relapse to atrial fibrillation. So I loaded and started an esmolol drip for rate control, and slowed her to 110, and then started IV magnesium. She converted to stable sinus rhythm in 1 hour and I did not have to load amiodarone.
" We must always be students, learning and unlearning till our life's end..."
@@davidmbeckmann thank you for ur useful information dr
I learned many things from you sir ,you are one of the inspirational for me ...salute sir,thank you so much sir....
Very meticulous & elaborate lectures......thanks alot Sir ...
excellent description sir, thanks with respect
Well elaborated thanks
Awsum video sir.. Thank u so much sir..
Very nice sir
Thank you so much
Very informative lecture.
Thank you so much
Very concise..and interesting
thank you sir of possible please upload video for other drugs useful in practical exam !!
Thank you. It's contraindicated to use with anesthetic drugs. What will happen if magnesium sulfate is still given? How will it affect margin of safety?
I guess both have suppressive action on neural conduction so might relate to excessive depression of brainstem centres and both have bit of hypotensive action......
Sorry if answer wasn't expected from someone else.
thank you sir,wonderful lecture
sir do you have a case study about hellp syndrome?
Sir low dose ICMR regimen is 3gm iv f/b 5 gm I'M(2.5gm IM in each buttock) with a 2.5gm IM on alternate buttocks
But in this lecture low dose regimen is different
So is this regimen different from ICMR?
sir if a woman has undergone 1 vbac can we conduct vbac again
how many times a vbac can be allowed in a woman with previous lscs
+santhi priya Yes you can. There is no hard and fast rule about the no. of VBACs that can be done. Previous successful VBAC increases the chances of success in a subsequent VBAC.
+Ajit Virkud thank you sir
sir can u do video on other drugs like oxytocin etc usefull for exam !!
Shweta Patel I already have video on oxytocin. Please check out my YT channel called Ajit Virkud.
Tq sir
thnk you sir
yes iam interested
what is atypical eclampsia
+Rubina Faiz Read my book Modern Obstetrics, II edition.Ch. 33
Sir can u explain mechanism of calcium gluconate in obstetrics
thanx sir
sir... what is amount of iron lost in one singleton pregnancy
+dr rubina There is iron lost in the form of fetus, placenta, and blood loss during delivery; but iron is also conserved because of amenorrhea of 9 months; so that net iron lost in singleton pregnancy is 630 mg. Please refer to my textbook Modern Obstetrics, II edition, APC Publishers. I have an online teaching class on Telegram app every week for examination going students, if you are interested in joining contact me on ajitvirkud@gmail.com