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JINHAO 9036 gift Natural Wood Fountain Medium Ink N Pen Max 48% OFF Handmade

JINHAO 9036 Natural Wood Fountain Pen Handmade Ink Pen (Medium N

$10

JINHAO 9036 Natural Wood Fountain Pen Handmade Ink Pen (Medium N

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Product Description

Each pen has different wood grain, each pen is one and only.

9036 Family9036 Family
Use screw converterUse screw converter

Use Ink Converter

A screw type ink converter is included, fit for bottle ink.

HOW TO USE:

1. Dip the pen nib completely into the ink bottle, turn the plunger until the air removed completely from the converter.

2. Turn the plunger negative direction to draw ink up, repeat several times, until it’s filled with ink.

3. Use paper to wipe away excess ink from the nib, finally, assemble the pen body and cap.

Use ink cartridgeUse ink cartridge

Use Ink Cartridge

This pen also apply to ink cartridge (need to buy separately), easy to carry and write at any time.

You can buy JINHAO ink cartridges in my shop, the ASIN is B06WRRGKH1.

Use screw converterUse screw converter

Ink Converter

Use ink cartridgeUse ink cartridge

Ink Cartridge

Oak Wood 9056 51A 85 8802
JINHAO 9036 JINHAO 9056 JINHAO 51A JINHAO 85 JINHAO 8802
Material Wooden Pen Barrel Wooden Pen Barrel Wooden Pen Barrel and Steel Cap Metal and Wood Metal and Wood
Nib Fine/Medium Fine/Medium Extra Fine Extra Fine Fine
Item Dimensions(inch) 5.51 x 0.59 x 0.59 5.65 x 0.69 x 0.69 ‎5.47 x 0.47 x 0.47 5.61 x 0.51 x 0.51 5.39 x 0.47 x 0.47
Weight ‎0.88 oz 1.22 oz 0.81 oz 0.88 oz 1.55 oz
Pen Cap Screw Type Screw Type Push Type Screw Type Push Type
Color Ebony Wood/Cherry Wood/Oak Wood Ebony Wood/Rosewood/Tiger Wood/Vera Wood/Peach Wood Ebony Wood/Hard Maple/Peach Wood/Red GuiBao Wood/Rosewood/Tiger Wood Peach Wood/Rosewood/Black/Blue/Red/Steel Body Wooden Barrel/Shell Carving/Birds and Wintersweet Painting
Ink Adding Method Ink Converter/Ink Cartridge Ink Converter/Ink Cartridge Ink Converter/Ink Cartridge Ink Converter/Ink Cartridge Ink Converter/Ink Cartridge

JINHAO 9036 Natural Wood Fountain Pen Handmade Ink Pen (Medium N

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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?