@cristianoliveras: me arriving on Earth to teach you all about how to be a free spirit

Cristian Oliveras
Cristian Oliveras
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Region: US
Thursday 30 January 2020 22:29:09 GMT
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emma_hs1
Emma :
“I’ve arrived and I’m gone”😂💀
2020-01-31 01:45:07
1642
nylalocher
nyla :
1 st
2020-01-30 22:29:51
2
ftnumberone
師父 :
[laughwithtears]
2020-01-31 06:33:55
0
sarh_._
عندكوو شاامبوو!😂🌝 :
مثير لشفقة😒😏😣
2020-02-01 14:42:54
5
darkhelmet_78
Chuck :
the end😞.......😂
2020-01-30 22:51:32
3
lexi_440
Lex :
early
2020-01-30 22:32:25
1
xholli.annx
𝑯𝑶𝑳𝑳𝑰𝑨𝑵𝑵🐆🍒 :
spamming everyone who follows me!!rnnnn✌🏼✌🏼💕xx
2020-01-30 22:49:43
333
kkalxbear
k :
What’s this app
2020-01-31 01:16:32
14
izzy4529
Isabel :
What is this
2020-01-31 06:32:08
0
user03948294782
user098712345 :
omggg😂😂😂☹️
2020-01-30 22:43:50
1
gaybitch_atyourservice
Cade :
First
2020-01-30 22:30:02
1
jmz.jaylene
່ :
hey
2020-01-30 22:31:34
1
bhe_retro
BHE_Retro :
Hahahahahaha hahahahahaha
2020-01-30 22:32:44
1
_juero_
guero :
Early
2020-01-30 22:46:52
1
whuzzupp
~∆KK∆~ :
When it says 5 sec.ago love this btw
2020-01-30 22:31:30
1
mmonettttt
i love my bf :
Earlyyyyy
2020-01-30 22:31:20
1
natalyhenandez
•Nataly🤙🏽💯• :
First comment :)
2020-01-30 22:30:02
2
6y.a_
🦋 :
ههههههههر
2020-01-31 09:13:50
1
brittclaus
Brittclaus :
2 min ago
2020-01-30 22:31:22
1
0swp_
0swp_ :
أحلام العصرر.😂..
2020-01-31 06:23:45
14
makenzie.hefnerrr
Makenzie.hefnerrr♥️ :
Ayyy
2020-01-30 22:31:01
2
ethanrod05
Ethanrod05 :
How do you do thattt
2020-02-01 21:47:44
58
jinx6748
Libee :
hay girl hayyy
2020-01-30 22:50:26
1
lxr.edit
زياد :
.َ.
2020-01-31 07:58:05
3
rjkiddell
__________ :
😂 funny
2020-01-31 08:00:38
0
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Other Videos

4 units = Calcium? Here's a super fast, but incredibly important, tip for anyone managing patients receiving massive transfusion protocols, especially with packed red blood cells (RBCs): Don't forget the calcium! RBCs contain citrate, which is an anticoagulant. The problem is that citrate loves to chelate (or bind onto) calcium, effectively removing it from circulation and leading to hypocalcemia in your patient. Why is calcium so vital during a massive transfusion? You don't have time to wait for a lab result when a patient is bleeding out, so proactively administer calcium! Here's why it's critical: Cardiac Function: Hypocalcemia can directly cause cardiac depression, leading to a lower blood pressure. In a patient already struggling with hemorrhage, this can be catastrophic for cardiac output and perfusion. Coagulation: Calcium is an essential cofactor for the coagulation cascade. Simply put, your patient needs calcium to form clots and stop bleeding. If you're giving blood to a hemorrhaging patient, you absolutely need their clotting factors to work effectively. Arrhythmia Risk: Critically ill patients are already at increased risk for dysrhythmias. Hypocalcemia further elevates this risk, potentially leading to life-threatening heart rhythm disturbances. The Simple Rule: For every four units of packed red blood cells (RBCs) you transfuse, give two to three grams of calcium gluconate. It's an easy and low-risk intervention that can have a profound positive impact on your massively transfused patient's hemodynamics and coagulation. What are your go-to protocols for managing calcium during massive transfusions?
4 units = Calcium? Here's a super fast, but incredibly important, tip for anyone managing patients receiving massive transfusion protocols, especially with packed red blood cells (RBCs): Don't forget the calcium! RBCs contain citrate, which is an anticoagulant. The problem is that citrate loves to chelate (or bind onto) calcium, effectively removing it from circulation and leading to hypocalcemia in your patient. Why is calcium so vital during a massive transfusion? You don't have time to wait for a lab result when a patient is bleeding out, so proactively administer calcium! Here's why it's critical: Cardiac Function: Hypocalcemia can directly cause cardiac depression, leading to a lower blood pressure. In a patient already struggling with hemorrhage, this can be catastrophic for cardiac output and perfusion. Coagulation: Calcium is an essential cofactor for the coagulation cascade. Simply put, your patient needs calcium to form clots and stop bleeding. If you're giving blood to a hemorrhaging patient, you absolutely need their clotting factors to work effectively. Arrhythmia Risk: Critically ill patients are already at increased risk for dysrhythmias. Hypocalcemia further elevates this risk, potentially leading to life-threatening heart rhythm disturbances. The Simple Rule: For every four units of packed red blood cells (RBCs) you transfuse, give two to three grams of calcium gluconate. It's an easy and low-risk intervention that can have a profound positive impact on your massively transfused patient's hemodynamics and coagulation. What are your go-to protocols for managing calcium during massive transfusions?

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