Mnemonic: ABCD
Mnemonic: PPM
Malnourished (depleted intracellular Phosphate, Potassium, Magnesium) → Refeeding → Increased glucose load → Insulin spikes → Drives PPM into cells → Hypophosphatemia (major abnormality), hypokalemia, hypomagnesemia
If patient hasn’t not eaten for >5 days, aim to refeed at <50% energy and protein levels.
Monitor and aggresively supplement PPM.
Wound strength is determined by both quantity and quality of collagen and an appropriate balance of deposition and breakdown. The amount of collagen in a wound plateaus at several weeks post-injury. Timeline: 1. First few weeks: Strength increases rapidly, reaching about 20% of pre-injury strength at 3 weeks. 2. Around 6 weeks: Wound strength…
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