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JAMA 272:1867–1868 17. King A, Holder MG Jr, Ahmed RA (2013) Errors as allies: error management training in health professions education. BMJ Qual Saf 22(6): 516–519 18. Ziv A, Wolpe PR, Small SD, Glick S (2006) Simulation-based medical education: an ethical imperative. Simul Healthc 1:252–256 19. Vozenilek J, Huff JS, Reznek M, Gordon JA (2004) See one, do one, teach one: advanced technology in medical education. Acad Emerg Med 11:1149–1154 20. Jane Cook M (2012) Design and initial evaluation of a virtual pediatric primary care clinic in second life ((R)).
A very large bolus of diuretic may also lead to reflex renal vasoconstriction and a higher risk of ototoxicity. Fluid restriction is an important adjunct to diuretic therapy in severely fluid overloaded patients. Using a fluid challenge in volume-overloaded patients with obvious peripheral oedema is counterproductive; inadequate urine output in these patients is invariably related to a low cardiac output and treating this often requires inotropic therapy. Thiazides: The combination of a thiazide with a loop diuretic increases the urine volume significantly in patients with ACHF.
Valchanov K, Parameshwar J (2008) Management of the heart failure inpatients. BJA-CEPD Rev 8:167-171 13. Felker GM, Lee KL, Bull DA et al (2011) Diuretic strategies in patients with acute decompensated heart failure. N Engl J Med 364:797–805 14. Valchanov K, Arrowsmith JE (2012) Do venodilators have a role in the perioperative management of heart failure? Eur J Anesth 29:121–128 15. Sackner-Bernstein JD, Skopicki HA, Aaronson KD (2005) Risk of worsening renal function with nesiritide in patients with acutely decompensated renal failure.
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