Alexander Philip, MD, MS, MPH, FAAEM
Emergency Physician
2776 Cleveland Ave Fort Myers FL, 33901About
Dr. Alexander Philip practices Emergency Medicine in Fort Myers, FL. Dr. Philip assesses patients who seek immediate medical attention at any time of day or night. Emergency Medicine Physicians are trained to efficiently work with each patient and situation no matter how acute or life-threatening. Dr. Philip examines patients, determines means of testing, diagnoses conditions, and decides the best treatment methods.
Provider Details
Alexander Philip, MD, MS, MPH, FAAEM's Expert Contributions
How long is recovery from a broken ankle?
Generally bone takes 6-8 weeks to heal. READ MORE
Heart rate problem
No, manage symptoms not numbers. The low heart rate is likely nothing concerning but should be brought up with your doctor. READ MORE
whats wrong with me
Hard to say without a physical exam or pictures. You’d need a formal evaluation by your primary doctor and most importantly a board certified podiatrist. READ MORE
Cirrhosis of the liver
Definitely needs to go to ER if confused. READ MORE
How do I keep my heart healthy after a heart attack?
Eat well and take the medication your doctors recommended on discharge. Once your doctor has cleared you, establish a good exercise regimen and lifestyle changes. READ MORE
Question re fluid resuscitation and heart failure in ear and procedure
A few things you need to take into account. 1) what’s the patients ejection fraction. 2) is the patient volume depleted (intravascular) 3) is the patient fluid responsive? Point 1 will be answered with a recent echo. Assuming compensated heart failure with a normal ejection fraction and no evidence of moderate/severe aortic stenosis then that’s a plus. Point 2 can be established quickly in the er based on clinical exam but my favorite method is use of ultrasound to see if IVC is collapsing or not. Collapsing ivc usually indicates the need for fluids. The third point can be established with the Cheetah/nicom device. This will help you realize if stroke volume is increasing with fluids and thus patient is fluid responsive. Once you know these three parameters you can establish how much (volume)/aggressive (rate)you can hydrate your patient. Typically in the er if we see a heart failure patient that needs fluids, for example someone with sepsis, then we will start with a 250cc bolus and check the following parameters mentioned above. In your question you mention hypotension, bradycardia, hypothermia. This can be an indication of sepsis with end organ damage but other issues such as myxedema coma must also be ruled out (screen tsh), as the treatment will additionally require more than just fluids and antibiotics including stress dose steroids and thyroid hormone replacement. Best of luck with school! READ MORE
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