An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Summer, my favorite season. It can't get here soon enough. Will summer help us with the coronavirus/COVID and help terminate this thing sooner rather than later? This study was published on April 2nd out of Hong Kong in Lancet Microbe. I believe it may be some good news or I may be too optimistic. This paper …
Continue reading Summer heat may help us with COVID! (Hopefully!!)
The WeVent team came together to create this respiratory management protocol to help us take care of patients with COVID-19. First of all, a big hat tip to the authors: Aurio Fajardo C; MD. Medicina Interna. Unidad de Paciente Crítico. MsC en Ventilación Mecánica, Universitat de València. MsC en Medicina Intensiva. Grupo Ventilación Mecánica Chile …
Continue reading Respiratory Management Protocol for SARS-CoV-2 by WeVent
This is a discussion regarding an in-vitro study of how Ivermectin could potentially work for COVID-19. Give credit where credit is due. This paper was sent to me by @itskatiesway, @bug_drugs, @sanamoh92, @sy_doctornetwork, @paul.neil95, @nascarnora. Thank you all for sending data to me. Also, I am getting somewhere around 50-100 messages per day from the community. …
This first post was published on 4/4/2020 regarding hydroxychloroquine and azithromycin in COVID patients. Other studies will be noted by dates below. I decided to consolidate multiple posts into one for the sake of simplicity. For those of you new to the page/blog, I am a Critical Care physician. My team and I are usually …
Continue reading Hydroxychloroquine & Azithromycin in COVID-19: Analyzing The Data
One of the beauties of practicing in the ICU is that although many of my patients take up a lot of resources, the pharmacy-cost component of it isn't too high. I like my cheap IV fluids, norepinephrine, run-of-the-mill antibiotics, heparin, PPI's, tube feeds, sedation meds, etc. None of these are too outlandishly expensive. People generally …
Continue reading The Cytokine Storm & Tocilizumab in COVID-19 Infections
We can always count on the ASPEN team to come through for us regarding nutritional recommendations for our patients with COVID-19. A hat tip to them. A hat tip also to my pharmacist teammate, Amanda, for sending this to me (and many other literature goodies). This is free so download your own copy and don't …
Continue reading Nutrition in the Critically Ill with COVID-19 Infection
I cannot believe that there is still a mystery from the WHO as to whether COVID is a droplet or airborne virus. The World Health Organization has obtained the paper I referenced yesterday. In addition, the study in the NEJM that I covered on 3/18/2020. Please read the document for yourself. I have provided links, …
Continue reading The WHO Strikes Back: Droplet vs. Airborne Precautions
Disclaimers before we get this started. The following is my opinion. This article has not been peer-reviewed. I am going to attempt to be said peer. A hat tip to the folks at the University of Nebraska Medical center who have looked into trying to determine if COVID-19, or SARS-CoV-2 (the virus that causes COVID-19) …
Continue reading COVID: Let’s call it airborne already. UPDATED on 4/1/2020 and 9/21/2020
Several days ago I posted about the FDA approval to start clinical trials to see how convalescent plasma of patients who had already beat COVID-19 would hopefully help patients who are currently suffering from COVID-19. This was now published in JAMA. This paper on plasma in COVID was published in JAMA yesterday states that there …
Continue reading Convalescent Plasma for COVID-19: First Update in JAMA
Sometimes medicine behaves like the stock market; a whole bunch of enthusiasm followed by a realistic pullback. This has now occurred with the concept of using one ventilator for multiple patients. I agree that we need to use some ingenuity in this crisis, but this one never sat well with me, hence me not commenting …