An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
For over 100 years, hyperbaric chambers have been used as an evidenced based treatment for diving emergencies. However, hyperbaric indications are typically not common knowledge outside of diving and outpatient wound care fields. This primer is intended to help intensivists understand hyperbaric oxygen therapy (HBOT) indications and challenges relevant to critical care. Cite this post …
Continue reading Hyperbaric Oxygen Therapy (HBOT) for Intensivists- by Kurt Laipple
CODE BLUE! Run! Run! Arrive and the patient has no IV access. What should we do next? Place a peripheral IV or place an intraosseous access? Which will lead to better outcomes? These authors took a retrospective look at in-hospital cardiac arrest at one center. They looked at a total of 1039 patients when it …
Continue reading In-Hospital Cardiac Arrest! No Access. Place an IV or an IO?
Way back when I was just a baby intern, I remember placing these large IJ cannulas in the patients who suffered cardiac arrests to proceed with hypothermia. Later in my training, in December of 2013, the NEJM published the Targeted Temperature Management (TTM trial) looking at 33°C versus 36°C after Cardiac Arrest. The paradigm began …
Continue reading Hypothermia (33°C) vs. Normothermia (37.5°C) in Cardiac Arrest – TTM2
This page is a work in progress regarding anaphylaxis and was first updated on 4/26/21 and last updated on 4/22/22. Stay tuned for updates.Cite this post as: Eddy J. Gutierrez, "Anaphylaxis: Act Fast and Save a Life", eddyjoemd blog, April 26, 2021. Available at: http://eddyjoemd.com/anaphylaxis/. Citations for Anaphylaxis: (Updated 4/14/22) Li X, Ma Q, Yin …
I have quite a love-hate relationship with central lines. They sometimes give me the warm and fuzzies when my Emergency Medicine colleagues call me for a sick patient in the ED who is entirely appropriate for the ICU. I see a right internal jugular central venous catheter on the chest x-ray. In my practice, I …
Continue reading Peripheral Vasopressors: Are They Safe for our Patients?
Part of the reason why I love critical care includes all the sexy high adrenaline stuff we do to keep people alive. Some of the not so sexy stuff is trying to save money as well as resources to provide good value for our hospital systems and the country as a whole if we're being …
Continue reading Choosing Wisely in Critical Care: There are now 10.
To conclude 2019, I posted on Instagram my personal statistics/procedure log from my job as an Intensivist in a non-academic facility. I am a private practice physician. The vast majority of the time, I do not work with an NP nor a PA. I have been collecting the data regarding how many encounters I have …
Continue reading Procedure Log for a Private Practice Intensivist: 2020 Update
I have seen well respected clinicians provide a patient with a gastrointestinal (GI) bleed with high doses of systemic vasopressin. Throughout my three years of residency training and two years of fellowship at a well respected institution, I have not seen this used once in practice. Let's take a look at what this really means …
Continue reading GI Bleed Dose Vasopressin: Is it even a thing?
This post is a rebuttal to my original post on why you should NOT pursue Critical Care. In reality it was not supposed to be a deterrent, but rather to be completely transparent as to what you can realistically expect out of the career in critical care. Most of this applies to the role of …
Continue reading Career Advice: Why you SHOULD Pursue Critical Care (ICU)
Dr James Stoller from the Cleveland Clinic published this review on emotional intelligence needed in ICU physicians/practitioners. You can be the smartest person in the world but unless you have developed the key components of emotional intelligence, many of those skills will not have their time to shine. When I was in training, I cared for …
Continue reading Emotional Intelligence in the Intensive Care Unit (ICU)
