An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Is your shop still using strict NPO after midnight for its surgical patients? It’s time to talk to the powers that be to have this changed, supported by evidence, of course. The controversy of “Strict NPO After Midnight” has been ongoing for many years now as the data has suggested it’s silly but still performed. …
Continue reading NPO after Midnight: What do the Guidelines Say?
Are soft drinks associated with increased mortality? This study is trying to tell me that soft drinks, whether they are diet or sweetened by sugar are associated with higher mortality? I honestly can't say I'm surprised. Glad I'm not investing in the Coca Cola company. I personally do not drink sodas but I do indulge …
Continue reading Soft drinks: are they associated with increased mortality?
Is there a doctor on the airplane? I will start off by stating that this is not a call that should only be responded to by someone with an MD or a DO behind their name. I know of many seriously good critical care nurses who push away physicians who freeze in a tough situation …
Continue reading Is there a doctor on the airplane? What to expect in an emergency
In the ICU, we are at times obsessed with making our patients “euboxic” or, more clearly stated, all labs values within normal ranges. That being said, electrolytes are something we replete every day and our nurse friends often have protocols which instruct them on how to manage and correct these derangement to hopefully optimize the …
Continue reading Replace/Correct the Magnesium Deficiency Before Potassium (Hypokalemia)!
Our curiosity is what drove is to our respective fields in medicine. As an intensivist, I LOOOOVE trending numbers and analyzing the minutia of the details to predict in what direction my patient is going. There is a difference, though, between utilizing labs to better serve your patient and using labs to satisfy your academic …
Hyperkalemia, that dreaded page at 4am that makes our hearts race and we rush to our EMR where we click every single order on the order set. We should really be better at getting an EKG on ourselves and thinking through the whole process. Is the sample hemolyzed? Is the patient already on CRRT and …
This an open access from the AHA regarding management of Cardiogenic Shock. This is good stuff. There's nothing brand new (to me at least) but it's always good have the (mostly) updated data in one place. Of course, I'm solely going to touch on the topics of Medical Management because I can't perform PCI nor …
Continue reading Cardiogenic Shock per the American Heart Association (AHA)
I have coined the term "journal clubish" or journal club-ish to be a less formal method of appraising evidence based journals. This is actually the first blog post I have created and it was written on 10/6/2017. As part of my job, I read A LOT. I read articles that are great and articles that …
Continue reading Journal Clubish or Journal Club-ish: An Introduction
