An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Unfortunately, delirium in ICU and critically ill patients is a quite common problem that we are having trouble making progress on controlling. It is quite frustrating when I am caring for a patient who has recovered from their main life-threatening insult to be left encephalopathic and the family constantly asking "what's wrong". The most common …
Continue reading Delirium in the ICU & Critically Ill Patients
There's a lecture that I have shared with audiences looking at opioid-sparing medications for pain and sedation in the intensive care unit that I have been working on for several years. In this post, I will be sharing this content with you all with the citations you everyone can better their practices and we can …
Continue reading Non-opioid Pain/Sedation Management in the ICU
I covered the 2015 version of meta-analysis back in April when I couldn't get my hands on this one, the 2018 version. I appreciate the Cochrane Library for making this free. You could get to it from my website. The last time I posted about Lidocaine was in April when I had fewer than 1500 …
The Ketamine kick continues! I am not going to pretend I knew everything about everything as I've created this page over the last several months. People who walk around saying things like they were born with that knowledge sometimes need to be checked. We all had that one eye-opening day where it was like, "(explicative) …
Continue reading Ketamine & Catecholamine-dependent Heart Failure: Be Careful
I’m hard at work on a protocol for my shop to decrease opioid usage as well as preparing my lectures on opioid sparing medications. Amongst those are the gabapentinoids. You’ve seen them often, I’m sure, mostly to treat neuropathic pain such as diabetic neuropathy as well as trigeminal neuralgia but what about for actual painful …
This is cool, really cool. We need more data, but this is a great start. I would not call this the most robust study I have ever seen regarding the care of patients in the intensive care unit. I learned a lot of basic science from reading the introduction as well as discussion on this …
Continue reading Magnesium for Sedation in Mechanically Ventilated Patients?
I have great disdain for delirium. Natural light brings me great joy. Today, for example, the sun isn't shining bright. The day is cloudy and gloomy. I am, in turn, a little grouchy. Daylight savings is coming and I'm already upset about it. I can turn on the light but it won't be the same. …
Continue reading Delirium in Mechanically Ventilated Patients: Let the Natural Light in!
What are your experiences with ketamine for intubation? I am really glad that I stumbled onto this article that was shared by @the_resuscitationist and @medicotactico. When you're dealing with airways and medications that have can concerning adverse effects, you really shouldn't trust me on anything and should read the article yourself. Link in bio. This one is …
Continue reading Ketamine for Rapid and Delayed Sequence Intubation
Team, I'll get to making this whole post prettier in the AM when I have some rest under my belt. I saw everyone chiming in on bedsideroundz’ page how they provide versed/midazolam for sedation in their critically ill patients and I had no choice but to put off my bedtime for a few hours and …
Continue reading Minimize Benzodiazepine Use for Sedation in the ICU
We are all trying to combat delirium by all possible means. Getting pts their glasses and hearing aides. Keeping the lights on during the day. Having family around to speak to them. We’ve also had recent trials which have been quite disappointing using medications. Could there be a good cheap medication to prevent #delirium? This …
Continue reading Melatonin on Delirium in Hospitalized Patients