An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Update: I will cover the I-TECH study published on 2/18/22 on Ivermectin in COVID-19 Patients soon. The link to the article (but not my thoughts just yet) is down below in the citations. I am on service this weekend and don't have time to tackle it appropriately. Spoiler alert: as much as this is a …
Continue reading Ivermectin Doesn’t Help Healthy Patients with COVID-19
I am not going to belabor this too much but we should stop using azithromycin in the community setting for COVID-19. The rationale for this recommendation was based on an article that was published on 4 March 2021 in the Lancet. The article is titled "azithromycin for community treatment of suspected COVID-19 in people at …
Continue reading Azithromycin in Outpatient COVID-19: Not Recommended
First of all, I would like to tip my hat to the author of the article, Dr. James Stoller, who graciously reached out to me when I took apart his paper on emotional intelligence several months ago. Today, I am going to be reviewing an article that was published in the March edition of CHEST …
There have been many times during this pandemic where we have tried to reinvent the wheel when it comes to patient care. What we have learned, however, is that returning back to our evidence-based fundamentals have led to the best outcomes. The PROSEVA trial in 2013 showed us that prone positioning in ARDS patients led …
Continue reading Proning Spontaneously Breathing COVID-19 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.
I am going to be completely honest here and mention that this particular article that I'm going to be looking at today looking at hypothermia in COVID is more for entertainment purposes at this juncture rather than actual data. The paper that I am using as a citation for this post was published on 30 …
Continue reading Hypothermia for ICU COVID-19 Patients? Exploring other options
Today is February 12 of 2021 and I'm gonna be discussing this new not quite yet peer-reviewed article from the recovery trial collaborative group titled “Tocilizumab for COVID-19” or it might be called “Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): Preliminary results of a randomized, controlled, open-label, platform trial. Should we be giving …
Continue reading Tocilizumab for COVID-19: The Return (RECOVERY Group)
During this journey I have learned that standard-of-care is not necessarily practiced as well as we all think. We all have our own issues, but there are some things that should just be done in the interest of our patients. During the current pandemic, I have come to realize that many institutions did not have …
Continue reading High Flow Nasal Cannula in Clinical Practice: Recommendations/Guidelines
For historical context, today is 11/19/2021 when I have provided a major update to this page with the citations. Like everything else on my page, it is a work-in-progress. The guidelines are still recommending 6mg of dexamethasone per day for oxygen-requiring patients with COVID-19. I have extensively covered the data behind doing so on this …
Continue reading Methylprednisolone in COVID-19: Pulse dose & other regimens
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