An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
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 is episode 50 of the Saving Lives Podcast. On September 25th I took the plunge into the podcast stratosphere with a version of my YouTube video titled "A Day in the Life of an Intensivist". I have been doing YouTube for several years now but I am usually on time constraints and setting up …
We are individual humans with free will. Today, I made the choice to receive the COVID vaccine. It was not a decision that was made lightly. After all, there are numerous unknowns regarding the vaccine that can only become knowns with time. And right now I feel we do not have a great deal of …
Continue reading The COVID-19 Vaccine: My Personal Decision To Get It
This week, my video on YouTube titled "ICU/Intensive Care: How to Present A Patient During Rounds" surpassed 100000 views on my YouTube channel. This is the first time that my medical channel has accomplished this feat and I am quite happy about it. It's quite funny to me that my third YouTube video is still …
Continue reading 100,000 views on a Medical YouTube Video: How much did I earn?
Those of us who are in the ICU, especially those of us taking care of the patients caught up in this pandemic have learned that certain patients can be quite challenging to oxygenate and ventilate. For the uninitiated, the whole purpose of mechanical ventilation is to be a band-aid of sorts for patients who we …
Continue reading Hypercapnic Respiratory Failure: Tricks for Ventilator Management
Believe it or not, there is not a lot of data regarding using noninvasive ventilation, also called NIV or BiPAP to care for patients with acute asthma exacerbations. The data is actually quite limited, unfortunately. This paper published a few days ago in the AJRCCM took a retrospective look at a large number of patients …
Continue reading Noninvasive Ventilation (NIV/BiPAP) in Acute Asthma Exacerbations
We all know what the standard of care is for adults who come in with acute asthma exacerbations. They receive supplemental oxygen to keep sats >92%, bronchodilators, anticholinergics, steroids, with possibly some bonus magnesium. In addition, we obtain a series of labs, chest films, and an arterial blood gas. The really sick patients have findings …
Continue reading High Flow Nasal Cannula (HFNC) in Acute Severe Asthma Exacerbations
Check out the podcast with my take Convalescent Plasma from this article. See the article used for 4/1/22 update in the citations. https://youtu.be/9Jyk2MEtGYc Check out my other COVID-19 related posts HERE. Citations for Convalescent Plasma Simonovich VA, Burgos Pratx LD, Scibona P, Beruto MV, Vallone MG, Vázquez C, Savoy N, Giunta DH, Pérez LG, Sánchez …
Continue reading Convalescent Plasma in COVID-19 Severe Pneumonia: PlasmAr
Could a CBC w/diff tell us who's going to do poorly with COVID? Using the neutrophil to lymphocyte ratio could be quite helpful. Can we identify who’s going to get incredibly ill and who isn’t from COVID? I know we struggle with this significantly as we make phone calls to family members every single day …
Continue reading Neutrophil to Lymphocyte Ratio (NLR): Predicting Outcomes in COVID
I always like to clarify that I am an ICU physician and not an outpatient physician. I personally have never written for fluvoxamine in my career and have never provided it to a COVID patient. That being said, I feel much of the help we need regarding therapies for COVID are to prevent these folks …
Continue reading Fluvoxamine & COVID: A Potential Outpatient Option