An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
I remember like it was yesterday the first COVID patient who I intubated. I was scared. Heck, I still have a healthy respect for the procedure because these patients don’t do well on the vent. In addition, they tend to tank their O2 sats as soon as the RSI drugs kick in. Everything needs to …
Continue reading Intubation/Extubation: a High-Risk Aerosol Generating COVID Procedure?
Let's answer the question that we have all asked ourselves if we have ever obtained blood cultures before. Why do we need two sets? Why can't we just obtain one sample. Do we really need the full quantity of blood requested? This is all in response to a hilarious meme by @codebluememes earlier today. Ultimately …
Continue reading Why Do We Order Two Sets of Blood Cultures?
This post is a collection of evidence-based practices in the management of patients in the cardiac and cardiothoracic ICU (CVICU) with my personal take on it. I am working on improving this page regularly. The last update was on 10/06/22.Let's start off with the basics. Patients who have cardiac surgery, especially those who go "on …
Continue reading CVICU: Management of Post-Op Cardiac Surgery Patients
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)
To those of you who don't know me, I am a Critical Care Medicine Physician. I love my job. You all should be able to clearly see that in the passion for my work. Why else would I be exerting all this effort on social media for almost free? If I won the lottery tomorrow, …
Continue reading Career Advice: Why to NOT pursue Critical Care (ICU) Medicine
This page is a work in progress as a IV Fluid guide and will continue to grow throughout the years. Last updated on 3/3/22. This page is quite the mess right now if I am being honest. I will get it together at some point. Just many projects running simultaneously. Table of Contents for the …
Continue reading The IV Fluid Guide: 0.9% NaCl, Ringers Lactate, Plasmalyte & Albumin
Allow me to start off with a disclaimer. I favor cheap and readily available therapies over expensive therapeutics. There has been a lot of talk about Vitamin D and it's relationship with COVID-19. Honestly too much for me to get into. It seems as if there's something new every day. What we lack, though, is …
Continue reading Vitamin D for COVID-19: Are we missing a potential therapeutic?
In this post which will be updated continuously, I will be examining the clinical questions regarding ICU nutrition. These data do not apply to the non-ICU patients. The first thing that we need to acknowledge is that nutrition in the critically ill is not one size fits all nor set it and forget it in …
Continue reading Nutrition in the Critically Ill/Intensive Care Unit (ICU)
I covered this topic about hypophosphatemia in the critically ill back in the infancy of my Instagram account on 4/19/2019. Seems like an eternity ago. I know it's not very Zentensivist of me to have this as part of my practice, but this is something I actively chase in my patients. Phosphorus, generally speaking, is …
Continue reading Phosphorus/Hypophosphatemia in the Critically Ill: Let’s Correct it!