Intubation/Extubation: a High-Risk Aerosol Generating COVID Procedure?

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 …

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CVICU

CVICU: Management of Post-Op Cardiac Surgery Patients

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 …

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Emotional Intelligence in the Intensive Care Unit (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 …

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The IV Fluid Guide: 0.9% NaCl, Ringers Lactate, Plasmalyte & Albumin

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 …

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Vitamin D for COVID-19: Are we missing a potential therapeutic?

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 …

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icu nutrition

Nutrition in the Critically Ill/Intensive Care Unit (ICU)

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 …

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Phosphorus/Hypophosphatemia in the Critically Ill: Let’s Correct it!

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 …

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