An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
Back in December 2017, I found out that I had passed my ABIM board certification exam for critical care medicine. I created this video on youtube for those who are interested in learning about the methodologies I pursued to be able to pass this challenging exam. Needless to say, it was the most challenging board …
Continue reading ABIM Critical Care Board Certification Exam: How I passed my Boards
Several years ago, I took and passed my ABIM Board Certification exam for Internal Medicine. I made this video for YouTube when I was a younger whipper snapper and it has proven to have been quite helpful for some. In this video, I go over the different methods which I used to study for and …
Continue reading ABIM Board Certification Exam: Passing the Internal Medicine Boards
Ivermectin in COVID, this is the second time I cover this medication during this pandemic. Please note the date this blog post was written as things could have changed since then. This is NOT medical advice. This paper has NOT been peer reviewed. I will try to peer review it myself. Ultimately, I recommend you not …
Continue reading Ivermectin in COVID-19: Taking another look
How I wish that this was a positive study regarding Remdesivir. We’re in need of a helpful tool. I’ve thrown every possible treatment including tPA at patients to try to save them and nothing is 100% at this point. I took apart the first Remdesivir study several weeks ago and was not impressed. History is …
This post is regarding using passive leg raising and stroke volume to determine fluid responsiveness in patients who need resuscitation. Check out far more in depth data regarding all this HERE. Don't think that I'm anywhere close to being finished on discussing fluid resuscitation and when to stop, I think I could spend a whole …
Continue reading Passive Leg Raising + Stroke Volume for Fluid/Volume Responsiveness
Passive leg raising (PLR) is a technique I am going to cover extensively as I am writing a lecture where this will be a hot subtopic. I've covered it before on my blog and instagram. It's all in the effort to NOT drown our patients in IV fluids when they're hypotensive. Turns out that performing a …
Continue reading Resuscitation & Passive Leg Raise: Don’t use the blood pressure
Taking a quick COVID break, we've had enough of that for now. Let's get back to some simple critical care basics: measuring blood pressure in the ICU. We do this on all of our patients at least hourly for the stable patients. It is performed continuously on our unstable patients. Ultimately, though, we need to …
Continue reading Standard Blood Pressure Measurements in the Critically Ill ICU population
Some legendary names came out to play for this article regarding corticosteroids in COVID-19. Meduri is the author of the famous Meduri Protocol for methylprednisolone in ARDS and Villar is the author of the article I shared on February 13th (seems like forever ago, really) where they provided dexamethasone for ARDS and showed a mortality …
ELSO, the Extracorporeal Life Support Organization, is now doing free training course/modules/program on ECMO (extracorporeal membranous oxygenation), both VV and VA in this COVID-19 time. Take advantage! You need to register, of course. It has been over two years since I did ECMO and this is a good refresher course for me. Check it out …
Continue reading ECMO in Adults Training Course for FREE from ELSO
I typically appreciate guidelines. They do a pretty reasonable job to help us take care of our patients and standardize how we do things. Here, I break down the IDSA guidelines on COVID. With all due respect to the Infectious Disease Society of America (IDSA) , I do not like these guidelines. I'd rather they …