Our curiosity is what drove is to our respective fields in medicine. As an intensivist, I LOOOOVE trending numbers and analyzing the minutia of the details to predict in what direction my patient is going. There is a difference, though, between utilizing labs to better serve your patient and using labs to satisfy your academic …
Evidence Based Medicine Pyramid
Link to EBM images. The evidence based medicine pyramid is an illustration to help us understand the hierarchy of medical literature and its interpretation. Like this some yahoo such as myself can't give expert opinion that supersedes a randomized controlled trial. I am thrilled that my page has gotten a few people turned on to …
Melatonin on Delirium in Hospitalized Patients
We are all trying to combat delirium by all possible means. Getting pts their glasses and hearing aides. Keeping the lights on during the day. Having family around to speak to them. We’ve also had recent trials which have been quite disappointing using medications. Could there be a good cheap medication to prevent #delirium? This …
Continue reading Melatonin on Delirium in Hospitalized Patients
Helmet vs Face Mask NIV for ARDS
I originally posted this article on 6/21/19 while preparing my NIV/BiPAP lecture. During that process, I learned and shared on IG about using a helmet rather than a mask for NIV (non-invasive ventilation). Looking at the footage that has been coming out of Italy and other parts of the world, you can catch a glimpse …
High-Flow Nasal Cannula in Respiratory Failure: FLORALI Trial
High-Flow Oxygen through Nasal Cannula in Acute Hypoxemic Respiratory Failure (FLORALI Trial) I first shared this article in June of 2019 on Instagram when my account had a mere 2500 followers. Since then the amount of followers to my account have skyrocketed and I could not have done it without the help of each and …
Continue reading High-Flow Nasal Cannula in Respiratory Failure: FLORALI Trial
Central Venous Pressure (CVP): Known Limitations in 1962
To my knowledge, this is the second article looking at central venous pressure (CVP). It was published back in 1962. This paper piggybacks off of, what I believe to be the first paper on CVP that I covered here. Ultimately, I read all these papers as I was creating a lecture that is titled "Resuscitation …
Continue reading Central Venous Pressure (CVP): Known Limitations in 1962
Central Venous Pressure/Right Atrial Pressure: The Origin
I’m working on a talk where I take a trip through memory lane regarding resuscitation. We were all trained to use central venous pressure or right atrial pressure (CVP or RAP) to guide resuscitation and it remains on the Surviving Sepsis guidelines today. This post is about the origin of central venous pressure.Where does the …
Continue reading Central Venous Pressure/Right Atrial Pressure: The Origin
Hyperkalemia Management in the Acutely Ill
Hyperkalemia, that dreaded page at 4am that makes our hearts race and we rush to our EMR where we click every single order on the order set. We should really be better at getting an EKG on ourselves and thinking through the whole process. Is the sample hemolyzed? Is the patient already on CRRT and …
Cardiogenic Shock per the American Heart Association (AHA)
This an open access from the AHA regarding management of Cardiogenic Shock. This is good stuff. There's nothing brand new (to me at least) but it's always good have the (mostly) updated data in one place. Of course, I'm solely going to touch on the topics of Medical Management because I can't perform PCI nor …
Continue reading Cardiogenic Shock per the American Heart Association (AHA)
Brachial Arterial Line: A Systematic Review of Sorts
Since I've started working at my new institution, I've placed two brachial arterial lines and an axillary line. As any intensivist will admit, if you're looking elsewhere from the radial, it means that the patient is pretty sick and you need some results quickly. While performing this procedure, I've received strange looks from the nurses …
Continue reading Brachial Arterial Line: A Systematic Review of Sorts