An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
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 …
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)
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
I have coined the term "journal clubish" or journal club-ish to be a less formal method of appraising evidence based journals. This is actually the first blog post I have created and it was written on 10/6/2017. As part of my job, I read A LOT. I read articles that are great and articles that …
Continue reading Journal Clubish or Journal Club-ish: An Introduction
Lithium toxicity is something we confront in the intensive care unit. (Hypothetical) Case scenario: Patient comes in, accidental overdose of lithium, HD stable, physical exam unremarkable, labs pristine, lithium level of 2.x. Poison control called. ED interventions performed flawlessly. Nephro consulted in the ED and recommends HD if level is above (insert arbitrary number here). …
Continue reading Lithium Toxicity: Dialyze or Monitor these Patients?