An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
We've gotten quite good at putting today negative pressure rooms for our patients who are hospitalized with COVID. We've gotten our PPE sorted out. We're pretty solid with our donning and doffing. But when should we discontinue contact precautions on these patients? Should they be on isolation for their entire hospitalization? When can family members …
Continue reading Discontinuing Contact Precautions in COVID-19 Patients
Check out the addendum from 10/19 at the end of this post. COVID IS SOOOOO FRUSTRATING TO TREAT! Another tool taken out of the tool box with this COVACTA study looking at tocilizumab in COVID-19. Several weeks ago, I covered tocilizumab and cytokine storm in this post. Check it out for further details. I am …
Continue reading Does Actemra/Tocilizumab Actually Work? Update to the COVACTA Study
Please see the bottom of the page with the most recent update to the colchicine literature in COVID-19. This post covers the GRECCO-19, and COLCORONA, and RECOVERY Trials. I have mentioned this many times before, I like readily available, inexpensive medications such as dexamethasone and colchicine to treat our COVID patients. In this case, the …
Continue reading Colchicine for COVID-19: GRECCO-19, COLCORONA & RECOVERY
YouTube and Instagram sensation David Convissar, MD, (aka @countbackwardsfrom10) had his paper on Lung Ultrasound During the Coronavirus Pandemic published. It's online as of just a few days ago in Anesthesia and Analgesia. He knows quite a bit about COVID from personal experience. He shared his journey, from learning he had contracted the virus to …
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 …
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 …
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 …
Could plasma exchange help save the lives of COVID patients? Let's straighten out some nomenclature first. We all have questions about what is what and there is much confusion. I personally like the say all these words roll off the tongue. Makes you sound smart when you say it. There's more to it than what …
If you continue reading on this page, you'll note that I have attempted to tackle the whole conundrum of anticoagulation in COVID patient with the pendulum swinging. My first post on the matter was back on 4/6/20 (when this post was initially created) and the second was on 4/12/20. My attempts to keep modifying my …
Continue reading VTE Prophylaxis or Anticoagulation in COVID: Visiting the Guidelines
Let's be quite clear here, there's no miracle drug for all this. I am personally not enthusiastic about Remdesivir in Severe COVID-19. I personally have zero experience with Remdesivir at this point in time. Hopefully you all can comment on whether you anecdotally think it works or not. This study was published earlier today in …
