Ivermectin for COVID-19

This is a discussion regarding an in-vitro study of how Ivermectin could potentially work for COVID-19. Give credit where credit is due. This paper was sent to me by @itskatiesway, @bug_drugs, @sanamoh92, @sy_doctornetwork, @paul.neil95, @nascarnora. Thank you all for sending data to me. Also, I am getting somewhere around 50-100 messages per day from the community. …

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Hydroxychloroquine & Azithromycin in COVID-19: Analyzing The Data

This first post was published on 4/4/2020 regarding hydroxychloroquine and azithromycin in COVID patients. Other studies will be noted by dates below. I decided to consolidate multiple posts into one for the sake of simplicity. For those of you new to the page/blog, I am a Critical Care physician. My team and I are usually …

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Nutrition in the Critically Ill with COVID-19 Infection

We can always count on the ASPEN team to come through for us regarding nutritional recommendations for our patients with COVID-19. A hat tip to them. A hat tip also to my pharmacist teammate, Amanda, for sending this to me (and many other literature goodies). This is free so download your own copy and don't …

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The WHO Strikes Back: Droplet vs. Airborne Precautions

I cannot believe that there is still a mystery from the WHO as to whether COVID is a droplet or airborne virus. The World Health Organization has obtained the paper I referenced yesterday. In addition, the study in the NEJM that I covered on 3/18/2020. Please read the document for yourself. I have provided links, …

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covid airborne

COVID: Let’s call it airborne already. UPDATED on 4/1/2020 and 9/21/2020

Disclaimers before we get this started. The following is my opinion. This article has not been peer-reviewed. I am going to attempt to be said peer. A hat tip to the folks at the University of Nebraska Medical center who have looked into trying to determine if COVID-19, or SARS-CoV-2 (the virus that causes COVID-19) …

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Convalescent Plasma for COVID-19: First Update in JAMA

Several days ago I posted about the FDA approval to start clinical trials to see how convalescent plasma of patients who had already beat COVID-19 would hopefully help patients who are currently suffering from COVID-19. This was now published in JAMA. This paper on plasma in COVID was published in JAMA yesterday states that there …

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Multiple Patients on a Ventilator: FAIL

Sometimes medicine behaves like the stock market; a whole bunch of enthusiasm followed by a realistic pullback. This has now occurred with the concept of using one ventilator for multiple patients. I agree that we need to use some ingenuity in this crisis, but this one never sat well with me, hence me not commenting …

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covid extubation protocol

COVID-19 Extubation Protocol (in the works)

Many questions on how to extubate these patients. There's no right answer yet. I've read of a high reintubation rate for these patients and cardiac arrest after extubation we need to be prepared for that. This is a living, breathing document. I would like to make changes as you all point out things that I have missed. Let's attempt …

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COVID-19: Don’t order an unnecessary nebulization!!

Colleagues, I know that lots of us have knee-jerk tendencies to order nebulizations on everyone who is on a ventilator, NIV, or any type of shortness of breath under the sun because it makes us feel warm and fuzzy inside where we say "I did something". This behavior needs to stop. We are potentially aerosolizing …

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