An intensivist on a learning frenzy. Caring for the critically ill using evidence-based medicine.
I am not a trauma surgeon. I am not a trauma physician. I do not take care of trauma patients in my current practice. I did several rotations in the trauma intensive care unit during my fellowship training but by know means am I going to pretend to have the knowledge that my colleagues who …
Continue reading Resuscitation of Trauma Patients: 0.9% NaCl (saline) or Plasma-lyte?
When starting my medical training, I had yet to learn the difference between a Cordis and a MAC introducer. I used to hear these words called out in an emergency as follows: Quick! We need to resuscitate this patient with blood, STAT! Call for the massive transfusion protocol, and grab me a Cordis STAT! Do …
Continue reading Cordis vs. MAC Introducer: What’s the Difference?
More than 50% of residents do not know how much sodium is in 0.9% NaCl. I know you do, though... it's 154mmol/L. Far more than our "normal" of 140mmol/L. You should know your IV fluid contents. Why do I nag so much with intravenous fluids and their contents? Truth be told, I did not know …
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
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