A 19 year old is brought to the ED after 2 days of progressive confusion and drowsiness
Last week he had a fever and runny nose. Got better.
He soon becomes unresponsive and requires intubation
This is his MRI performed the next day. What’s going on? What do you do?
Today my team sat down with our insurance broker. My health insurance premium for my employees went up 30% for our renewal.
The government cut their pay to me and all doctors by 3.37% this year for the first two months then reduced the cut to 1.66% for the remainder of the year.
I’m tired of paid mouthpieces telling Congress and Americans that doctors are the reason for our high healthcare costs. If you agree with me, share this post and let your friends and colleagues know where the money in healthcare is going.
Hint: it isn’t to doctors
Results from #PROTECTION presented #CCR24 & published @NEJM.
- DB RCT of amino acid infusion vs placebo in n=3511 people undergoing cardiac surgery w/ bypass.
- Reduced incidence of AKI (26.9% vs 31.7% NNT=20) & need for RRT (1.4% vs 1.9% NNT=200)
Potential game changer!
🧵
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This may be my favorite episode of @CritCareTime we’ve done yet!
@Askins_Razor & I go DEEP discussing diuretics: how do they work, when to use them, drip vs bolus, & most of all why a negative fluid balance is so beneficial.
Plus rants on CVP & MIVF
Don’t miss it!
ICU puzzle:
70 yo female pt without being on any medications, no smoking history, no other known comorbidity factors except moderate obesity, underwent surgical repair of hip fracture. Per note: preoperative assessment: normal lung auscultation, moderate cardiac enlargement
Manage severe acute pancreatitis like a pro! The days of just arbitrarily flooding patients with fluids and not feeding our patients are behind us. 🎩 tip to the authors.
https://t.co/4Ise540F2X
Members of CHEST’s Sepsis/Shock Section within the Critical Care Network provide an update on trials and guidelines that consider how low-dose corticosteroids impact mortality in adults with septic shock. Read more: https://t.co/p8LH0y5kX1
@CritCareTime@ross_prager Speaking of a procedure a lot *don't* currently perform, maybe discuss percutaneous ultrasound gastronomy sometime? Seems like a way to increase efficient patient flow in the ICU, especially for those who already perform bedside tracheostomy: https://t.co/Vis5Pdm67H
@jducanto I think if you mainly follow fellow physicians, organization, etc who only post medical information, and only scroll through “following” you can avoid the toxic content