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#intensivecaremedicine

Posts tagged as #intensivecaremedicine on Instagram

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We are all trying to combat delirium by all possible means. Getting pts their glasses and hearing aides. Keeping the lights on during the day. Having family around to speak to them. We’ve also had recent trials which have been quite disappointing using medications. Could there be a good cheap medication to prevent #delirium? This paper on using #melatonin is a strong meta analysis that looks into this and could potentially change my practice... but not for the reasons on the surface. I’ve even recently heard of using melatonin for sepsis, but that’s a discussion for another day and something else I’m going to dig into. Either way, a 🎩 tip to the authors. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is the link on my IG profile on the top left. #criticalcare #criticalcaremedicine #pharmacist #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #physicianassistant #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #pharmacyschool
#hyperkalemia, a daily issue for the #intensivist, #emergencymedicine docs, and #nephrologist. It’s really not that hard to manage once you check your own pulse. This tasty little algorithm definitely puts the adrenaline in check after you see that number called in as a critical from the lab and shows up glowing red on your computer screen telling you to just do something! A 🎩 tip to the authors. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is the link on my IG profile on the top left.  #criticalcare #criticalcaremedicine #pharmacist #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #journalclubish #np #acutecarenursepractitioner #pa #physicianassistant #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #pharmacyschool
This is a question I would always ask myself as I would check off the boxes on admission orders as a resident, not as a fellow because the residents do it, and sometimes now as an attending. I always thought it was a waste of resources and uncomfortable to the patients to not only inject them with pharmacological DVTs prophylaxis, but also burden them with those SCDs. I’m really grateful for my colleagues in Saudi Arabia for putting together this study and sealing the deal for me as to how to manage this moving forward. A definite 🎩 tip to them. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is the link on my IG profile on the top left. #criticalcare #criticalcaremedicine #pharmacist #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #physicianassistant #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #pharmacyschool #heparin #lovenox #enoxaparina
Nach 3 Wochen 2 freie Tage am Stück frei!!! Putzen, Wäsche, Einkaufen... 🤗🥳 und endlich auch Zeit für uns❤️ und nebenbei was Gutes und Gesundes auf die Gabel. Love it❤️❤️❤️ #medicallife #intensivecaremedicine #notfallmedizin #lovemyjob #freetime😎 #healthyfood #fitnessmotivation #fulltimejob #liveyourlife #kaloriendefizit
To all my #intensivist, #hospitalist and #surgeon colleagues. Heck, let’s bring in all my #icunurse, #ccrn, and #respiratorytherapist colleagues. Do you practice in an open or closed #icu? What are your thoughts on the matter? I can see the benefits of both as I have practiced in both models, but I really really enjoy my closed ICU. Fewer different faces that my patients and their families see, the better bc it leads to less confusion of what’s going on as information can be related and therefore interpreted in different ways. What are you doing on your Saturday night? I’m obviously doing this 🤣. A 🎩 tip to the authors. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is the link on my IG profile on the top left. #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #respiratorytherapy #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation
Auf zur #nachtschicht #öpnv #intensivecaremedicine #spitzenmedizinundmenschlichkeit #düsseldorf #leflairdüsseldorf
Fantastic performance by all involved in the in-situ #simulationtraining . Best way to learn is with #interdisciplinaryteaching #icu #intensivecare #intensivecareunit #intensivecarenurse #intensivecaremedicine #neurocriticalcare
Not a great deal of data on #bipap utilization in #ards patients but this study provided some great insight on what we should NOT do: put pts with a P/F ratio of less than 150 on NIV. The issue that I have, and this is my personal stance on the matter, is that ARDS pts do not get better overnight (unless the clinician has overlooked that the ARDS is secondary to fluid overload in a septic patient and decided to diurese them the following day 🤣). If the PF ratio is less than 150, the first three things I’m thinking about is to intubate, intubate, and intubate. I definite 🎩 tip to the authors as this study is a big deal and despite numerous limitations, it still gives us data to help us take care of our patients. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is on this profile. #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #respiratorytherapy #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #respiratorytherapist #criticalcarenurse
The learning objective of this virtual ARDS patients is to show that alveolar distending pressure can be high with too much driving pressure whereas end inspiratory plateau pressure remains below 30 cmH2O. This ARDS has a low compliance with low recrutability and a significant baby lung. Here PEEP has to be limited but there are other options if you want to keep high level of PEEP for oxygenation and limit driving pressure because of the risk of overdistension, any other option (I have 2...), is pH an issue? #respiratorytherapists #intensivecareunit #medicalresearch #mechanicalventilation #healthcaresimulation #anesthesiologist #intensivecare #anesthesiologyresident #europeansocietyofintensivecare#ventilationtherapy #medicalscience #mechanicalventilations #anesthesiologist #intensivecaremedicine #respiratorytherapy #medicaleducation #criticalcaremedicine #criticalcare #criticalcarecourse #ards#pneumologia #pneumology #intensivist #intensivista #respiratorytherapiststudent #pulmonaryfibrosis #respiratorytherapist,#internalmedicine#internalmedicineresidency
A new class of young residents in anesthesiology learning mechanical ventilation with 2.0 interactive simulation software, screen projection on the wall. Best way to share interactively our knowledge 👍#respiratorytherapists #intensivecareunit #medicalresearch #mechanicalventilation #healthcaresimulation #anesthesiologist #intensivecare #anesthesiologyresident #europeansocietyofintensivecare#ventilationtherapy #medicalscience #mechanicalventilations #anesthesiologist #intensivecaremedicine #respiratorytherapy #medicaleducation #criticalcaremedicine #criticalcare #criticalcarecourse #intensivist #intensivista #respiratorytherapiststudent #respiratorytherapist#medicaleducation
How’s the hopefully improved handwriting? 🤣 Today’s article is a good meta-analysis on using #bipap or #cpap in pts who are no in COPD nor heart failure with pulmonary edema exacerbations. This shows why so many of us reach towards NIV as quickly as we do. A 🎩 tip to the authors You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is on this profile. Happy Sunday! #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #respiratorytherapy #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #respiratorytherapist #criticalcarenurse
HFNC for COPD exacerbations? This is something I’ve tried but didn’t know there was any data behind it until I ran into this article. This study has a TON of limitations but I still applaud the authors for trying. Keep in mind that the patients were not that sick. Not even the types of patients we bring to the ICU necessarily. But it’s still an option. A 🎩 tip to the authors. I hope my handwriting is more legible now 😎. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is on this profile. #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #respiratorytherapy #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #respiratorytherapist #criticalcarenurse #hfnc #copd #icu
The future of mouth care for ICU patients? . . . . 🔎https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2512-8 . . . ✒_____________________________ #intensivecareunit #intensivecaremedicine #intensivecarenursing  #intensivecarenurse  #criticalcare  #criticalcarenurse #criticalcarenursing  #criticalcaremedic #criticalcareparamedics  #cardiac #medicine  #nursing #nurse #mouthcare  #ventilatorassociatedpneumonia
Guidelines for the Provision of Intensive Care Services (GPICS) Edition 2. . . . June 2019 . . . . 🔎 https://t.co/fILD9nFYKP . . . ✒ . . . . . . . . . . . . . . . . . . . . . . . . . . .  #criticalcare  #criticalcaremedicine  #criticalcarenursing  #intensivecaremedicine  #criticalcaremedic #intensivecare #intensivecareunit  #guidelines  #ics
Just one of them crazy days...spillover from my duty yesterday 🥵🤯😳 #intensivecareunit #intensivecaremedicine #criticalcaremedicine #postcardiacsurgery #mvr #crrt #iabp #pacemaker #milrinone #pulmonaryhypertension #pulmonaryarterycatheter #toxicduty 06/26/19
This was an extremely important study that was recently published in the #nejm regarding the use of paralytics for #ards. This is definitely a practice changing article that needed to be done. Otherwise, patients would be provided unnecessary paralytics as the previous guidelines I posted suggest. I was training at one of the shops where this study took place and it was a HUGE undertaking. The researchers should definitely be congratulated. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is on this profile.  #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #physicianassistant #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #pharmacist
New-onset QT prolongation is a novel predictor of mortality in critically ill patients . . . Critical Care 2019 . . . . "QT prolongation is associated with increased mortality in different types of patients. QT prolongation is common in critically ill patients, and the association between heart rate corrected QT (QTc) and outcome in critically ill patients has raised broad interests most recently ... The overall mortality rate in patients with a new-onset QTc prolongation is more than two times higher than those patients without (22.2% vs 9.6, OR = 2.69, p = 0.001) (Fig. 1b). ... Multivariate logistic regression showed that QT prolongation is still independently associated with ICU mortality even after adjusted for age and gender (p = 0.001, 95% C.I., 1.51–4.79). ... However, QT prolongation is no longer a predictor of ICU mortality if APACHE-II score was further adjusted (p = 0.329), likely due to that QTc itself is strongly associated with APACHE-II score (r = − 0.235, p 
Fisioterapeuta de UTI, você sabia que existe um escore capaz de predizer mais de 80% da possibilidade de falha de ventilação não invasiva (VNI) em pacientes hipoxêmicos? 👨‍⚕️👩🏻‍⚕️😧😥🏥 H: heart rate 💓 A: acidosis 🔬 C: consciousness 😖 O: oxygenation 😷 R: respiratory rate 😥  O escore HACOR leva em consideração a frequência cardíaca, acidose, nível de consciência (escala de coma de Glasgow), oxigenação (troca gasosa pela relação PaO2/FiO2)  e frequência respiratória em pacientes hipoxêmicos. Uma pontuação maior que 5 na primeira hora de VNI prediz 81,8% de chance de falha.  Se meu paciente hipoxêmico apresenta grande chance de falha segundo o escore, deve-se discutir intubação orotraqueal. O escore é uma forma de combinar os fatores que mais contribuem para falha da terapia, com destaque para nível de consciência e troca gasosa.  Veja o escore detalhado na imagem. Você o encontra no artigo "Noninvasive Respiratory Support  in Acute Hypoxemic Respiratory Failure", publicado na Respiratory Care em junho de 2019 (quentinho) por Thomas Piraino. Neste mês de junho, a Respiratory Care publicou uma série de revisões com grandes nomes da terapia respiratória sobre VNI, incluindo temas como efeitos fisiológicos da VNI, tipos de ventiladores, percepção de um paciente, VNI em hipoxêmicos e hipercápnicos, entre outros. Recomendo a leitura. 😉  #fisioterapia #physicaltherapy #fisioterapeuta #physiotherapist #fisioterapiarespiratória #respiratorycare #fisioterapiahospitalar #fisioterapiaintensiva #vni #niv #ventilaçãomecânica #mechanicalventilation #terapiaintensiva #intensivecaremedicine #criticalcare #uti #icu #breathe #lung #reabilitação #rehabilitation #natalrn #rn
The solution, give some time for inspiration to the patient. With Pressure Support patient can change his inspiratory time cycle by cycle (main difference with Pressure control) but you give a rule : expiratory trigger in %. When inspiratory flow decreases at x % of peak inspiratory flow, expiratory valve open. So if x decreases inspiratory time increases. Here, because compliance is low, inspiratory muscles pressure trigger the ventilator, valve open and rapidly pressure is high so flow decelerates and expiratory trigger open the expiratory valve. Because patient continue his inspiratory effort, a second cycle is triggered. Decreasing expiratory trigger will increase insufflation until end of inspiration and avoid double triggering. Patient will feel much better, OK? The last curve on the Servo-i ventilator is diaphragm electrical activity (EAdi) so you can see patient inspiratory effort! During double triggering there is only one inspiratory effort, with this asynchrony respiratory frequency, tidal volume and minute ventilation monitoring are high and wrong. With EAdi you can asses synchrony, neural drive,inspiratory muscle pressure and measure compliance and driving pressure but let’s see that another time if you are interested ... you can watch the video from may 17th below to see settings on the simulator #respiratorytherapists #intensivecareunit #medicalresearch #mechanicalventilation #healthcaresimulation #anesthesiologist #intensivecare #anesthesiologyresident #europeansocietyofintensivecare#ventilationtherapy #medicalscience #mechanicalventilations #anesthesiologist #intensivecaremedicine #respiratorytherapy #medicaleducation #criticalcaremedicine #criticalcare #criticalcarecourse #lungtransplant #transplantation #intensivist #intensivista #respiratorytherapiststudent #pulmonaryfibrosis #respiratorytherapist, photo with permission.
Real vs virtual patient with Pulmonary idiopathic fibrosis awaiting lung transplantation in ICU (low thoracopulmonary compliance). Patient ventilator interaction is not good under pressure support, what do you see and what do you propose ? Give a comment and I will show what we did to improve the situation. #respiratorytherapists #intensivecareunit #medicalresearch #mechanicalventilation #healthcaresimulation #anesthesiologist #intensivecare #anesthesiologyresident #europeansocietyofintensivecare#ventilationtherapy #medicalscience #mechanicalventilations #anesthesiologist #intensivecaremedicine #respiratorytherapy #medicaleducation #criticalcaremedicine #criticalcare #criticalcarecourse #lungtransplant #transplantation #intensivist #intensivista #respiratorytherapiststudent #respiratorytherapist, photo with permission.
Sporting our sushi and butterflies in the workplace today 😊😘🥰🍣🦋🍣🦋 #surgicalcaps #surgicalscrubcaps #bouffant #bouffantcap #intensivecareunit #criticalcaremedicine #intensivecaremedicine #sushi #butterflies 06/24/19
I definitely have a love/hate relationship with guidelines. In this case, this article that was published just 11 days ago on 6/13/19 is already outdated bc it did not take into account the landmark article on paralytics published in NEJM on 5/23/19. Nonetheless, this figure which I will definitely be printing out and providing to all my #respiratorytherapist today at work will get you through the vast majority of #ards cases. ARDS is a very challenging disease process to take care of and you need to have all your ducks in a row to ensure the patient is properly taken care of. That includes reaching out to neighboring hospitals and playing nice across county and city lines. I trained at an ECMO center and am plenty comfortable taking care of those pts but I do not do ECMO at my current shop. I do, however, have the direct number of the ECMO guys nearby and have a strong relationship with them. Pts come first over ego. A definite 🎩 tip to the authors. You can obtain the link to this article on my website: www.eddyjoemd.com or https://linktr.ee/eddyjoemd which is on this profile. #criticalcare #criticalcaremedicine #ccrn #criticalcareunit #internalmedicineresidency #intensivecare #intensivecareunit #internalmedicine #intensivecaremedicine #foamed #intensivist #journalclubish #np #acutecarenursepractitioner #pa #respiratorytherapy #icu #icudoctor #ccm #pccm #fellowship #residency #critcare #pulmcrit #foamed #meded #medicaleducation #respiratorytherapist #criticalcarenurse

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