Let’s Plan for Extubation in the Morning

“Truth is like the sun, its value wholly depends upon our being at a correct distance away from it.” -Hjalmar Söderberg The evening is invigorating; the Stockholm Marathon has been run and cobblestoned cafés, concealed within winding, narrowed side-streets are in the throes of summer’s end.  I take a coffee and meander about the Grand [... read more]

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Rising Lactate & the Art of Venous Blood Gas Interpretation

A 23 year old woman is admitted with severe abdominal pain following 5 days of profound non-bloody diarrhea and 72 hours of recalcitrant non-bloody emesis.  She has lost 7 pounds in this time frame and has been unable to maintain oral hydration.  Her eyes are sunken and her vital signs are notable for a heart [... read more]

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FAQ: How To Study for the Critical Care Medicine Board Examination?

"Let the wild rumpus start!" -Maurice Sendak Many of you are preparing for the Critical Care Medicine Board Examination; thank you to those who have downloaded my free review notes.  I often receive a question or two about the exam and how germane my notes were, in retrospect.  This is a difficult question to answer [... read more]

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IDSA Guidelines 2016: HAP, VAP & It’s the End of HCAP as We Know It (And I Feel Fine)

“It is important to realize that guidelines cannot always account for individual variation among patients.  They are not intended to supplant physician judgement with respect to particular patients or special clinical situations.” -IDSA/ATS Guidelines 2016 A 73 year old man is admitted from a nursing home for an NSTEMI and is treated on the telemetry [... read more]

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