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Lessons

Furosemide and Venodilation

Furosemide (Lasix) is a loop diuretic that works on the Na/K/2Cl cotransporter in the thick ascending loop of Henle. It’s a medication we routinely use in the hospital for patients with congestive heart failure exacerbations (CHF) who are retaining extra fluid in their distal extremities, lungs, abdomen, and other dependent …

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Central Line Versus Peripheral IV Flow Rates In Resuscitation

The indications for central venous catheters (CVCs) include invasive hemodynamic monitoring, transvenous cardiac pacing, hemodialysis, lack of peripheral venous access, administration of vasopressors, nutritional support, and in some texts…. volume resuscitation. It’s this last one that bothers me. Yes, some CVCs like multi-lumen access catheters (MAC) can be wonderful for massive resuscitation, …

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Trusting Diagnostic Test Results

As healthcare providers, we routinely rely on monitors, lab results, imaging studies, and a myriad of other diagnostic tests to diagnose new medical problems and monitor responses to therapy. Before interpreting the conclusions or results of these tests, we must ask a simple question – can you trust the test?

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Anesthesia For Awake Craniotomies

I finally had the opportunity to do an asleep-awake-asleep craniotomy today! This type of procedure aims to preserve portions of the eloquent cortex – parts of the brain that are critical for speech, language, motor function, and localization. Patients are awake for brain surgery. I wanted to give a play-by-play of …

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