icu

Prone Chest X-Rays

In severe COVID-19 pneumonia with refractory hypoxemia, patients are often proned (put on their abdomen), deeply sedated, and paralyzed to improve synchrony with the ventilator. The goal with proning is to create a more...

Deep Sulcus Sign

A pneumothorax occurs when air fills the pleural space between the lungs and chest wall. This can cause partial or total lung collapse leading to difficulties with alveolar ventilation, hemodynamic lability, etc. If a chest...

Tension Pneumothorax

Here's an example of a large, right-sided tension pneumothorax (PTX). Disruption in the lung leads to a one-way valve where air fills the pleural space and expands the PTX during inspiration but cannot escape...

RK.MD Perioperative And Critical Care Reference Sheet

Ever since finishing my fellowships, I wanted to create a free reference sheet (front and back) containing "high yield" information in the areas of critical care and perioperative medicine. I feel I'm well suited...

What’s An Incentive Spirometer?

After any general anesthetic (specifically those provided for surgeries in the thoracic or upper abdominal compartments), physical activity and nutrition are crucial to promote recovery. In the ICU in particular, many patients receive incentive...

Billing In Critical Care

This post is supposed to be a primer about billing in critical care. I'll update it regularly as practices change. Critical care (CC) billing is based on time rather than complexity. There are two current...

Preparing For ICU Rounds As A Fellow

It's important for the intensive care unit (ICU) treatment team to construct and communicate our daily assessment and plan with all relevant parties involved in a patient's care. We accomplish this during "rounds" each...

Procalcitonin Inflammatory Biomarker

Procalcitonin (PCT) is a 116 amino acid peptide precursor to calcitonin, a hormone involved in calcium homeostasis. PCT increases significantly in the context of proinflammatory bacterial infections but remains low in viral and other...

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