Here’s a free reference sheet (front and back) with “high-yield” information in critical care and perioperative medicine. I’m well-suited to pursue this educational endeavor, given my training as a physician who works in both settings, and I hope that many of you will benefit from the information. Now some details:
As an anesthesiologist, I’ve placed nasogastric/orogastric tubes (NGTs/OGTs) in patients who will remain intubated post-operatively to decompress the stomach and to provide a short-term enteral route of administration while the patient remains on mechanical ventilation. As an intensivist, I more commonly place NGTs to deliver nutrition (i.e., tube feeds) and…
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 spirometers (IS) to facilitate “pulmonary hygiene” – a series of interventions to exercise the lungs, decrease…
This post is supposed to be a primer about billing in critical care. I’ll update it regularly as practices change.
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 morning with a team usually led by the ICU fellow consisting of the patient’s nurse, an…
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 inflammatory states. In serum, PCT rises in 2-4 hours and peaks at 4-30 hours, but interestingly…
As a critical care fellow, I’ll spend a total of two months (four, 2-week rotations) in the cardiac intensive care unit (ICU). I just finished my first rotation there and got to befriend many of the cardiac surgery attendings and fellows who I’ll be working alongside in the operating room…
I spent the last two weeks in the coronary care unit (CCU) as part of my first elective. Although the CCU is an ICU, the patients are much more “medical” than surgical, and therefore, present different challenges compared to what I saw at the beginning of my fellowship.
Moonlighting basically entails taking on paid work on top of my normal job. Our program restricts moonlighting hours to ~20 hours per month, so we remain focused on our fellowship at hand instead of lucrative opportunities to make extra money.
I’m finished with an eight day stretch of days/nights in our combined surgical, burn, and trauma ICU. What an incredible way to start off fellowship!