Recent content by FLdoc2011

DKA is one of the more time consuming/labor intensive things we treat acutely in the ICU. As a medical resident in the ICU we spent many nights up trending electrolytes/glucose/metabolic panels every couple hours adjusting fluids and drips. From a prehospital standpoint I'd say start on...

A 41yr old with aortic stenosis? That should set off some bells as to a specific valvular pathology and an associated condition....

I agree, good pickup about possible bleeding. Post-op patient who appears in some short of shock state, bleeding always high on list. Kidneys are retroperitoneal structures so bleeding there could cause a significant RP bleed and would certainly focus some of my exam on that area.

I agree with a lot of what has already been said. Remember as well that to some degree this is a team sport and we have roles to fill in different aspects of the care of a particular patient. I will offer some encouragement in that I rely on you guys, among other things, to be good initial...

I think you're being a little black and white with certain things. First, Dr Marik is not hack and well known in the sepsis circle. I think it's fine to always be somewhat skeptical about certain claims, but at the same time just as much damage can be done about being stubbornly steadfast...

Because right now it's a theory based on a single center and not a controlled trial. Certainly raises an interesting thought regarding this treatment and will hopefully spawn further trials but in general we don't adopt some treatment/modality based on such limited data without it being...

Just saw a syncope consult, with prior significant cardiac history including a prior shock for VT and when I looked at the EMS paperwork the pt's initial glucose was in the 30's. So I guess useful to check. :)

Low ectopic atrial rhythm

Not much to add here, other than honestly the most important that can be done is clarifying his code status and bringing in the DNR paperwork. I routinely see these patients in the ED after they show up, there's no family or paperwork and they get intubated. Otherwise not much to do beyond...

An elevated INR doesn't mean someone "overdosed" them on warfarin. There are some many drug and diet interactions that it's one of the tougher drugs to manage. And in the absence of acute bleeding I'm not at all excited about an INR of 5.9 and would just let it trend down. Certainly if the...

I'd also add to some degree the low barrier to entry in regards to length of training/education.

Have been involved in a lot of in-hospital arrests and I try not to interrupt compressions. Can be tricky but certainly possible to intubate during compressions or during a brief pulse check.

Yea that's a whole other debate but in general yes, there are still some "prestigious" residencies that will not accept a DO, truth be told however they likely would still look down on a lower-tier MD school grad as well so they're competitive for everyone. That said, AOA programs are...

I won't re-hash some of what's been said here, but was she on plavix or an actual anticoagulant such as coumadin, Pradaxa, eliquis, or xarelto? I agree in that preceding CP can be worrisome but an elderly fall with some head trauma is also worrisome and a very reasonable reason to document...

Not entirely sure what is being asked as there are 3 different scenarios here: 1: COPD exacerbation 2: Sepsis 3: COPD exacerbation AND sepsis You're right though in that technically you meet criteria for SIRS during a COPD exacerbation, not hard to do. The short answer is I would treat...