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Top Ten Ways to Succeed In SICU rotation!! July 22, 2007

Posted by Dr. Birdi in : CCF, Resources , add a comment

***Excerpt taken from SICU Handbook available for viewing and download with CCF SICU Resources.

1. Maintain your availability in the SICU

The nurses and other personnel who work in the unit are seasoned, experienced professionals. Unfortunately, as in other aspects of health care, they are being forced to “do more with less,” which means that frequently there is one nurse to two (or three!) patients; so-called one-on-one nursing assignments are extremely rare. This means that the nurses are busier, and the one thing that they shouldn’t have to do is constantly hunt for you. The usual response to this statement is “I have (more…)

Survey of Current Issues in Surgical Anesthesia / Critical Care Medicine July 20, 2007

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November 28 - December 2, 2007 - Naples Florida
Presented by: Cleveland Clinic Division of Anesthesiology (more…)

Summer NEO Critical Care Society Meeting Minutes July 19, 2007

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The summer edition of the North Eastern Ohio Critical Care Society (NEOCCS) was held at Johnny’s Downtown in Cleveland, OH. The event was sponsored by Hospira. The meetings featured Intensivists-Anesthesiologists, Critical Care Fellows, Residents and an ICU Nurse Practitioner.  The discussion was related to sedation in the ICU and specifically addressed the “almost impossible” to sedate post op patient at risk for respiratory collapse. Dr. Ali Jahan (CCF) was the presenter for the evening. He moderated a heated debate upon the use of several different pharmacological agents (such as haldol, propofol, benzodazepines, narcotics, dexemetetomidine) as well as ventilation techniques (NIPPV vs. intubation) in (more…)

SICU Journal Club Minutes (Part 1) July 19, 2007

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Dr. Michael Fernando (CA-2) did an excellent presentation of Acute Renal Failure and Sepsis featured in the July 2004 New England Journal of Medicine. With the significant morbidity and mortality associated with sepsis, septic shock and acute renal failure it is prudent to understand the mechanisms of this disease process as well as evaluate which interventions make therapeutic sense! This review in NEJM gives us some insight and may help intensivists answer some of these questions. This is archived in the collection of Journal Club Presentations.

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It was identified that early sepsis maybe a state in which physiologically the body is depleted of (more…)

SICU Journal Club Minutes (Part 2) July 18, 2007

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Dr. Ricardo Riveros (CA-2) presents a thorough review of Mechanisms of Sepsis-Induced Cardiac Dysfuntion featured in the May 2007 Critical Care Medicine. This was a very difficult review of basic science as well as the mechanistic molecular biology of the cardiac dysfunction that occurs in septic patients with myocardial dysfunction. This article focuses on the intracellular pathways that are disrupted by sepsis hence leading to cell death, apoptosis. Dr. Riveros points out the animal models and patient studies used to study these mechanisms as well as their downfalls. A great resource for basic review of what goes wrong within the cell during sepsis. This is archived in the collection of Journal Club Presentations.

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Basic Management Conferences - Bioethics July 16, 2007

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Dr. Martin L. Smith (Dept. of Bioethics CCF) led a thought provoking discussion on the controversial and sometimes very difficul issues dealing with end of life care and decision making abilities in the ICU. Several of the patients in the ICU are unable to make the decisions for themselves and it is up to the physician, family, friend or DPOA to make the decision on behalf of the patient and in the patient’s best interest. This can turn out to be quite a complicated path because as Dr. Smith reveas in his presentation, sometimes no one can clearly tell what the patient would have wanted if he/she were in their current position. Issues of family wishes, moral, legal and religious obligations can quickly bring us into merky water. Enjoy the presentation and please feel free to comment below.

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August Call Schedules Updated July 16, 2007

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Fellow and CA-3 CCF SICU call schedules for the month of August (Module 2) have been updated and are available for review here or by clicking on the Call Schedules tab above. All requests were able to be accommodated for the month. The page is password protected and if you are unable to access it please feel free to contact me and I will provide you with the login information.

July Call Schedules Updated July 10, 2007

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You can find the updated CCF SICU call schedules by clicking on the link above for Call Schedules or clicking here. This page is password protected for security reasons. If you do not know the password, please send me an email using the “contact me” button above and I will provide you with the required login information.

It is a work in progress! July 10, 2007

Posted by Dr. Birdi in : Resources, About , add a comment

Just bare with me over the next few weeks and we will have this website loaded with useful information and resources. Meanwhile, please subscribe to the website using the link to the right. This way you will instantly stay up to date with any new changes that are made.

SMS functionality to the website just added! Once you are logged in using the links below, you can send an instant message to a SMS enabled (text messg) cell phone from anywhere in the world to the website developer by using the tool in the sidebar. Enjoy it!

Remember, this site is contantly changing on the basis of new information, resource, news and most of all YOUR input. So please feel free to add comments to any of the topics you see by clicking on the “add a comment” link on the top of each post. you may also feel free to contact me directly using the contact me form is you have specific questions, comments, suggestions or you that you would rather not make public information.

Another extensive resource for procedures July 10, 2007

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Even though I should be studying for my boards, I just enjoy browsing the web too much! Here is another excellent and thorough resource I found online in the blogger community that reviews several procedures including Central Line Placement, Thoracentesis, Paracentesis, Arterial Line, Lumbar Puncture, etc. The review is not video based but does have very detailed images used to illustrate the techniques as well as nice decriptive explanations. ClinicalCases.org is a free online case-based curriculum of clinical medicine and is one of the most popular medical blogs on internet. A lot of the information may not be relevant to the ICU but it is still a good resource for topic reviews. I would encourage you to browse the site and get your learn on :) Incidentally, this website has significant input from the Cleveland Clinic and the Case Western Lerner College of Medicine - The blog was developed by Dr. Vesselin Dimov (Internal Medicine, CCF).

ClinicalCases.org was featured in the British Medical Journal and Medscape.com, and was referenced several times in the medical education literature. The project is hyperlinked in the web sites of 11 medical schools in the U.S., Canada and Europe. This case-based curriculum was started by physicians at Cleveland Clinic and Case Western Reserve University (St. Vincent/St. Luke) Internal Medicine Residency Program for the purpose of medical education.

Check it out Clinicalcases.org.

Here is a link to the Procedural guides.