Category: Critical Care

Surgical smoke evacuators and inertia in the time of COVID [PODCAST]

“Early in the pandemic, in thinking of and discussing possible solutions to help protect health care workers, two of my former colleagues and I recalled a device called the Surgical Smoke Evacuator (SSE), which we used extensively since the 1990s…

Understanding critical care in the ICU: then and now [PODCAST]

“I write this as a caregiver, patient educator, and clinical researcher. The coronavirus pandemic has shone a spotlight on intensive care units (ICUs).  Due to the rapid and continued increase in critical illness from COVID-19 infection, discussi…

Dear families: We are strong, but we are tired

After 33 years as an ICU RN, I had finally decided I couldn’t do this anymore. It was my last nightshift. The last shift convinced me I had made the right decision. The CNA and I went door to door to turn each ICU patient that was not capable of turnin…

Pay attention to science and medicine, or else you may be the next careless victim

I enter the hospital to work again. I must work as I have three small children and a husband presently out of work because of COVID. He is “non-essential.” A violinist is playing at the employee entrance. I know they do this to lift our spirits. But it…

I am an emergency medicine physician. I had COVID-19 infection twice and I’m tired.

I am a critical care and emergency medicine physician, I have had COVID-19 infection twice, and I’m tired. My first infection was early on in the pandemic.  I had to place a Blakemore tube in a young man who was going to die from his massive bleeding f…

Do protocols and pathways improve care?

As I’ve written before, I have to confess I’ve never been a huge fan of pathways and protocols. They often struck me as rigid and insensitive to the nuances of differences between patients. There are also times when they are just absurd whe…

Put your thank you into action: Wear masks correctly and avoid large gatherings

I have a video visit in the pulmonary clinic with one of my favorite patients. I ask her how she’s doing and wave to her husband sitting in the background of the living room where she is set up. Deborah says, “We’re good. We’re healthy. We are staying …

Scared to death and learning to trust

Cardiologists with national reputations were available at a hospital just an hour away. I had connections there and could get what I was sure would be better care for my mother than she would receive in the small hospital where she had been taken follo…

Did we do right by her? Did we do right by her family?

She was dead when we walked in the room. Lungs ventilated, kidneys dialyzed, on pressors to maintain enough tension within her blood vessels to keep blood traveling to her brain and with a tentatively beating heart, but dead, nonetheless. The microbes …

Understanding critical care in the ICU: then and now

Late one evening, an ICU physician calls a family to say Dad’s breathing rate had slowed to such an extent that he did not believe Dad would survive the night without life support. This seasoned doctor added that he had never seen patients come back fr…