Category: Lightning rounds

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Following up from the last lightning rounds on vascular procedures, we look at non-vascular bedside procedures in the ICU: paracentesis, thoracentesis (including chest tubes), lumbar punctures, and bronchoscopy. How do we tap, what are our tricks, what’s the role of ultrasound, who needs a bronch, and more.

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A vascular access roundtable, discussing our practices surrounding arterial lines, central lines, PICC lines and midlines, and PA catheters. When do we place them? When can they come out? What sites do we like? When (and how) do we use ultrasound? What’s up with the axillary site, why does Brandon hate PICCs, the age-old debate on ultrasound probe orientation… all this and more.

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Quick takes on common controversies in the ICU, with Bryan and Brandon:

1. Stress ulcer prophylaxis: drug selection, candidates, and when to discontinue
2. Stress dose steroids: candidates, dosing, lab tests, and weaning
3. Titrating PEEP: considering the disease process, PEEP/FiO2 tables, driving pressure trials, and pragmatic approaches