TIRBOs – Page 2 – Critical Care Scenarios

TIRBO #12: On heroics (or: is critical care hard?)

Some musings in response to people who are impressed by the work we do.

TIRBO #11: Mastering wire guidance

Advanced techniques for manipulating the guidewire during non-fluoroscopic bedside procedures such as central line placement.

TIRBO #10: Put the I back in Team

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When it’s a bad idea to help out others with their work.

TIRBO #9: Some quotes about why

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A selection of lesser-known quotes relevant to the practice of medicine.

TIRBO #8: What does skin really tell you about hemodynamics?

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The relationship between skin warmth and color, cardiac output, and systemic vascular resistance.

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TIRBO #7: Selecting vasopressors

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A practical approach to choosing and escalating vasopressors for patients in shock.

TIRBO #6: The many varieties of subclavian line

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Reviewing the different approaches to placing central venous catheters in the subclavian vein.

TIRBO #5: Tracheoinnominate fistulas

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A quick review of tracheoinnominate fistulas: how they happen, what they look like, and most importantly, what you’ll need to do.

TIRBO #4: Hope

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Why an assumption in your training should be to call for assistance, but expect it will never arrive. Plan to manage problems yourself. Let help surprise you—otherwise hope becomes your plan.

TIRBO #3: Weaning vs Titration

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When do interventions need to be “weaned”? Stop using this word when you don’t mean it! Titrate, target to effect, but only wean when there is a physiologic dependence.