friday morning. started work around 7 this morning. i was initially confused what i was supposed to do today or where to go. but then JW messaged me last night to work with him. he's a nice guy. very down to earth. doesn't show off his knowledge!
anyway, so we started rounds on 6 West in Shapiro where the intensive care unit is. JW and I weren't sure exactly which team we should join. but it turned out just fine. we tagged along with dr david silver. an anesthesiology attending, who specializes in cardiac anesthesia. we both thought he was a great teacher. couple of things we learned (and i will discuss in more details later):
1) patients on ventilators who need sedation need to occasionally be on sedation holiday so that over-dose of sedatives does not cause delirium.
2) there is the RAS scale for sedation, which should be matched against when diagnosing a patient
3) the CAM scale is for delirium
4) we learned about acute respiratory distress syndrome (ARDS) and the need for peep-ing so as to prevent total lung failure
5) learned the clincal symptoms of leukocytosis
6) Need for esophageal balloon to actually measure internal pressure. important to note that big breasts and other anterior weights (like obesity affecting abdomen) can actually affect internal pressure sig.
7) also post-oped a pt who was diagnosed with a heart tumor! had never heard/seen that before!
I'll talk in more details about these jargons in an upcoming post! till then, thanks for stopping by!
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