Critical Care

Critical Care Controversies! Vitamin C+Thiamine+Hydrocortisone for Severe Sepsis and Septic Shock

Editor: 
Richard Byrne, MD

Can cheap, safe infusions of vitamins really succeed where so many hundreds of novel therapies have failed? The recent article in Chest by Dr. Paul Merik has taken the critical care world by storm, with reported mortality rates of 8.5% in patients treated with a simple vitamin C/thiamine cocktail (with none of the deaths directly attributable to sepsis). The skepticism and push-back have been nearly unprecedented, especially on #FOAMed. Whether you're a skeptic or an early adopter, you need to understand the basis for the debate by checking out this high-yield summary.

Richard Byrne, MD
Tags: 
Critical Care
sepsis
septic shock
vitamin c
Tue, 05/02/2017 - 5:00am
Topic: 
Critical Care
Research
Category (Day): 
Tuesday

Back to Basics: Open & Depressed Skull Fractures

Editor: 
Alexis Pelletier-Bui, MD

This post is not intended to be a comprehensive review of skull fracture types and management, but rather a discussion of two subtypes of skull fracture – open and depressed fractures.  I chose this topic because it’s something I saw frequently during my recent elective working in an emergency department in Kumasi, Ghana.  In the United States at trauma centers these patients are frequently managed immediately by neurosurgery; however, with few consultants available, I was able to be more involved in the prolonged care of these patients. If faced with these types of severe head/skull injuries in a community hospital, it is important to feel comfortable with the initial management.  

Eric Gruber, MD
Tags: 
skull fracture
trauma
head trauma
Mon, 05/01/2017 - 5:00am
Topic: 
Critical Care
Trauma
Category (Day): 
Monday

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