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

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.

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Thrombolysis in Acute Stroke

Ever wonder where the the current American Heart Association and American Stroke Association (AHA/ASA) guidelines for thrombolysis in acute ischemic stroke come from?   Included is a summary of the landmark studies that have contributed to these recommendations (NINDS& ECASS III) as well as a review of IST-3. 

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Do Residents Affect Press Ganey Scores?

In the era of Press Ganey, patient-oriented outcomes, hospital reimbursement, and physician compensation are all tied to patient satisfaction. Improving patient satisfaction is now a multi-billion dollar industry and encroaches on every aspect of healthcare, including residency training. How do doctors at the beginning of their careers affect patient satisfaction and impact Press Ganey Scores? This post reviews two studies shedding light on this issue.

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