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Two Weeks in a Critical Care Traineeship - Day 5

By Ola Adejuwon posted 08-17-2014 20:35

  
A 2014 Critical Care trainee shares her daily experiences during the onsite training portion

FRIDAY (DAY 5)
I am rounding in the surgical ICU (SICU) today with Dr. Lisa Harinstein. Cleveland Clinic has 34 SICU beds, with 2 clinical pharmacy specialists. We rounded on a 10-bed SICU team. Some of my patients’ issues were:

- A 54-year-old female with PMH of enterocuteanous fistula, s/p SB resection, now with short gut syndrome presenting with hypotension, severe abdominal pain taken emergently to the operating room. Post/op, the patient had intestinal explant, now with urine output < 0.5 ml/kg/hr. Serum creatinine is 3 today, up from 2.5 yesterday. The patient is on propofol and fentanyl and has been dependent on parenteral nutrition. Pancreatic swab cultured VR Enterococcus faecium and blood cx - pan susceptible Klebsiella pneumoniae.

- A 59-year-old female with nodule goiter requiring thyroidectomy complicated by hematoma and pulseless electrical activity (PEA).

-    A 41-year-old female with necrotizing pancreatitis secondary to gallstones. Presenting now with abdominal compartment syndrome.

-    A 58-year-old male POD #1 of liver transplant. History of HCV & HCC. The patient was initiated on transplant regimen—mycophenolate, tacrolimus, steroids, valganciclovir and Bactrim.


Follow me this week and next as I blog about my daily experiences at The Cleveland Clinic! (Read my Day 4 post at http://connect.ashp.org/blogs/ola-adejuwon/2014/08/12/two-weeks-in-a-critical-care-traineeship-day-4).

If the Critical Care Traineeship sounds right for you, you can learn more about it at www.ashpfoundation.org/criticalcare. Applications for 2015 are being accepted through September 19, 2014.

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