A 2014 Critical Care trainee shares her daily experiences during the onsite training portion
MONDAY (DAY 6)
Still in the SICU, we have new admissions—pancreatic cancer with pleural effusions. Another patient is scheduled for a hepatectomy this morning. Patient #4 from yesterday has SCr at 5.0, all medications adjusted for renal function, including the famotidine in the TPN. Our thyroidectomy Patient #2 from yesterday is not doing too great; she has a Richmond Agitation Sedation Scale (RASS) of -4 to -5 off sedation.
I had two afternoon topic discussions with Dr. Harinstein. They were:
- Friday: Nutrition support
— Caloric goals, 3 in 1 compatibilities. Discussions on the use of standard clinimix premixed solution vs. non-standard formulations. Addition of medications to parenteral nutrition, (for example, famotidine, insulin and octreotide, etc.) Shortages of IV Fat emulsion, trace elements and electrolytes.Dosing of levothyroxine in the setting of thyroidectomy.
Acute pancreatitis and abdominal compartment syndrome—Inflammatory processes, objective measurements and imaging studies. Controversies on administration of antibiotics for necrotizing and hemorrhagic pancreatitis.
Follow me all this week as I blog about my daily experiences at The Cleveland Clinic. You can read my Day 5 post at http://connect.ashp.org/blogs/ola-adejuwon/2014/08/14/two-weeks-in-a-critical-care-traineeship-day-5.
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.