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So, I did the search function, and still have some questions.
I'm starting SICU 8/1 and have a few questions that Marino perhaps doesn't answer. Forgive me if these seem rudimentary, but these questions are often not taught (and can be institutional) or written about (often because no clear consensus may exist and thus to publish would open the author up to criticism from all levels).
HOWEVER, I'm looking for generalities (I know there are exceptions which I'll handle) and little pearls. I know to take certain things with a grain of salt as, well, things vary......
Here they are:
First, other than Marino, are there any good SICU (or just CCM) pocket books out there which are worthy? I like Marino in that he explains things very well.
**Any resources on chest tube management? Marion says the chest tube need NOT be connected to a vacuum source. But, at what general "level" can you determine a tube may be removed??
**In the SICU (I had an MICU rotation MS4), which are the "go to" vent settings?? Also, I've noticed that semantics comes into play at different institutions (ex: PEEP with Pressure Support seems essentially like BIPAP only with an ET Tube and Vent). Is APRV (airway pressure release ventilation) becoming popular in ARDS cases?? Also, do ARDS cases in SICU go to MICU?? OR do the SICU folks manage them there.
**I've never been clear about blood cultures, frankly. If you get a blood Gram stain AND culture, shouldn't the Gram stain always (aside from fungal or Mycobacterial) come back ASAP?? Also, how many days can you wait until the blood cultures remain negative, to call them negative? (I will be reading Marino but if anyone has this at their fingertips, any general rules are appreciated). *****I know it takes different bugs different amounts of time to culture, but is there a general rule? I've always heard 48 hrs.
**Any key concepts one should brush up on prior to the rotation. I always like to hit the ground running, and any input is appreciated.
Thanks for the input, in advance. Again, I'll be reading Marino starting tonight or tomorrow.
cf
I'm starting SICU 8/1 and have a few questions that Marino perhaps doesn't answer. Forgive me if these seem rudimentary, but these questions are often not taught (and can be institutional) or written about (often because no clear consensus may exist and thus to publish would open the author up to criticism from all levels).
HOWEVER, I'm looking for generalities (I know there are exceptions which I'll handle) and little pearls. I know to take certain things with a grain of salt as, well, things vary......
Here they are:
First, other than Marino, are there any good SICU (or just CCM) pocket books out there which are worthy? I like Marino in that he explains things very well.
**Any resources on chest tube management? Marion says the chest tube need NOT be connected to a vacuum source. But, at what general "level" can you determine a tube may be removed??
**In the SICU (I had an MICU rotation MS4), which are the "go to" vent settings?? Also, I've noticed that semantics comes into play at different institutions (ex: PEEP with Pressure Support seems essentially like BIPAP only with an ET Tube and Vent). Is APRV (airway pressure release ventilation) becoming popular in ARDS cases?? Also, do ARDS cases in SICU go to MICU?? OR do the SICU folks manage them there.
**I've never been clear about blood cultures, frankly. If you get a blood Gram stain AND culture, shouldn't the Gram stain always (aside from fungal or Mycobacterial) come back ASAP?? Also, how many days can you wait until the blood cultures remain negative, to call them negative? (I will be reading Marino but if anyone has this at their fingertips, any general rules are appreciated). *****I know it takes different bugs different amounts of time to culture, but is there a general rule? I've always heard 48 hrs.
**Any key concepts one should brush up on prior to the rotation. I always like to hit the ground running, and any input is appreciated.
Thanks for the input, in advance. Again, I'll be reading Marino starting tonight or tomorrow.
cf