On July 1, new doctors start their residency. On July 4, our nation celebrates its independence. This is fitting because, truly, we in the medical field are fighting for the freedom of our patients. 

Typically, we titrate Vascopressors to a mean arterial pressure of 65. Does this harm patient with septic shock? Dr. Hassabolus goes over the literature.

I am clearly in the aggressive fluid resuscitation camp for patients who present with septic shock or sepsis-induced hypotension. And I have been vindicated by the literature.

CLASSIC: https://www.nejm.org/doi/full/10.1056/NEJMoa2202707

CLOVERS: https://www.nejm.org/doi/full/10.1056/NEJMoa2212663

CHEST Review: https://journal.chestnet.org/article/S0012-3692(23)00637-2/fulltext 

ESICM Guidelines: https://pubmed.ncbi.nlm.nih.gov/40163133/

I was taken aback by the term, "Medical Gaslighting," used in this recent article. So, I sat down with the principal author and discussed the article and its larger implications beyond Gynecology. 

Article link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2833711

A malpractice lawsuit can be very stressful for physicians - it sure was stressful for me. So, are all plaintiff attorneys bad people? What about those physicians who are expert witnesses for plaintiffs? I asked this and much more of Dr. Jeff Willis, an Emergency Medicine physician who left bedside practice to do medical legal consulting full time. It was an eye-opening conversation. 

Dr. Willis' Consulting Firm: https://ocmedlegal.com/

Expert Retainer: https://www.expertretainer.com/ 

Like it or not, compliance with the SEP-1 Bundle is here to stay, despite its questionable effect on outcomes. We can either rail against it or learn to how do it well. In this episode, to culminate Critical Care Awareness Month, Dr. Hassaballa shares tips on how to achieve good results with the SEP-1 bundle. 

PulmCCM is one of the best Substacks out there. So, I sat down with Dr. Matt Hoffman, Critical Care physician and creator of PulmCCM to discuss his journey and evidence-based medicine in general. 

Substack Link: www.pulmccm.org 

When Death Comes To The Intensivist: https://www.sensible-med.com/p/when-death-comes-to-the-intensivist 

In the last episode of the “Sleep in the ICU” series, Dr. Hassaballa goes through several easy tips to help get a good night’s sleep. 

American Academy of Sleep Medicine Tips: https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/ 

Dr. Hassaballa tells the story of when he filled in as a Tele-ICU Nurse. It wasn’t a pretty picture, and it highlights how important nurses truly are to the healthcare field. 

A very Happy Nurses Week to every nurse in the world! There is no “care” in healthcare without nurses. 

In Part 2 of the Sleep in the ICU series, Dr. Hassaballa discusses the SCCM guidelines with respect to sleep in critically ill adults and what we should do in the ICU. 

SCCM Guidelines: https://www.sccm.org/clinical-resources/guidelines/guidelines/guidelines-for-the-prevention-and-management-of-pa 

SCCM Update: https://sccm.org/clinical-resources/guidelines/guidelines/focused-update-padis-guideline