Critical Thinking in the ICU

Dr. Aaron Light will discuss unique situations encountered in the ICU that require the clinician to critically think. In addition he will present patient cases with pertinent and distracting information for you to determine what is the best course of action for the patient. After which a review of each will offer a better understanding and discuss the associated pathology, physiology and assessment components.

[@maximuz6050]

Hello, 10 year practicing RRT here. Case studies were great on this video, really gets the brain working and they are fun. I thought I would chime in on Case #4 from the facebook post. I see where Dr. Light was coming from with the ABG info but putting that aside, the pH and bicarb are showing us a severe metabolic acidosis. If this example weren't real would the ABG numbers wouldn't matter. If anything I think the most important information missing is the patient history. I took this example case as a test question almost. Taking that into account, this seemed as if the patient had a seizure from high blood glucose levels(maybe DKA) given that 1 liter of fluid helped change the ABG dramatically within an hour. Likely fluid was tried first with insulin likely to be started if indicated. Having low or high blood glucose can cause seizures to happen but treatment will be different for each type. Maybe this patient was diabetic without even knowing! It happens. Thanks for the CEU's Drager!