Decode Medicine from OPD to ICU rounds
ICU Delirium Definition(DSM-5) ICU delirium is an acute, fluctuating disturbance of consciousness and cognition, characterized by: Impaired attention Altered level of awareness Disorganized thinking ± perceptual disturbances It develops over hours to days and is a manifestation of acute brain dysfunction.ICU psychosis’ is an outdated misnomer. DSM-5 criteria explicitly state that these new changes in […]
Acalculous Cholecystitis (AAC) Acalculous cholecystitis (AAC) is acute inflammation of the gallbladder in the absence of gallstones. It primarily occurs in critically ill or postoperative patients, often those with sepsis, trauma, burns, or prolonged fasting/parenteral nutrition. AAC represents about 5–10% of all cases of acute cholecystitis, but it carries a much higher morbidity and mortality
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SHOCK Definition Shock is acute circulatory failure resulting in inadequate oxygen delivery (DO₂) relative to tissue oxygen demand (VO₂), leading to cellular dysoxia, organ dysfunction, and, if untreated, death. The key concept is inadequate tissue perfusion, not simply low blood pressure. Why Shock Is Difficult to Define Historically, shock was equated with hypotension. But hypotension
Hypertensive Crisis Hypertensive crisis is a spectrum of severe blood pressure elevation associated with actual or potential acute target-organ damage. It is broadly classified into: Hypertensive Emergency Hypertensive Urgency (The 2024 AHA Scientific Statement and 2025 AHA/ACC Hypertension Guideline recommend abandoning the term “hypertensive urgency.” Instead, patients are classified as:severe asymptomatic hypertension) Hypertensive Emergency Severe
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Acute Pancreatitis Acute Pancreatitis is an acute inflammatory process of the pancreas caused by premature activation of pancreatic digestive enzymes leading to autodigestion, inflammation, edema, necrosis, and systemic inflammatory response. It ranges from: Mild self-limiting interstitial edema to Severe necrotizing pancreatitis with multiorgan failure. Diagnostic Criteria (Revised Atlanta Classification) Diagnosis requires 2 of 3 criteria:
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Ventilator Settings Trigger Trigger is the mechanism that initiates a ventilator breath. In simple words:”What tells the ventilator to start inspiration?” The trigger may be:Patient generated or Time generated Types of Trigger A. Time Trigger Ventilator starts breath according to set respiratory rate. Example:RR = 12/min so Breath every: 60/12 = 5 sec Ventilator triggers
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One of the most common frustrations among intensivists is the lack of autonomy. In many hospitals, the intensivist manages the ventilator, vasopressors, CRRT, and life-threatening emergencies—but the final decisions often remain with the admitting consultant. The debate usually revolves around open ICUs vs. closed ICUs. But perhaps we’re asking the wrong question. The Real Problem
Can Intensivists Ever Have True Autonomy? The Answer May Lie Outside the ICU. Read More »
Every conference promises the same thing: “Advancing medical education.” Yet every delegate leaves with a branded bag, a notebook they’ll never use, a pen that disappears within a week, a conference T-shirt, souvenirs, and sometimes an extravagant gala dinner. It raises an uncomfortable question: Are we paying for education—or for packaging? Where Does the Registration
One of the most repeated phrases in medicine is: “Guidelines are only meant to guide you.” It sounds wise. It sounds balanced. But here’s the uncomfortable question: How many of us have actually read the guideline before saying that? Guidelines Are More Than Recommendations Modern clinical guidelines are not someone’s opinion. They are the result
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Every year, thousands of doctors travel across the country to attend conferences. The justification is almost always the same: “It’s for academic purposes.” But an uncomfortable question deserves an honest discussion: How much of what we learn at conferences actually changes our clinical practice? The Original Purpose Medical conferences were designed to: When these objectives