Should we use sliding-scale insulin as monotherapy for hospitalized diabetic patients? Slide-scale insulin (SSI) is a method to correct hyperglycemia through frequent dosing of short acting insulin based on a patient’s blood glucose and pre-set rubric. When blood glucose is low little or no insulin is given and when blood glucose is elevated higher doses
Profile Shaun
Does metformin need to be routinely held in the hospitalized patient? Metformin is a widely prescribed oral medication used in the management of type 2 diabetes mellitus. It is routine practice to hold metformin in the hospitalized patient due to risk of metformin-associated lactic acidosis (MALA). A recent publication by the Journal of Hospital
Your patient has end-stage renal disease (ESRD) and is anuric on chronic hemodialysis (HD). He receives angiography while admitted for concern for ACS. Despite having his regularly scheduled HD the day prior and showing no signs of volume overload or metabolic disturbances after, he receives emergent HD post-procedure. Is this necessary or could he have
Do you need to place a central line in every patient requiring initiation of vasopressors A very common scenario we see in the hospital is a patient in shock during which the decision to start vasopressors is made. Is central venous catheter (CVC) placement necessary in all of these patients? A recent “Things We Do
Use clinical judgment or an existing risk stratification system, such as MEWS or PEWS, to identify patients who may benefit from more or less monitoring. Forgo overnight vital sign checks for low-risk patients. Check overnight vitals for low-risk patients at 10 pm and 6 am. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204996/