Dr. Vikasdeep Intensivist

Dr. Vikasdeep Intensivist Contact information, map and directions, contact form, opening hours, services, ratings, photos, videos and announcements from Dr. Vikasdeep Intensivist, Doctor, Bathinda.

Consultant Intensivist dealing with all kind of critical cases and general medicine cases like

Ventilator cases
shock (unrecordable BP)
Brain Death
sepsis with Multi drug resistant organisms, Poisoning, Snake Bites
Complicated Dengue Malaria Typhoid

My CCM (Critical Care Medicine) Fellowship. Thank you everyone who I came in touch with during pursuit.
18/05/2022

My CCM (Critical Care Medicine) Fellowship. Thank you everyone who I came in touch with during pursuit.

A complicated case of Organophosphate Poisoning55 year old gentleman k/c/o Coronary Artery Disease referred after 5 days...
02/05/2022

A complicated case of Organophosphate Poisoning

55 year old gentleman k/c/o Coronary Artery Disease referred after 5 days of OP Poisoning in altered sensorium, 1 episode of seizure, quadriparetic on tracheostomy requiring ventilatory suppport.

Initial examination showed altered sensorium, power 2/5, dehydrated, increased Heart rate with stable Blood Pressure. Patient was immediately shifted to ICU.

Initial labs showed LVEF of 35%, Deranged kidney function & very high Sodium (Na 179). Outside medications showed Furosemide & Mannitol. Patient was put on ventilatory support with aggressive ICU care & aggressively resuscitated (given fluids). A fine balance was tried to kept between demand and fluid overload. Patient was given aggressive physiotherapy, given high protein diet, rapidly mobilised. Large amounts of fluids were given without going into overload.

Upon the gradual return of limb power, patient was gradually weaned off ventilator and successful decannulated after passing swallowing test & attaining good cough reflex.

Lessons:

1. Urine inducing medications (Furosemide & Mannitol should not be given as “routine” in patients with altered sensorium, seizure and Reduced heart pumping.

2. Fluid judgement should be made clinically first before jumping onto device based assessments.

3. Atropine & 2-Pralidoxime should only be given & stopped when indicated.

4. A good nursing care is all that finally takes out a patient from such turbulent course.

65 year old gentleman, chronic heavy alcoholic came with altered sensorium, high grade fever 🥵 and shock (?septic). Diff...
08/03/2022

65 year old gentleman, chronic heavy alcoholic came with altered sensorium, high grade fever 🥵 and shock (?septic). Differential diagnosis

1. Septic encephalopathy
2. Toxic Encephalopathy
3. Metabolic Encephalopathy
4. Unknown Drug Encephalopathy
5. CNS structural lesions

After a meticulous history & examination 🧐 & relevant investigations, we zeroed in on septic cause as urine showed Acinetobacter baunanni ( New Delhi Bug 🐜 NDM i.e Caraapenemase resistant Acinetobacter CRAB).

Treated with adequate combinations of antibiotics, patient was tracheostomised due to poor cough 😷 reflex and prolonged ventilation requirement.

Patient recovered well and was sent home 🏡 on tracheostomy.

Organised a work shop on the importance of Enteral Nutrition in ICU. Important salient features of nutrition in ICU were...
03/12/2021

Organised a work shop on the importance of Enteral Nutrition in ICU. Important salient features of nutrition in ICU were highlited and recapitulated. Take home messages:

1. Nutrition is a form of therapy, more important than medicines.

2. Always prefer Gut feed whenever possible. Total parenteral ( intravenous) nutrition should be the last resort.

3. Use Nutritional assessment scores. (SGA, NUTRIC Score).

4. Try to inculcate ASPEN/ ESPEN guidelines in your practice.

02/07/2021

OP Poisoning (Pesticide) Masquerader

This patient presented with typical history(alleged) & symptoms (increased secretions, coma) s/o OP Poisoning. But detailed examination showed NORMAL PUPILS & ABSENCE of GARLICKY ODOUR which led to thinking of alternative diagnosis. On pestering, relatives finally told the correct toxin patient was exposed to. Thus patient was saved from unnecessary detoxification & antidote therapy. At the end, Patient recovered fully without any residual deficit.

Lesson: 1. Chloracetanilide (Herbicide, W**d Killer) Poisoning can be a great mimicker of OP Poisoning, though it’s very rare.

2. Meticulous physical examination can save unnecessary investigations & polypharmacy.

3. Not every presentation with increased secretions is OP (Pesticide) Poisoning.

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Bathinda
151001

Telephone

+919872807398

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