Caroline Fife M.D.
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    • The COVID-19 Diaries
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    • Health Information Technology and Wound Care
    • Healthcare Payment Policy
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    • Pressure Cooker: Rethinking Pressure Ulcers
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In Honor of World Wide Pressure Injury Prevention Day – Let’s Talk About What REALLY Causes PI’s

In Honor of World Wide Pressure Injury Prevention Day – Let’s Talk About What REALLY Causes PI’s

by Caroline Fife, M.D. | Nov 19, 2020 | Pressure Cooker: Rethinking Pressure Ulcers

In honor of “World Wide Pressure Injury Prevention Day,” I’d like to propose that we acknowledge that severe pressure injuries (and probably “stage 1 pressure injuries”) form from the inside-out due to the compromise of named blood vessels that supply a 3-dimensional...
The Miracle of NPWT

The Miracle of NPWT

by Caroline Fife, M.D. | Jul 7, 2020 | Health Information Technology and Wound Care, Pressure Cooker: Rethinking Pressure Ulcers

Do you remember how you felt the first time you saw this? Do you still have the photos of the first patient you treated with Negative Pressure Wound Therapy (NPWT)? The photos below are very poor quality because they are Polaroids from 1997! This was one of the first...
In Honor of World Wide Pressure Injury Prevention Day – Let’s Talk About What REALLY Causes PI’s

The “Photo Review” Challenge – and a New Paradigm of Pressure Injury Formation

by Caroline Fife, M.D. | Jun 4, 2020 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

This morning I did Grand Rounds for the Baylor Department of Geriatrics (via Zoom, of course!), discussing a new paradigm for pressure ulcer formation. I’ve blogged about this before, and published a paper about it. If you would like to think about something OTHER...
WPS Coverage for Debridement and What We REALLY Need to Worry About

WPS Coverage for Debridement and What We REALLY Need to Worry About

by Caroline Fife, M.D. | Oct 7, 2019 | Healthcare Payment Policy, Pressure Cooker: Rethinking Pressure Ulcers

WPS Government Health Administrators (GHA) is a Medicare Administrative Contractor (MAC) and its Local Coverage Determination (LCD) on Wound Care became effective on April 16, 2018. The U.S. states impacted by the WPS LCD on Wound Care are: Jurisdiction 5 (J5) –...
Yes! It IS a Pressure Injury! An Ischemia Reperfusion Injury…

Yes! It IS a Pressure Injury! An Ischemia Reperfusion Injury…

by Caroline Fife, M.D. | Aug 21, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry

The story of my son’s intraoperative pressure injuries In August of 2017, Hurricane Harvey dumped 52 inches of rain on Houston turning the 4th largest city in America into a literal island. However, with our house above water, I was selfishly focused on...
The Undaunted Spirit Award

The Undaunted Spirit Award

by Caroline Fife, M.D. | Aug 19, 2019 | Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers

Patients inspire me every day. This lady in her 9th decade showed me a picture on her smart phone (which alone is an accomplishment). She’s at church playing the accordion and the piano at the same time. I’ll add her to my gallery of patients with “undaunted spirit.”...
Them That's Been Sued and Them That's Going to Be

Them That's Been Sued and Them That's Going to Be

by Caroline Fife, M.D. | Jul 8, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

To paraphrase Bum Phillips, “There’s two kinds of doctors, them that’s been sued and them that’s gonna be sued.” I’ve been sued more than once but they were all “non-suited” except one. When I was on the medical school faculty, the University paid a settlement on my...
In Honor of World Wide Pressure Injury Prevention Day – Let’s Talk About What REALLY Causes PI’s

WATCH: 5th MT Head Pressure Ulcer Forms from the Inside Out

by Caroline Fife, M.D. | Jun 12, 2019 | Pressure Cooker: Rethinking Pressure Ulcers

This pressure ulcer formed from the inside out on the right 5th MT head. The lesion evolved over 11 weeks. What do you think this means? If you saw the wound as it is on the photo to the right below, is there any intervention that would have prevented the development...
Strategies for Winning Pressure Ulcer Lawsuits

Strategies for Winning Pressure Ulcer Lawsuits

by Caroline Fife, M.D. | Feb 28, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

Successful Strategies for Winning Pressure Injury Litigation against Health Care Providers Talk about why they should be able to “Get to Zero!” Use the facility’s “Pressure Ulcer Prevention Protocols” against them. Use the NPUAP Staging System – the Plaintiff’s best...
OxyBand and Digital Ischemia

OxyBand and Digital Ischemia

by Caroline Fife, M.D. | Feb 11, 2019 | Don't Miss This, Pressure Cooker: Rethinking Pressure Ulcers

I recently saw a patient with digital ischemia who got improvement in both pain and tissue viability with transdermal oxygen from the OxyBand dressing. There are a lot of possible reasons for digital ischemia, so it’s important to know why the patient has ischemic...
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