In this episode, I’ll discuss whether a nasal MRSA screen is useful for choosing antibiotics in critically ill patients with an intraabdominal infection. Subscribe on iTunes, Android, or Stitcher A recent multicenter, retrospective, cohort study looking at the performance of a nasal MRSA screen in predicting intraabdominal infection with MRSA was published in the journal Pharmacotherapy. […]
Episode 583: The first update to the SCCM Guidelines on the Management of Adults With COVID-19 in the ICU
In this episode, I’ll discuss the first update to the Surviving Sepsis Campaign Guidelines on the Management of Adults With Coronavirus Disease 2019 (COVID-19) in the ICU. Subscribe on iTunes, Android, or Stitcher Published recently in the journal Critical Care Medicine is the first update to the Surviving Sepsis Campaign Guidelines on the Management of Adults With […]
Episode 582: Why hypokalemia can result from digoxin immune fab fragment administration
In this episode, I’ll discuss why hypokalemia can result from digoxin immune fab fragment administration. Please note, in the recording, I call this “episode 588” however it is in fact episode 582. Subscribe on iTunes, Android, or Stitcher In the setting of digoxin toxicity, the sodium-potassium ATPase pump is impaired and potassium shifts from the intracellular […]
Episode 581: A case of antidepressant discontinuation syndrome in the ICU
In this episode, I’ll discuss a case of antidepressant discontinuation syndrome in the ICU. Subscribe on iTunes, Android, or Stitcher Antidepressant discontinuation syndrome has a significant potential to occur in ICU patients. This could be from unrecognized withdrawal from the antidepressant when home medications are stopped during the initial treatment of critical illness or from […]
Episode 580: How common is paralysis with awareness in the ICU?
In this episode, I’ll discuss awareness with paralysis in the ICU. Subscribe on iTunes, Android, or Stitcher In episode 578 I discussed the ED-AWARENESS study, a single-center, prospective, observational cohort study on 383 mechanically ventilated ED patients that found a 2.6% incidence of awareness with paralysis in ED patients. Recently in Critical Care Medicine a meta-analysis […]
Episode 579: Three Alternative routes of administration for dexmedetomidine
In this episode, I’ll discuss 3 Alternative routes of administration for dexmedetomidine. Subscribe on iTunes, Android, or Stitcher Dexmedetomidine is an alpha2 adrenergic agonist sedative agent commonly used in the ICU as a continuous IV infusion. However, alternative routes of administration for dexmedetomidine have been studied. In a study of 8 healthy volunteers, dexmedetomidine 1 […]
Episode 578: How common is awareness with paralysis in the ED after RSI?
In this episode, I’ll discuss the frequency of awareness with paralysis in the ED. Subscribe on iTunes, Android, or Stitcher Rapid sequence intubation is a common procedure in the ED. After this procedure where a paralytic such as succinylcholine or rocuronium has been used along with a short-acting sedative such as propofol, ketamine, or etomidate, […]
Episode 577: Succinylcholine vs rocuronium with magnesium pretreatment
In this episode, I’ll compare succinylcholine vs rocuronium with magnesium pretreatment. Subscribe on iTunes, Android, or Stitcher Succinylcholine and rocuronium are the two main neuromuscular blockers that are used in rapid sequence intubation. Many clinicians have a strong preference for one or the other based on how they value the small differences between them. Succinylcholine […]
Episode 576: Predicting Success of Dexmedetomidine as a Sedative
In this episode, I’ll discuss predicting the success of dexmedetomidine as a sedative. Subscribe on iTunes, Android, or Stitcher Anecdotally, dexmedetomidine has always seemed like a hit-or-miss sedative, working wonderfully in many patients and barely or not at all in others. Researchers recently published in Pharmacotherapy a single-center, retrospective, cohort study of 158 critically ill […]
Episode 575: Novel dosage forms that should not be crushed (but look like they can be)
In this episode, I’ll discuss novel dosage forms that should not be crushed but look like they can be. Subscribe on iTunes, Android, or Stitcher Two relatively new dosage form technologies are nanocrystals and amorphous solid dispersions. These technologies are meant to address the problems of oral absorption of certain medications that have poor aqueous […]
Episode 574: The 4 factors that predict agitation in lightly sedated ventilated patients
In this episode, I’ll discuss the 4 factors that predict agitation in lightly sedated ventilated patients. Subscribe on iTunes, Android, or Stitcher Light sedation is encouraged in ventilated patients due to less delirium. However agitation is one of the risks of a light sedation strategy. If the agitation is not treated in time, a patient […]
Episode 573: Ceiling dose of ketorolac for renal colic in the ED
In this episode, I’ll discuss the ceiling dose of ketorolac for renal colic in the ED. Subscribe on iTunes, Android, or Stitcher The analgesic ceiling dose of ketorolac is 10 mg, and this has been established in several articles going as far back as more than 30 years ago. In 1989, a study in the Journal […]
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