In this episode, I’ll discuss the use of NSAIDs in patients with traumatic brain injury. Subscribe on iTunes, Android, or Stitcher Whether it is OK to use nonsteroidal anti-inflammatory drugs (NSAIDs) after a traumatic brain injury (TBI) is controversial. On one hand, non-opioid pain management is important to use whenever feasible; on the other hand, […]

In this episode, I’ll discuss the use of succinylcholine vs rocuronium for tracheal intubation in emergency department patients. Subscribe on iTunes, Android, or Stitcher Few topics are as hotly debated in emergency medicine circles as the use of succinylcholine vs rocuronium for tracheal intubation. In brief, the “pro succinylcholine” group emphasizes its rapid onset and […]

In this episode, I’ll discuss the performance evaluation of a large language model for medication management tasks. Subscribe on iTunes, Android, or Stitcher With the growth of artificial intelligence (AI) tools based on large language models, there is uncertainty on how well they perform clinical tasks such as medication management. A group of researchers published […]

In this episode, I’ll discuss catheter-directed thrombolytics for patients with intermediate-high-risk pulmonary embolism. Subscribe on iTunes, Android, or Stitcher How to use catheter-directed thrombolytics to benefit patients with intermediate-high-risk pulmonary embolism has been the subject of considerable research over the last decade. Researchers recently published a major study in this area in the New England […]

In this episode, I’ll discuss phenobarbital vs. benzodiazepine-based pathways for alcohol withdrawal syndrome in the ICU. Subscribe on iTunes, Android, or Stitcher Considerable research has been done comparing phenobarbital with benzodiazepines for alcohol withdrawal syndrome in critically ill adult patients. A group of authors have synthesized this research in a systematic review and meta-analysis published […]

In this episode, I’ll discuss the antibiotics that inhibit bacterial toxin production. Subscribe on iTunes, Android, or Stitcher Some bacteria produce microbial toxins that significantly contribute to infection severity. Notable examples include Clostridioides difficile, Staphylococcus aureus, and Streptococcus pyogenes. During infection with these organisms, it is possible that therapies that suppress toxin production may lessen […]

In this episode, I’ll discuss the continuation of newly prescribed gabapentin for acute pain management after hospital discharge. Subscribe on iTunes, Android, or Stitcher The frequency of gabapentin use for the treatment of inpatient postoperative pain has increased due to the promotion of multimodal analgesia with the goal of reducing the use of opioids. A […]

In this episode, I’ll discuss a meta-analysis of controlled trials evaluating induction agents for tracheal intubation of critically ill patients. Subscribe on iTunes, Android, or Stitcher When critically ill patients require an induction agent to tolerate tracheal intubation, clinicians must balance induction-agent effectiveness with potential adverse effects. Clinical endpoints of the various studies of induction […]

In this episode, I’ll discuss acetazolamide instead of metolazone as an adjunct to loop diuretics. Subscribe on iTunes, Android, or Stitcher When a patient with volume overload has an insufficient response to loop diuretics, adjunctive therapy with a 2nd diuretic is used. This is referred to as sequential nephron blockade which uses two different mechanisms […]

In this episode, I’ll discuss how early you should start vasopressin after the norepinephrine infusion rate reaches 0.25 μg/kg/min or higher in a patient with septic shock. Subscribe on iTunes, Android, or Stitcher   The best time to add vasopressin after norepinephrine in septic shock is still unclear. A group of authors recently published a […]

In this episode, I’ll discuss whether there is a benefit from switching to dexmedetomidine when sedation is started with midazolam. Subscribe on iTunes, Android, or Stitcher Sedation guidelines recommend light sedation with a non-benzodiazepine agent such as dexmedetomidine or propofol. However, many ICU patients are started on midazolam-based sedation regimens either due to a compelling […]

In this episode, I’ll discuss differences in heart rate in patients with sepsis and AFib between phenylephrine and norepineprhine. Subscribe on iTunes, Android, or Stitcher Phenylephrine, unlike norepinephrine, does not stimulate beta receptors and therefore should not raise a patient’s heart rate. This is often used as a reason to administer phenylephrine to patients with […]