In this episode, I’ll discuss an article about using bivalirudin for anticoagulation during ECMO. Subscribe on iTunes, Android, or Stitcher In recent years some ECMO centers have decided to use bivalirudin over heparin to maintain systemic anticoagulation during ECMO as the literature to support this practice has grown. One center that made this switch in […]
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Episode 797: What is a good empiric dose of vancomycin for patients on CRRT?
In this episode, I’ll discuss empiric dosing of vancomycin for patients on CRRT. Subscribe on iTunes, Android, or Stitcher A lower dose of vancomycin is recommended for use in patients receiving CRRT in common 3rd party medication references such as Lexi-Comp. However there is little published data available to base such dosing recommendations on. A […]
Episode 796: When should dialysis be used to treat ethylene glycol poisoning?
In this episode, I’ll discuss when dialysis is recommended to be used to treat ethylene glycol poisoning. Subscribe on iTunes, Android, or Stitcher The metabolites of ethylene glycol (glycolate and oxalate) are responsible for the development of metabolic acidosis, neurotoxicity, acute kidney injury, and mortality. Fomepizole effectively blocks the development of these toxic metabolites and […]
Episode 795: When can octreotide be discontinued in patients with variceal bleeding?
In this episode, I’ll discuss when octreotide can be discontinued in patients with variceal bleeding. Subscribe on iTunes, Android, or Stitcher When given to patients with variceal bleeding, octreotide helps achieve hemostasis and prevent rebleeding. While it is a relatively inexpensive intervention at between $50 and $100 per day, octreotide does carry a high incidence […]
Episode 794: Protocolized diuresis for deresuscitation
In this episode I’ll discuss a pilot study of protocolized diuresis for deresusciation of septic patients. Subscribe on iTunes, Android, or Stitcher Deresuscitation is a term I expect to read much more about in literature in the near future. It refers to the practice of correcting the fluid balance of patients who have just been […]
Episode 793: Topical lidocaine for wound vac dressing changes
In this episode, I’ll discuss topical lidocaine for wound VAC dressing changes. Subscribe on iTunes, Android, or Stitcher Vacuum-assisted closure of wounds uses a device to decrease air pressure on a wound and allow it to heal faster. As part of this process, a wound VAC dressing made of foam or gauze is placed over […]
Episode 792: Should recent laxative use preclude testing for C diff?
In this episode, I’ll discuss whether recent laxative use should preclude testing for C diff. Subscribe on iTunes, Android, or Stitcher The IDSA C Diff guidelines make the following recommendation regarding C Diff testing in a patient who recently received a laxative: Patients with unexplained and new-onset ≥3 unformed stools in 24 hours are the preferred […]
Episode 791: What dose of steroids can prevent post-extubation stridor and re-intubation?
In this episode, I’ll discuss what dose of steroids can prevent post-extubation stridor. Subscribe on iTunes, Android, or Stitcher Corticosteroid administration before elective extubation has been used to prevent post-extubation stridor and reintubation. Multiple steroid regimens have been studied to prevent post-extubation stridor and re-intubation. No one regimen has been proven superior. Three example regimens […]
Episode 790: How well does a negative nasal MRSA screen rule out infection with MRSA?
In this episode, I’ll discuss how well a negative nasal MRSA screen rules out infection with MRSA. Subscribe on iTunes, Android, or Stitcher Many hospitalized patients are treated empirically with anti-MRSA antibiotics only to have cultures come back negative for MRSA after several days of anti-MRSA therapy. This represents an antibiotic stewardship opportunity if the […]
Episode 789: There’s more than one way to properly administer adenosine
In this episode, I’ll discuss an article comparing different methods of administering adenosine. Subscribe on iTunes, Android, or Stitcher Because the half-life of adenosine is measured in seconds, administration must be rapid and followed by a 20 mL saline flush for enough of the medication to reach the site of action before it is metabolized. […]
Episode 788: Persistent MRSA bacteremia after vancomycin therapy
In this episode, I’ll discuss persistent MRSA bacteremia after vancomycin therapy. Subscribe on iTunes, Android, or Stitcher The usual course of treatment for MRSA bacteremia is a minimum of 14 days, and the median time to bacterial clearance is about 7 days. For this reason, IDSA guidelines recommend an assessment to determine whether a change […]
Episode 787: The Mindset of a Clinical Pharmacist
In this episode, I’ll discuss 6 ways to develop a clinical pharmacist’s mindset. Subscribe on iTunes, Android, or Stitcher When it comes to having a positive impact on patient care, how a pharmacist thinks can be as important as their knowledge base. This episode is a collection of 6 mindset techniques that I have found […]
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