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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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. […]

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 […]

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 […]

In this episode, I’ll discuss the effect of a sepsis huddle on identifying sepsis and compliance with the sepsis bundle in an Emergency Department setting. Subscribe on iTunes, Android, or Stitcher The Sepsis huddle has been described as a method of improving sepsis bundle compliance. The concept is that a group of clinicians convene (often […]

In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. Subscribe on iTunes, Android, or Stitcher Despite the black box warning that antipsychotics can increase mortality in elderly patients, medications like haloperidol are sometimes needed to control agitation from hospitalized elderly patients that have delirium […]