In this episode, I’ll discuss whether melatonin can prevent ICU delirium. Subscribe on iTunes, Android, or Stitcher Numerous medications have been studied in an attempt to find something that prevents the development of ICU delirium. Studies involving melatonin have produced mixed results, and a group of authors from Australia sought to determine via a high […]
Episode 699: Can non-verbal ICU pain scales indicate the severity of pain?
In this episode, I’ll discuss whether non-verbal ICU pain scales can indicate the severity of pain. Subscribe on iTunes, Android, or Stitcher The use of pain assessments for patients who are unable to verbally communicate are recommended in the SCCM Pain, Agitation & Delirium Guidelines. 2 examples of such assessments are the Behavioral Pain Scale […]
Episode 698: Does Tranexamic Acid Have a Role In Aneurysmal Subarachnoid Hemorrhage?
In this episode, I’ll discuss whether tranexamic acid has a role in the treatment of aneurysmal subarachnoid hemorrhage. Subscribe on iTunes, Android, or Stitcher Tranexamic acid is an antifibrinolytic agent that inhibits the conversion of plasminogen to plasmin. This results in the inhibition of fibrinolysis and should promote the stabilization of a clot that is […]
Episode 697: Lipid Rescue Dosing for LAST vs Enteral Drug Toxicity
In this episode, I’ll discuss the dosing of lipid rescue therapy for LAST vs enteral drug toxicity. Subscribe on iTunes, Android, or Stitcher Intravenous lipid emulsion (ILE) or “lipid rescue” therapy is used in local anesthetic systemic toxicity (LAST) and enteral drug toxicity. Anesthesia, toxicology, and ACLS guidelines recommend intravenous fat emulsion with various levels […]
Episode 696: Is your micro lab hiding susceptibility data from you?
In this episode, I’ll discuss the suppression of antimicrobial susceptibility results. Subscribe on iTunes, Android, or Stitcher When a hospital microbiology laboratory performs antimicrobial susceptibility testing using microdilution or disk diffusion methods, not all of the results are presented to clinicians in the medical record. Some of the data is ‘suppressed’ meaning the micro lab […]
Episode 695: Why does ketamine for RSI sometimes cause post-induction hemodynamic instability?
In this episode, I’ll discuss why ketamine can sometimes cause post-induction hemodynamic instability when it is used for rapid sequence intubation. Subscribe on iTunes, Android, or Stitcher While ketamine is often considered a hemodynamically neutral induction agent for rapid sequence intubation, there are reports of post-induction hypotension and hemodynamic collapse occurring occasionally with ketamine use. […]
Episode 694: What vasopressor is best to use in traumatic brain injury?
In this episode, I’ll discuss an article about which vasopressor is best in early traumatic brain injury patients. Subscribe on iTunes, Android, or Stitcher Patients who have severe traumatic brain injury and develop hypotension that requires vasopressor therapy are already at risk for mortality and poor long term outcomes. But could the choice of vasopressor […]
Episode 693: Fondaparinux in critically ill patients with severe renal dysfunction
In this episode, I’ll discuss an article about using fondaparinux in critically ill patients with severe renal dysfunction. Subscribe on iTunes, Android, or Stitcher Evaluating options for venous thromboembolism (VTE) prophylaxis in critically ill patients is challenging and many issues can limit options including renal failure, bleeding risk, and thrombocytopenia. Fondaparinux use is often […]
Episode 692: Is the story for vitamin C in critically ill patients over?
In this episode, I’ll discuss the use of vitamin C in critically ill patients. Subscribe on iTunes, Android, or Stitcher Even before the combination of vitamin C with thiamine and hydrocortisone was published, researchers have been exploring the potential benefit of vitamin C use in critically ill patients. The journal Critical Care Medicine has recently […]
Episode 691: How does obesity affect SC and IM medication administration?
In this episode, I’ll discuss how obesity affects SC and IM medication administration. Subscribe on iTunes, Android, or Stitcher The thickness of the subcutaneous layer increases with obesity and this has potential implications for both subcutaneous and intramuscular medication administration. The AJHP recently published a review article on the implications of obesity for drug administration […]
Episode 690: What is the incidence of torsades from low-dose ondansetron in peri-operative patients?
In this episode, I’ll discuss the incidence of torsades from low-dose ondansetron in peri-operative patients. Subscribe on iTunes, Android, or Stitcher Ondansetron prescribing information has a warning that Electrocardiogram (ECG) changes including QT interval prolongation have been seen in patients receiving ondansetron. Some references list this as a concern, but many clinicians believe that a […]
Episode 689: What is the best vasopressor to use in post-resuscitation shock?
In this episode, I’ll discuss what vasopressor to use in post-resuscitation shock. Subscribe on iTunes, Android, or Stitcher The ideal choice of vasopressor for post resuscitative shock is unknown, and researchers from the Paris Cardiovascular Research Center conducted an observational multicenter study to determine whether epinephrine or norepinephrine was the superior vasopressor to use in […]
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