In this episode, I’ll discuss how getting the depth of sedation correct in the ED might reduce mortality rates by half. Subscribe on iTunes, Android, or Stitcher A group of researchers from Washington University School of Medicine in St. Louis published a prospective before-after pilot and feasibility trial of an educational initiative aimed at instituting […]

In this episode, I’ll discuss the impact of pharmacist involvement on hospital sepsis response teams. Subscribe on iTunes, Android, or Stitcher While it makes sense that having someone who focuses on medications on a sepsis response team would lead to faster antibiotic administration times, data supporting this was sparse. That is until a group of […]

In this episode, I’ll discuss using clinical decision support to minimize sedation gaps in patients receiving rocuronium for rapid sequence intubation. Subscribe on iTunes, Android, or Stitcher Awareness with paralysis in ED patients who receive the long-acting paralytic rocuronium during rapid sequence intubation but have a delay in receiving adequate sedation is a continuing area […]

In this episode, I’ll discuss anaphylaxis to sugammadex. Subscribe on iTunes, Android, or Stitcher The rate of anaphylactic reaction to the use of sugammadex has historically been put at somewhere between 1 in 2000 and 1 in 4000 patients; however, one article that used population statistics suggests it is more like 1 in 25,000 patients. This […]

In this episode, I’ll discuss using actual vs ideal body weight for dosing of sedatives in critically ill patients. Subscribe on iTunes, Android, or Stitcher The majority of sedative medications used in critically ill patients to allow them to tolerate mechanical ventilation and other aspects of ICU care are lipophilic.  As such, the medications have […]

In this episode, I’ll discuss how the use of dopamine for shock affects mortality rates. Subscribe on iTunes, Android, or Stitcher Surviving Sepsis Guidelines do not list dopamine as one of the vasopressors to use for the treatment of septic shock, and other types of shock are usually treated with non-dopamine vasopressors as well due […]

In this episode, I’ll discuss cefazolin for methicillin-susceptible staphylococcus aureus bacteremia. Subscribe on iTunes, Android, or Stitcher Until recently, the strongest data on what to use to treat MSSA bacteremia has always been for the penicillinase-resistant penicillins like nafcillin and cloxacillin. But these antibiotics have high rates of adverse events. Cefazolin has a much more […]

In this episode, I’ll discuss the risk factors associated with the development of venous thromboembolism in ICU patients. Subscribe on iTunes, Android, or Stitcher An review and systematic analysis published in Critical Care Medicine evaluated 39 observational cohort studies involving over 700,000 patients to identify what risk factors were associated with the development of VTE […]

In this episode, I’ll discuss sodium bicarbonate for critically ill adult patients with metabolic acidosis and shock. Subscribe on iTunes, Android, or Stitcher The tale as old as time with sodium bicarbonate is that while it corrects plasma pH in critically ill patients with metabolic acidosis, whether clinically meaningful outcomes are improved remains uncertain. To […]

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 […]

In this episode, I’ll discuss an article on the use of tranexamic acid to reduce transfusion in major noncardiac surgery. Subscribe on iTunes, Android, or Stitcher Plenty of surgical protocols have incorporated the use of tranexamic acid to reduce the need for transfusion, especially in cardiac surgical procedures. A group of authors recently published a […]