In this episode, I’ll discuss the 6th edition of the European guideline on management of major bleeding and coagulopathy following trauma. Subscribe on iTunes, Android, or Stitcher The 6th edition of the European guideline on management of major bleeding and coagulopathy following trauma has recently been published in the Journal Critical Care. While the majority […]

In this episode, I’ll discuss whether the Tisdale Risk Score can be used to identify ICU patients at risk of QTc prolongation. Subscribe on iTunes, Android, or Stitcher The Tisdale Risk Score (TRS) was first published in 2013 as a way to identify hospitalized patients at risk for QT interval prolongation. The scoring system assigns […]

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 […]

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 […]

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 […]