In this episode, I’ll discuss an article comparing IV acetaminophen with IV hydromorphone for acute pain in elderly ED patients. Subscribe on iTunes, Android, or Stitcher IV acetaminophen has been a tremendous disappointment when compared to opioids in terms of both efficacy and reducing opioid-related side effects. I have not yet seen a study demonstrating […]

In this episode, I’ll discuss whether a quinolone is really superior to a macrolide for legionella pneumonia. Subscribe on iTunes, Android, or Stitcher Traditionally it is thought that a bacteriocidal antibiotic is preferable to a bacteriostatic one, especially in severe infections such as legionella pneumonia. This leads many clinicians to assume that a quinolone such […]

In this episode, I’ll discuss paralytic first vs sedative first RSI and the chance of first attempt success. Subscribe on iTunes, Android, or Stitcher One of the most significant contributors to a positive outcome for a patient undergoing emergency tracheal intubation is that the first attempt at placing the airway is a success. The purpose […]

In this episode, I’ll discuss how a pharmacist can ensure the best possible outcomes for status epilepticus. Subscribe on iTunes, Android, or Stitcher Whenever I encounter a hospital inpatient with an acute seizure, I make sure that I have IV lorazepam available. Most seizures stop after about 2 minutes. In reality, this means that by […]

In this episode, I’ll discuss linezolid vs clindamycin for toxin inhibition in patients with invasive group A streptococcus infections. Subscribe on iTunes, Android, or Stitcher In episode 962 I discussed a review that concluded clinicians can consider linezolid an appropriate alternative to clindamycin for necrotizing infections due to group A strep. Since then, the Lancet […]

In this episode, I’ll discuss moderate vs low and high volume IV fluid resuscitation in sepsis and septic shock. Subscribe on iTunes, Android, or Stitcher In an effort to bring clarity to the relationship between fluid resuscitation volume and sepsis mortality, a group of authors recently published in the journal Critical Care Medicine a retrospective […]

In this episode, I’ll discuss the use of succinylcholine vs rocuronium for tracheal intubation in emergency department patients. Subscribe on iTunes, Android, or Stitcher Few topics are as hotly debated in emergency medicine circles as the use of succinylcholine vs rocuronium for tracheal intubation. In brief, the “pro succinylcholine” group emphasizes its rapid onset and […]

In this episode, I’ll discuss whether the bispectral index (BIS) correlates well to commonly used sedation scales. Subscribe on iTunes, Android, or Stitcher Bispectral index is commonly used by anesthesia providers as a tool to ensure adequate loss of consciousness in the operating room and lessen the chance of accidental awareness during anesthesia. The use […]

In this episode, I’ll discuss subcutaneous insulin therapy for patients with low to moderate severity DKA. Subscribe on iTunes, Android, or Stitcher When a patient with DKA is treated with a continuous IV infusion of insulin, this requires a high level of nursing care to safely monitor. Often this means the patient is in a […]

In this episode, I’ll discuss what works best for toxin-related status epilepticus. Subscribe on iTunes, Android, or Stitcher While benzodiazepines are first line treat for status epilepticus, they do not work in as many as one-third of patients. Early termination of convulsive status epilepticus is important because it lowers the chance of cardiac and respiratory […]

In this episode, I’ll discuss the antibiotics that inhibit bacterial toxin production. Subscribe on iTunes, Android, or Stitcher Some bacteria produce microbial toxins that significantly contribute to infection severity. Notable examples include Clostridioides difficile, Staphylococcus aureus, and Streptococcus pyogenes. During infection with these organisms, it is possible that therapies that suppress toxin production may lessen […]

In this episode, I’ll discuss the continuation of newly prescribed gabapentin for acute pain management after hospital discharge. Subscribe on iTunes, Android, or Stitcher The frequency of gabapentin use for the treatment of inpatient postoperative pain has increased due to the promotion of multimodal analgesia with the goal of reducing the use of opioids. A […]