In this episode, I’ll discuss subcutaneous insulin for the treatment of diabetic ketoacidosis (DKA). Subscribe on iTunes, Android, or Stitcher Diabetic ketoacidosis (DKA) is a serious condition with high mortality if not treated properly. The usual treatment for DKA involves IV insulin with frequent monitoring. For most hospitals this means admission to the ICU is […]

In this episode, I’ll discuss postintubation hypotension following rapid sequence intubation with full vs. reduced-dose induction agent. Subscribe on iTunes, Android, or Stitcher One of the most common complications of rapid sequence intubation (RSI) in the setting of acutely ill patients in the emergency department (ED) is postintubation hypotension. While the cause of hypotension may […]

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 is probably somewhere between 1 in 2000 and 1 in 4000 patients. This makes anaphylaxis to sugammadex probably 2-4 times more rare than anaphylaxis to rocuronium. Not to mention the rate […]

In this episode, I’ll discuss the effects of calcium during treatment of hyperkalemia. Subscribe on iTunes, Android, or Stitcher Using calcium in patients with severe hyperkalemia is recognized as the most critical first step of treatment. Textbooks and tertiary referenceswidely quote that the purpose of giving IV calcium in severe hyperkalemia is to stabilize the […]

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 the new SCCM and ASHP joint guidelines on stress ulcer prophylaxis in critically ill patients. Subscribe on iTunes, Android, or Stitcher All the way back in episode 134 (nearly 8 years ago), I discussed the anticipated update to the 1999 stress ulcer prophylaxis guidelines that were first scheduled to come […]

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 the administration of mannitol for elevated intracranial pressure. Subscribe on iTunes, Android, or Stitcher The definitive treatment for elevated intracranial pressure is to fix the underlying cause. Common causes are traumatic brain injury, intracranial hemorrhage, CNS infection, or intracranial neoplasm. Until definitive treatment can be arranged, temporary treatments to lower […]

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 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 […]

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 […]