In this episode, I’ll discuss the SCCM Rapid Sequence Intubation Guidelines. Subscribe on iTunes, Android, or Stitcher The SCCM recently published Clinical Practice Guidelines for Rapid Sequence Intubation in the Critically Ill Adult Patient. While any pharmacist that works in a critical care setting should take the time to read these new guidelines, there are […]

In this episode, I’ll discuss recent guidelines about fluid removal in critically ill patients. Subscribe on iTunes, Android, or Stitcher The European Society of Intensive Care Medicine Clinical has published part 3 of its Practice Guideline on fluid therapy in adult critically ill patients, which addresses fluid removal during the de-escalation phase. The title chosen […]

In this episode, I’ll discuss two doses of ketamine for analgesia in the ED. Subscribe on iTunes, Android, or Stitcher Low dose ketamine for analgesia is generally considered to be doses of 0.5 mg/kg IV or less. This dose is below the threshold that will cause dissociative anesthesia, and ketamine is considered to have a […]

In this episode, I’ll discuss the rapid administration of antiseizure medications. Subscribe on iTunes, Android, or Stitcher While the antiseizure medications lacosamide, levetiracetam, and valproate were initially labeled to be given via slow IV minibag infusion, evidence has continually been published supporting IV push administration over a few minutes for these medications. However, old habits […]

In this episode, I’ll discuss the effect of phenylephrine push prior to continuous infusion norepinephrine in patients with septic shock. Subscribe on iTunes, Android, or Stitcher Push dose vasopressors as a temporizing measure for profound hypotension in critically ill patients is frequently used in many institutions. However the extent of the data for this strategy […]

In this episode, I’ll discuss the optimal dosing regimen for meropenem and piperacillin/tazobactam in critically ill patients receiving continuous renal replacement therapy. Subscribe on iTunes, Android, or Stitcher Achieving adequate antibiotic concentrations over 100% of the dosing interval is particularly challenging for critically ill patients receiving continuous renal replacement therapy. A group of authors recently […]

In this episode, I’ll discuss predicting the chance of successful sedation and the development of hypotension with dexmedetomidine. Subscribe on iTunes, Android, or Stitcher Have you ever noticed that dexmedetomidine seems to be a “hit or a miss” type of sedative? It seems to me to work great for some patients and poorly for others, […]

In this episode, I’ll discuss the most effective and safest therapies for nausea/emesis in adult patients presenting to the emergency department (ED). Subscribe on iTunes, Android, or Stitcher In the Annals of Emergency Medicine a group of authors have published a systematic review and meta-analysis to identify the best medications to use for nausea and […]

In this episode, I’ll discuss a pharmacy-driven rapid bacteremia response program. Subscribe on iTunes, Android, or Stitcher While rapid diagnosis of bacteremia infections is wonderful, nothing matters until the patient actually receives effective antibiotic treatment. However the lag time between laboratory notification, physician order selection, pharmacy verification and dispensing, and nurse administration can be significant […]

In this episode, I’ll discuss tranexamic acid’s effects on mortality for trauma patients based on time given post-injury. Subscribe on iTunes, Android, or Stitcher Trauma guidelines have incorporated giving tranexamic acid within 3 hours of injury, citing the CRASH-2 study as rationale for this recommendation. But the idea that time from injury to treatment matters […]

In this episode, I’ll discuss conditional reflex urine culturing for antibiotic stewardship. Subscribe on iTunes, Android, or Stitcher Overtreatment of urinary tract infections is a common problem that antimicrobial stewardship teams face. One of the major reasons for this is the overdiagnosis of UTIs. The overdiagnosis leads to overtreatment because providers worry about the rare […]

In this episode, I’ll discuss how often opioid overdose patients also have a benzodiazepine co-exposure. Subscribe on iTunes, Android, or Stitcher When patients who overdose on opioids also have a benzodiazepine co-exposure, they are more likely to experience respiratory failure and less likely to be responsive to naloxone. But how common is co-exposure to benzodiazepines […]