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 […]

In this episode, I’ll discuss the chance of cardiovascular toxicity from bupropion overdose. Subscribe on iTunes, Android, or Stitcher Bupropion overdose carries a risk of cardiovascular toxicity however the onset is often delayed. This presents an additional risk to patients if they are incorrectly presumed to be of low cardiac toxicity risk and have reduced […]

In this episode, I’ll discuss the suppression of antimicrobial susceptibility results. Subscribe on iTunes, Android, or Stitcher When a hospital microbiology laboratory performs antimicrobial susceptibility testing using microdilution or disk diffusion methods, not all of the results are presented to clinicians in the medical record. Some of the data is ‘suppressed’ meaning the micro lab […]

In this episode, I’ll discuss why ketamine can sometimes cause post-induction hemodynamic instability when it is used for rapid sequence intubation. Subscribe on iTunes, Android, or Stitcher While ketamine is often considered a hemodynamically neutral induction agent for rapid sequence intubation, there are reports of post-induction hypotension and hemodynamic collapse occurring occasionally with ketamine use. […]

In this episode, I’ll discuss an article about which vasopressor is best in early traumatic brain injury patients. Subscribe on iTunes, Android, or Stitcher Patients who have severe traumatic brain injury and develop hypotension that requires vasopressor therapy are already at risk for mortality and poor long term outcomes. But could the choice of vasopressor […]

In this episode, I’ll discuss an article about using fondaparinux in critically ill patients with severe renal dysfunction. Subscribe on iTunes, Android, or Stitcher   Evaluating options for venous thromboembolism (VTE) prophylaxis in critically ill patients is challenging and many issues can limit options including renal failure, bleeding risk, and thrombocytopenia. Fondaparinux use is often […]

In this episode, I’ll discuss tenecteplase for stroke from 4.5 to 24 hours after the time last know well. Subscribe on iTunes, Android, or Stitcher While the use of thrombolytics for patients with acute ischemic stroke is usually done if the patient presents within 4.5 hours of the time last know well, data specifically with […]

In this episode, I’ll discuss recent articles regarding stress ulcer prophylaxis. Subscribe on iTunes, Android, or Stitcher The use of acid-suppressing agents to prevent the development of stress ulcers has been an area of intense research as the exact benefits and harms of this strategy in the context of modern ICU care is uncertain. Several […]