In this episode, I’ll discuss an article about drug order in rapid sequence intubation. Subscribe on iTunes, Android, or Stitcher Article Drug Order in Rapid Sequence Intubation Lead author: Brian Driver Published in Academic Emergency Medicine March 2019 Background There is continued debate over the optimal order of drug administration in rapid sequence intubation (RSI) […]

In this episode, I’ll discuss starting vasopressin at the same time as norepinephrine for patients in septic shock. Subscribe on iTunes, Android, or Stitcher Previous studies that have evaluated adding vasopressin to norepinephrine in septic shock have waited up to 12 hours before adding vasopressin. Because a delay in reaching a MAP of 65 mmHg […]

In this episode, I will discuss how I would treat Wernicke’s Encephalopathy if I were completely out of IV thiamine. Subscribe on iTunes, Android, or Stitcher Wernicke’s encephalopathy is an acute disorder that has significant mortality and neurologic morbidity associated with it. For a detailed episode of how to treat and prevent Wernicke’s go to […]

In this episode, I’ll discuss whether a short course of antibiotics for critically ill patients with postoperative intra-abdominal infection is just as good as a standard course. Subscribe on iTunes, Android, or Stitcher To answer this clinical question, researchers conducted a randomized trial in 21 ICUs in France. Eligible patients needed to have adequate source […]

In this episode, I’ll discuss which IM medication is the best first-line treatment for acute agitation in patients presenting to the emergency department. Subscribe on iTunes, Android, or Stitcher The authors of a study published in October 2018 in Annals of Emergency Medicine compared 5 or 10 mg haloperidol, 10 mg olanzapine, 5 mg midazolam, […]

In this episode, I’ll discuss the 4 clinical teaching roles for residency preceptors. Subscribe on iTunes, Android, or Stitcher The 4 teaching roles that ASHP wants PGY-1 residency preceptors to use are: 1. Instructing 2. Modeling 3. Coaching 4. Facilitating ASHP expects that PGY-1 residency preceptors have a working knowledge of these roles. During a […]

Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss an alternative scoring system for predicting the risk of augmented renal clearance. Augmented renal clearance is a phenomenon in some critically ill patients whereby their kidney function becomes supranormal. Standard antibiotic doses are often inadequate in the setting of ARC. The most accurate scoring […]

In this episode I’ll: 1. Discuss an article about the safety of high-dose IV labetalol 2. Answer the drug information question “Why is oral ketorolac restricted to patients that are continuing a 5-day course that started as parenteral therapy?” Subscribe on iTunes, Android, or Stitcher Article Safety of high-dose intravenous labetalol in hypertensive crisis Lead […]

Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss how to predict the risk of cardiac arrest after intubation. A retrospective analysis of 64 ICUs in France determined the prevalence of and risk factors for cardiac arrest during intubation in ICU. A total of 1,847 intubation procedures were included in the analysis. The […]

Subscribe on iTunes, Android, or Stitcher Most third-party drug interaction services or references don’t help with determining the clinical significance of a given drug interaction. But the book Top 100 Drug Interactions by Hansten and Horn helps me determine whether an interaction is real vs theoretical, so I can guide patients and physicians safely through […]

Subscribe on iTunes, Android, or Stitcher In this episode, I’ll discuss whether patients with liver disease and prolonged PT/INR levels still need VTE prophylaxis. Patients with liver disease and prolonged PT/INR levels appear to be teetering between the risk of bleeding and the risk of clotting. In a patient with cirrhosis, simply having a prolonged […]