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IBCC chapter & cast – Myxedema coma (decompensated hypothyroidism)
Myxedema coma is a misleading misnomer. Most patients don’t have non-pitting edema (myxedema), nor are they frankly comatose. The best way to think about this disease is simply decompensated hypothyroidism. Patients with under-treated or untreated hypothyroidism have no metabolic reserve. Stressors may easily push them into multi-organ failure. Myxedema coma is easily missed, because it […]
Tox and Hound – Happy New Year!
We here at the hive mind of the Tox and the Hound just want to thank you, dear readers, for joining us on this incredible journey. We’ve had an exciting year, where we’ve talked about a wide range of topics and ideas. We discussed . . . Post mortem drug redistribution Buprenorphine in the ER […]
Tox and Hound – All Drugs Go to Heaven
by Andrew Stolbach “Who cares about that?” This is what my supportive wife (who also happens to be a doctor) said when I told her I wanted to write about postmortem drug testing. I can understand where she is coming from. Before writing something, it is valid to ask if this is something that my […]
IBCC chapter & cast – Noninvasive respiratory support (BiPAP & HFNC)
Noninvasive respiratory support is among the greatest recent advances in critical care. When used properly, these techniques may facilitate avoidance of intubation, reduced length of stay, and better outcomes. Unfortunately, our knowledge of exactly how to use these devices remains woefully incomplete. In particular, there are rather few RCTs directly comparing BiPAP versus HFNC. In […]
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